Structural Racism, Historical Redlining, and Risk of Preterm Birth in New York City, 2013-2017.

Abstract:

:Objectives. To assess if historical redlining, the US government's 1930s racially discriminatory grading of neighborhoods' mortgage credit-worthiness, implemented via the federally sponsored Home Owners' Loan Corporation (HOLC) color-coded maps, is associated with contemporary risk of preterm birth (< 37 weeks gestation).Methods. We analyzed 2013-2017 birth certificate data for all singleton births in New York City (n = 528 096) linked by maternal residence at time of birth to (1) HOLC grade and (2) current census tract social characteristics.Results. The proportion of preterm births ranged from 5.0% in grade A ("best"-green) to 7.3% in grade D ("hazardous"-red). The odds ratio for HOLC grade D versus A equaled 1.6 and remained significant (1.2; P < .05) in multilevel models adjusted for maternal sociodemographic characteristics and current census tract poverty, but was 1.07 (95% confidence interval = 0.92, 1.20) after adjustment for current census tract racialized economic segregation.Conclusions. Historical redlining may be a structural determinant of present-day risk of preterm birth.Public Health Implications. Policies for fair housing, economic development, and health equity should consider historical redlining's impacts on present-day residential segregation and health outcomes.

journal_name

Am J Public Health

authors

Krieger N,Van Wye G,Huynh M,Waterman PD,Maduro G,Li W,Gwynn RC,Barbot O,Bassett MT

doi

10.2105/AJPH.2020.305656

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

1046-1053

issue

7

eissn

0090-0036

issn

1541-0048

journal_volume

110

pub_type

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