Association of historic redlining and present-day health in Baltimore

BACKGROUND: In the 1930s, the Home Owners’ Loan Corporation categorized neighborhoods by investment grade along racially discriminatory lines, a process known as redlining. Although other authors have found associations between Home Owners’ Loan Corporation categories and current impacts on racial segregation, analysis of current health impacts rarely use these maps. OBJECTIVE: To study whether historical redlining in Baltimore is associated with health impacts today. APPROACH: Fifty-four present-day planning board-defined community statistical areas are assigned historical Home Owners’ Loan Corporation categories by area predominance. Categories are red (“hazardous”), yellow (”definitely declining”) with blue/green (“still desirable”/”best”) as the reference category. Community statistical area life expectancy is regressed against Home Owners’ Loan Corporation category, controlling for median household income and proportion of African American residents. CONCLUSION: Red categorization is associated with 4.01 year reduction (95% CI: 1.47, 6.55) and yellow categorization is associated with 5.36 year reduction (95% CI: 3.02, 7.69) in community statistical area life expectancy at baseline. When controlling for median household income and proportion of African American residents, red is associated with 5.23 year reduction (95% CI: 3.49, 6.98) and yellow with 4.93 year reduction (95% CI: 3.22, 6.23). Results add support that historical redlining is associated with health today.