Persisting Racial Bias in Housing Regulations Affects the Health of New Mothers
In a groundbreaking study, researchers at the University of Rochester Medical Center have uncovered a striking connection between racially discriminatory home lending patterns from the 1940s and contemporary preterm birth rates among Black women in the United States.
The study, published in the journal JAMA Open Network, was co-authored by Elaine Hill, Ph.D., an economist in the University of Rochester Medical Center's Department of Public Health Sciences, alongside Stefanie Hollenbach, M.D., an assistant professor in the Department of Obstetrics and Gynecology, and a team of other researchers.
The researchers found that pre-term births occurred at a rate of 12.38% in HOLC 'hazardous' zip codes compared to 7.55% in areas labeled 'best' or 'still desirable.' This disparity suggests a significant association between historic redlining and poor obstetric outcomes in the modern day.
The study focused on the region surrounding Rochester, New York, and its findings provide further evidence of the influence of a legacy of structural racism on the disproportional burden of adverse pregnancy outcomes for Black women in the U.S. Women who resided in 'hazardous' areas were at higher risk for maternal complications such as pregnancy-related hypertension, neonatal complications, and neonatal intensive care unit admission.
The term redlining comes from the color used on HOLC maps to identify neighborhoods comprised predominately of people of color. Redlining policies, created by the federal Home Owners' Loan Corporation (HOLC) in the 1930s and 40s, were adopted by the Federal Housing Administration and the Department of Veterans Affairs. These policies led to decades of community disinvestment, concentrated poverty in inner city neighborhoods, and denied residents the ability to build intergenerational wealth through home ownership.
The health impact of redlining have long been hinted at, but it was not until the recent digitization of the original HOLC maps by the University of Richmond's Mapping Inequality project that researchers have been able to more precisely examine these questions. The study's findings indicate that the legacy of government-sanctioned discrimination persists to this day.
Additional co-authors include Loralei Thornburg and Christopher Glance with the University of Rochester Medical Center, as well as Lindsay R. Pool, Jasmine A. Abrams, and Rita Hamad, who are investigating the effects of historical housing ordinances on the health of Black women today. The researchers used a New York State database of live births from 2005 to 2018 for their analysis.
The study suggests the potential influences of a system of profound structural inequity that ripple forward in time, with impacts that extend beyond measurable socioeconomic inequality. As the nation continues to grapple with the legacy of systemic racism, this research underscores the urgent need for policies that address the root causes of health disparities and work towards creating a more equitable society.
