Redlining, racism and food access in US urban cores

Abstract

In the 1930s, the Home Owners' Loan Corporation (HOLC) graded the mortgage security of urban US neighborhoods. In doing so, the HOLC engaged in the practice, imbued with racism and xenophobia, of "redlining" neighborhoods deemed "hazardous" for lenders. Redlining has caused persistent social, political and economic problems for communities of color. Linkages between redlining and contemporary food access remain unexamined, even though food access is essential to wellbeing. To investigate this, we used a census tract-level measure of low-income and low grocery store food access from the US Department of Agriculture Food Access Research Atlas, redlining data from Mapping Inequality Project, and demographic data from the American Community Survey. We employed generalized estimating equations with robust covariance estimates to analyze data pertaining to 10,459 census tracts in 202 US cities. Tracts that the HOLC graded as "C" ("decline in desirability") and "D" ("hazardous") had reduced contemporary food access compared to those graded "A" ("best"). Increases in contemporary census tract proportions of Black, Hispanic, or other racial/ethnic minority residents, as well as disabled residents, were associated with reduced food access. Increases in contemporary proportions of residents age 75 years and older or those without a car were associated with better food access. Tracts that underwent housing redevelopment since being graded had better food access, while those undergoing gentrification had reduced food access. Results suggest that issues of redlining, housing discrimination, racism, ableism, displacement, and food inaccessibility are deeply intertwined.

WIC staff and healthcare professional perceptions of an EHR intervention to facilitate referrals to and improve communication and coordination with WIC: A qualitative study

“…This study could have far-reaching policy implications, such as promoting health equity. Due to long-standing structural racism, discrimination, and xenophobia, minoritized individuals are more likely to experience food insecurity in addition to adverse birth outcomes, which WIC improves [3,5,6,31]. Minoritized individuals face additional challenges in accessing WIC and other government benefit programs, such as discrimination and unfair treatment when applying for benefits [32,33].…”

Structural Racism as an Upstream Social Determinant of Diabetes Outcomes: A Scoping Review

“…Possible mechanisms for investigation based on prior work in other fields include 1) economic injustice and social deprivation, 2) environmental and occupational health inequities, 3) psychosocial trauma, 4) targeted marketing of healthharming substances, 5) political exclusion, 6) maladaptive coping behaviors, 7) stereotype threats, 8) state-sanctioned violence and alienation from property and traditional lands, and 9) inadequate health care (21). Prior work in the larger field of population health suggests additional pathways for investigation include the impact on human capital, differential access to health care resources, the differential influence of mass incarceration on racial minorities, and inequalities in the food environment (11,(50)(51)(52).…”

Health Care Policy and Disparities in Health

“…In one study, 74% of neighborhoods that the HOLC graded as high-risk or “hazardous” in the late 1930s continue to face significant challenges today 38 . These neighborhoods suffer from underperforming schools and limited access to grocery and health care facilities 39 . Furthermore, these neighborhoods are more likely to have inadequate infrastructure, heavy street and highway traffic, the presence of hazardous waste facilities, and superfund sites.…”

“…38 These neighborhoods suffer from underperforming schools and limited access to grocery and health care facilities. 39 Furthermore, these neighborhoods are more likely to have inadequate infrastructure, heavy street and highway traffic, the presence of hazardous waste facilities, and superfund sites. Historically redlined areas even have a direct correlation with higher rates of child poverty and adverse outcomes, such as obesity, smoking, drug use, and higher crime rates compared with nonredlined areas.…”