Living in a formerly redlined neighborhood may be linked to higher risk of a major adverse cardiovascular event, like a stroke or a heart attack, despite the racist lending practice being outlawed more than 50 years ago, according to a new study published in JAMA Network Open.
“Our nationwide study demonstrates that a century-old practice like redlining still affects our nation’s health today,” Salil Deo, an associate professor of surgery at Case Western Reserve University’s School of Medicine and cardiac surgeon at the VA Northeast Ohio Healthcare System, said in a news release this week.
Redlining, which refers to the color-coded maps created across hundreds of cities in the 1930s to classify mortgage-lending risk based on neighborhood, systematically cut certain communities off from investment and further entrenched segregation, as communities with a greater share of Black residents were often marked in red.
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Nearly a century later, those formerly redlined neighborhoods are still linked to poorer health outcomes, higher poverty rates and lower home values, while the people living in them are disproportionately Black residents and other people of color. Studies have also shown that modern-day redlining continues today.
In an effort to see whether redlining could also be associated with adverse cardiovascular events, researchers affiliated with hospital systems in Ohio and Texas drilled into health data from tens of thousands of veterans.
They examined a retrospective cohort of nearly 80,000 veteran patients receiving care for pre-existing cardiovascular disease between the beginning of 2016 and the end of 2019. They also used patients’ self-reported address data and redlining maps from the Home Owners’ Loan Corporation, which assigned neighborhoods a letter grade ranging from A to D, to see if there was an association.
After following up with veterans at a median of four years and checking whether they had experienced a major adverse cardiovascular event, the researchers found those living in formerly redlined neighborhoods with a “D” grade, or those ranked poorly for investment, had a 14% higher risk of such negative heart health outcomes and a 13% higher hazard of death from all causes overall when compared to those living in the wealthier, whiter neighborhoods that were graded “A.”
“This risk was lower, yet remained significant, after adjusting for social vulnerability and comorbidity burden,” the researchers wrote. “To our knowledge, few prior studies have linked neighborhood redlining and cardiovascular outcomes.”
Future studies on the issue, Deo said, should try to “better define the reasons for the observed relationships between intergenerational inequities and cardiovascular health.” “These can then be targeted to improve the wellbeing for all individuals,” he said.
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