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

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. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e8. doi:10.2105/AJPH.2020.305656).

• Publication year

  2020

• Venue

  American Journal of Public Health

• Publication date

  2020-05-21

• Fields of study

  Sociology, Medicine, Political Science, History

• Identifiers
  DOI 10.2105/AJPH.2020.305656PMID 32437270PMCID PMC7287548
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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