The spatial relationship between historical redlining and present-day neighborhood health disparity
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Keywords: redlining, HOLC, poverty, neighborhood, health disparity
Abstract Type: Paper Abstract
Authors:
Sabina Bhandari, University of Connecticut
Debs Ghosh, University of Connecticut
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Abstract
Present-day neighborhoods with limited access to healthcare are a product of two 1930-40s US Federal institutions/programs, the Federal Housing Association, and the Home Owner’s Loan Corporation. These programs ranked neighborhoods, where the neighborhoods with the highest investment risk were ‘redlined’ and had higher proportion of African American population. This facilitated discriminatory mortgage lending practices and further deepened social inequities from segregation, poverty, and long-term disinvestment in public services creating a spatial pattern of neighborhoods of haves and have-nots. We first examined the present-day relationship between concentrated poverty and segregation of African American population with a lack of access to healthcare at the county level using the 2020 US Census data. For segregation and concentrated poverty, we calculated extreme concentrations of household income and African American population. We obtained the scores for medically underserved counties lacking access to healthcare from the Health Resources and Service Administration. Second, we explored whether the present-day inequity of access to healthcare is associated with a historical policy of redlining and its resultant persistent poverty employing the HOLC redlined maps. The spatial bivariate association identified clusters of counties showing a positive relationship between higher needs for healthcare, low household income, and a higher percentage of African American population in Southeastern states (Louisiana, Mississippi, and Alabama) and Mid-Atlantic state (Virginia). These counties also had several historically redlined neighborhoods nearby and were in persistent poverty over decades. The results indicate that the present-day inequitable pattern of access to healthcare is shaped by historical structural policies based on race.
The spatial relationship between historical redlining and present-day neighborhood health disparity
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Paper Abstract