It’s no secret that where you live affects your overall health outcomes. However, it might come as a surprise to some that the discriminatory practice of redlining — which has been outlawed for over 50 years — is still having very real effects on heart health. According to a recent study from University Hospitals, living in a formerly redlined neighborhood is a risk factor for cardiovascular disease.
What is redlining?
The term “redlining” refers to the 1930’s-era practice in which the Home Owner’s Loan Corporation used color-coded maps to rank the loan worthiness of neighborhoods across the United States. Neighborhoods deemed least risky or “best” were marked in green and residents of those areas were able to easily access home loans. Neighborhoods that fell somewhere in the middle were coded as yellow or blue, while neighborhoods deemed most risky or “hazardous” were marked in red, or “redlined.” Because of this, it was virtually impossible for residents of redlined areas (mostly people of color) to access home loans. And it’s no accident that redlined areas were always in predominantly-Black neighborhoods. This is exactly how the “state-sponsored system of segregation” was designed. As a result, Black Americans were (and continue to be) largely excluded from the “American Dream” of homeownership, and left with limited options for housing mobility.
Although the Fair Housing Act of 1968 sought to end discriminatory housing practices, the harmful effects of redlining continue to be felt today. Segregated living patterns are still seen across the country, and sadly, many communities have seen little to no change as far as racial integration is concerned. In fact, a 2018 study found that Cleveland is the 5th most segregated metropolitan area in the entire country. In addition to perpetuating segregation, research has shown that redlining contributed to maintaining high levels of poverty — and consequently poor health — for decades to come.
Redlining is hurting your heart — literally.
In a recent study, researchers at UH Harrington Heart and Vascular Institute found a direct relationship between redlined areas and heart health. They reported that patients with the greatest number of cardiac risk factors and worst health outcomes were living today in the same geographic areas designated with the lowest lending scores many decades earlier. The study’s lead author and UH cardiologist, Dr. Sadeer Al-Kindi, said, “What’s surprising to me is that every city that I’ve looked into, there is significant residential segregation. … And no matter where you look, the relationship holds between the grading of the neighborhood (loan) risk and cardiometabolic health.”
Researchers are viewing this as an opportunity to learn from history and are working to extend their research to learn more about what specific factors in redlined neighborhoods predispose a person to a lifetime of health inequities. Hundreds of variables, including air pollution, access to healthy food, clean water, green spaces, and medical care, are now being investigated in an effort to determine which variables have the strongest association. With heart disease being the number one killer of adults in the United States, Dr. Al-Kindi pointed out that, instead of tackling the problem at the end stage, funding may be better spent identifying and tackling the health disparities at their source. Through proactive approaches like taking healthcare into communities and working to address the deep-rooted systemic issues affecting our country, this work has the potential to create long-term change for generations to come.