Understanding the social, economic, behavioral, and institutional factors that drive place-based differences in mid-life morbidity and mortality is critical to addressing health inequalities by race, ethnicity, and other characteristics. Historic racist housing policies (e.g., redlining, restrictive deeds and covenants) influenced the physical, social and economic structure of places resulting in racial and socioeconomic residential segregation in the US. The resulting place-based inequities in exposure and access are entwined with differences in wealth, which systemic denial of homeownership opportunities through racist housing policies may be a key upstream source of mid-life health inequities observed across the US today. Our previous work has shown that redlining is associated with high minority, low socioeconomic neighborhoods with shorter average life expectancy, higher neighborhood prevalence of chronic diseases, and worse physical and mental health. However, few studies have investigated the mechanisms by which historic redlining, subsequent neighborhood trajectories of investment and disinvestment, and racial residential segregation over time have shaped place-based inequities in exposure and access that impact health. Further, studies have not traced divergent neighborhood trajectories of change over decades and differential health outcomes at the individual-level at mid-life. The proposed project will examine structural racism as it is embedded in neighborhoods with 1) the resulting inequities in neighborhood access and exposure, and 2) disparities in morbidity and mortality in mid-life in a longitudinal, nationally representative study, the Health and Retirement Study. We will supplement Mapping Inequalitys Home Ownership Loan Corporation maps with historic information on industry and agriculture from the Sanborn Fire Insurance Maps to produce a publicly available, national, longitudinal database including measurements of redlining, disinvestment, abandonment, gentrification, and census-tract level health outcomes of 118 metropolitan areas across the US (Aim 1). We will examine historically redlined areas and subsequent neighborhood trajectories over time with current measures of exposure and access that impact health (Aim 2). We will assess the relationship between redlined areas with individual health outcomes at mid-life in the Health and Retirement Study. Responsive to NIHs commitment to addressing structural drivers of health, as well as NIAs Strategic Plan Goal B (understanding the effects of societal factors on aging, including the mechanisms through which these factors exert their effects), this study will provide understanding of the national impact of place-based structures, including redlining, neighborhood trajectories of disinvestment (i.e., mortgage lending), abandonment, gentrification (i.e., increases in income, home value and education level) and racialized or cultural displacement in cities over time, and health disparities in mid-life.
Funding:
Health and Human Services, Department of-National Institutes of Health
Funding Period:
01/01/2023 to 12/31/2027