The impact of redlining and place-based systemic racism on health inequalities at mid-life

红线和基于地方的系统性种族主义对中年健康不平等的影响

• 批准号: 10582012
• 负责人: Helen Carmon Spink Meier
• 金额: $ 63.85万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10582012
• 关键词: Address; Aging; Air Pollution; Alcohols; American; Area; Behavioral; Cardiovascular Diseases; Censuses; Centers for Disease Control and Prevention (U.S.); Chronic Disease; Cities; Data; Data Set; Data Sources; Databases; Diabetes Mellitus; Disclosure; Economics; Environment; Environmental Hazards; Exposure to; Federal Government; Fire - disasters; Fostering; Geography; Goals; Government; Green space; Grouping; Health; Health Promotion; Health and Retirement Study; Healthcare; High Prevalence; Home; Housing; Hypertension; Individual; Industrialization; Inequality; Institution; Institutional Racism; Insurance; Investments; Knowledge; Life Expectancy; Location; Longitudinal Studies; Maps; Measures; Mediating; Mental Health; Minority; Morbidity - disease rate; Neighborhoods; Outcome; Ownership; Participant; Policies; Population; Population Dynamics; Poverty; Prevalence; Production; Race; Research; Resources; Risk; Security; Shapes; Societal Factors; Source; Strategic Planning; Structural Racism; Structure; Supermarket; Time; Toxin; United States Environmental Protection Agency; United States National Institutes of Health; Work; demographics; density; disparities in morbidity; health care availability; health care service; health disparity; health inequalities; high risk; metropolitan; middle age; mortality; mortality risk; multiple chronic conditions; physical conditioning; residential segregation; social; socioeconomics; tobacco products

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. Historic racist housing policies (e.g., federal 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 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 through restrictions wealth and place-based investment over time. Our previous work has shown that Home Owners' Loan Corporation (HOLC) redlining from 1935-40 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 inequalities in `exposure' to harmful environments (e.g., industrial toxins) and `access' to health promoting resources (e.g., health care services) that impact individual-level morbidity and mortality. The proposed project will address this gap by, first, harmonizing siloed data sources to produce a national database of historical redlining, historic and current environmental hazards, housing investment, gentrification, and longitudinal neighborhood demographics and socioeconomics. Then, we will examine structural racism as it is embedded in neighborhoods with 1) the resulting inequalities in neighborhood `access and exposure' that drive health opportunities (Aim 2), and 2) disparities in morbidity and mortality risk beginning in mid-life in a nationally representative longitudinal study, the Health and Retirement Study (HRS) (Aim 3). We hypothesize that historically redlined areas will have greater proximity to present-day environmental hazards and reduced access to healthcare and health promoting resources, and that longitudinal neighborhood change associated with redlining will partially mediate these associations. We further hypothesize that HRS participants living in historically redlined areas will have greater risk of morbidity and mortality than HRS participants not living in redlined areas and that this association will vary by present-day intensity of racial residential segregation. This project will create actionable knowledge to address health inequities beginning in mid-life by uncovering how macrostructural factors, including historic, racist government policies result neighborhood and individual health disparities. Further, the data product generated in Aim 1 will be made publicly available to facilitate additional research on the impact of place in other longitudinal studies of health.

了解推动基于地方差异的社会，经济，行为和制度因素 中年的发病率和死亡率对于解决健康不平等至关重要。历史悠久的种族主义住房政策（例如 联邦红线，限制性契约和盟约）影响了 在美国导致种族和社会经济种族隔离的地方。系统否认 通过种族主义住房政策通过种族主义的房屋拥有机会可能是中途健康的关键上游来源 随着时间的流逝，当今美国在整个美国观察到的不平等。 我们以前的工作表明，从1935 - 40年开始，房主贷款公司（HOLC）是 与少数族裔，低社会经济社区相关，平均预期寿命较短，更高 慢性疾病的邻里患病率，身体和心理健康。但是，很少有研究 已经调查了历史性的红线，随后的邻里轨迹的机制 随着时间的推移，投资和投资投资以及种族居民种族隔离已经形成了基于地方的 对有害环境（例如工业毒素）和“访问”促进健康环境的不平等现象（例如工业毒素） 影响个人水平发病率和死亡率的资源（例如医疗服务）。 拟议的项目将首先通过协调孤立的数据源来解决这一差距 历史红线，历史和当前环境危害，住房投资，高档化， 以及纵向社区人口统计和社会经济学。然后，我们将研究结构性种族主义 它嵌入在社区中，有1）邻里“访问和曝光”的不平等现象 驱动健康机会（AIM 2），以及2）从中期开始的发病率和死亡率差异 全国代表性的纵向研究，健康与退休研究（HRS）（AIM 3）。我们假设 历史上红线的地区将更加靠近当今的环境危害并减少 获得医疗保健和促进资源的访问，以及相关的纵向社区变化 随着红线的影响，将部分调解这些关联。我们进一步假设HRS参与者居住在 与不居住的人力资源部有关 红线区域，这种关联将因当今种族隔离的强度而有所不同。这 项目将创建可行的知识，以解决从中期开始的健康不平等，通过发现如何 宏观结构因素，包括历史性，种族主义政府政策导致社区和个人健康 差异。此外，将公开使用AIM 1中生成的数据产品以促进其他 研究位置在其他健康纵向研究中的影响。