The impact of redlining and place-based factors on health at mid-life

University Of Michigan At Ann Arbor, Ann Arbor MI

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Abstract

Understanding the social, economic, behavioral, and institutional factors that drive place-based differences in mid-life morbidity and mortality is important. Historic housing policies (e.g., federal redlining) influenced the physical, social and economic structure of places in the US. Different homeownership opportunities may be a key upstream source of mid-life health differences 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 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 and subsequent neighborhood trajectories of investment and disinvestment have shaped place-based differences 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 different pathways from historic redlining and environmental hazards with 1) the resulting differences in neighborhood `access and exposure' that drive health opportunities (Aim 2), and 2) differences 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 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 place-based factors. This project will create actionable knowledge to address health differences beginning in mid-life by uncovering how macrostructural factors result neighborhood and individual health differences. 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.