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Journal article
Historical redlining and cardiovascular health: The Multi-Ethnic Study of Atherosclerosis
Proceedings of the National Academy of Sciences - PNAS, v 118(51)
21 Dec 2021
PMID: 34903653
Abstract
We investigated historical redlining, a government-sanctioned discriminatory policy, in relation to cardiovascular health (CVH) and whether associations were modified by present-day neighborhood physical and social environments. Data included 4,779 participants (mean age 62 y; SD = 10) from the baseline sample of the Multi-Ethnic Study of Atherosclerosis (MESA; 2000 to 2002). Ideal CVH was a summary measure of ideal levels of seven CVH risk factors based on established criteria (blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking). We assigned MESA participants' neighborhoods to one of four grades (A: best, B: still desirable, C: declining, and D: hazardous) using the 1930s federal Home Owners' Loan Corporation (HOLC) maps, which guided decisions regarding mortgage financing. Two-level hierarchical linear and logistic models, with a random intercept to account for participants nested within neighborhoods (i.e., census tracts) were used to assess associations within racial/ethnic subgroups (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Chinese). We found that Black adults who lived in historically redlined areas had a 0.82 (95% CI -1.54, -0.10) lower CVH score compared to those residing in grade A (best) neighborhoods, in a given neighborhood and adjusting for confounders. We also found that as the current neighborhood social environment improved the association between HOLC score and ideal CVH weakened (
< 0.10). There were no associations between HOLC grade and CVH measures or effect modification by current neighborhood conditions for any other racial/ethnic group. Results suggest that historical redlining has an enduring impact on cardiovascular risk among Black adults in the United States.
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122 citations in Scopus
Details
- Title
- Historical redlining and cardiovascular health: The Multi-Ethnic Study of Atherosclerosis
- Creators
- Mahasin S Mujahid - University of California, BerkeleyXing Gao - University of California, BerkeleyLoni P Tabb - Drexel UniversityColleen Morris - University of California, BerkeleyTené T Lewis - Emory University
- Publication Details
- Proceedings of the National Academy of Sciences - PNAS, v 118(51)
- Publisher
- PNAS
- Grant note
- 75N95020D00007 / NIDA NIH HHS N01HC95169 / NHLBI NIH HHS 75N99020D00007 / ORFDO NIH HHS N01HC95161 / NHLBI NIH HHS 75N95020D00002 / NIDA NIH HHS N01HC95164 / NHLBI NIH HHS 75N90020D00003 / CLC NIH HHS N01HC95167 / NHLBI NIH HHS 75N98020D00007 / NIH HHS 75N90020D00002 / CLC NIH HHS N01HC95159 / NHLBI NIH HHS 75N96020D00002 / NIEHS NIH HHS 75N99020D00005 / ORFDO NIH HHS N01HC95163 / NHLBI NIH HHS 75N99020D00002 / ORFDO NIH HHS N01HC95166 / NHLBI NIH HHS UL1 TR001079 / NCATS NIH HHS R01 HL131610 / NHLBI NIH HHS 75N99020D00003 / ORFDO NIH HHS 75N95020D00005 / NIDA NIH HHS 75N92022D00007 / NHLBI NIH HHS 75N93020D00002 / NIAID NIH HHS HHSN268201500003C / NHLBI NIH HHS N01HC95160 / NHLBI NIH HHS 75N99020D00006 / ORFDO NIH HHS 75N95020D00004 / NIDA NIH HHS HHSN268201500003I / NHLBI NIH HHS UL1 TR000040 / NCATS NIH HHS N01HC95168 / NHLBI NIH HHS 75N95020D00003 / NIDA NIH HHS 75N92021D00006 / NHLBI NIH HHS N01HC95165 / NHLBI NIH HHS 75N99020D00004 / ORFDO NIH HHS 75N96020D00003 / NIEHS NIH HHS N01HC95162 / NHLBI NIH HHS UL1 TR001420 / NCATS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Scopus ID
- 2-s2.0-85122592583
- Other Identifier
- 991019173838804721