连接过去与现在:历史上的红线是否影响当前的预期寿命?

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-28 DOI:10.1007/s40615-024-02220-9
Charlotte Freifeld, Ava Camarero, Joanne Oh, Alexandra Fairchok, Karen Yang, Michael Siegel
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引用次数: 0

摘要

导言:以往的研究表明,目前居住在 20 世纪 30 年代的红线区与疾病高发之间存在密切关系。然而,人们对历史上的划定红线、现代的划定红线与当前居民健康结果之间的关系知之甚少。本文旨在同时模拟历史上的划定红线和现代的划定红线对当前健康结果的影响:在本文中,我们使用结构方程模型来揭示当前和历史上的重新划线做法与现代预期寿命之间的关系,并探索了两个层次的潜在中介因素:(1) 种族隔离和结构性种族主义;(2) 调解健康结果。我们分析了全美 11661 个人口普查区的数据,使用的数据包括:1940 年的历史划定红线数据、2010 年至 2017 年的现代划定红线数据、2010 年至 2019 年的种族隔离和结构性种族主义指数、2021 年至 2022 年的健康结果数据以及 2010 年至 2015 年的预期寿命数据。历史上的 "重新划分 "使用房屋所有者贷款公司(Home Owners' Loan Corporation,HOLC)的评级来衡量,评级从 1.0 表示有利社区("绿线")到 4.0 表示不利社区("红线")不等。我们使用《住房抵押贷款披露法》(HMDA)数据对现代 "红线 "进行了衡量,并将其转换为四个四分位数,从第 1 级(低抵押贷款拒绝率)到第 4 级(高抵押贷款拒绝率):我们发现,历史上的红线区划与目前的预期寿命之间存在明显关系,平均预期寿命从 HOLC 1 小区的 80.7 岁稳步下降到 HOLC 4 小区的 75.7 岁,绿线区与红线区之间相差 5.0 岁。我们还发现,现代红线区划与当前预期寿命之间存在重要关系,平均预期寿命从 HMDA 1 小区的 79.9 岁持续下降到 HMDA 4 小区的 73.5 岁,相差 6.4 岁。在结构方程模型中,HOLC 评级每增加 1 级,历史上的 "重新划分 "就会使预期寿命减少 1.18 年。HMDA 四分位数每增加一个,现代的重新划分政策就会使预期寿命减少 1.89 年:本文提供了新的证据,证明红线政策的遗留问题并没有成为历史,而是当今一个紧迫的公共健康问题。
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Connecting Past to Present: Does Historical Redlining Affect Current Life Expectancy?

Introduction: Previous research has documented a strong relationship between currently living in the redlined zones of the 1930s and suffering from a higher prevalence of disease. However, little is known about the relationship between historical redlining, modern-day redlining, and current resident health outcomes. This paper aimed to simultaneously model the associations between both historical redlining and modern-day redlining on current health outcomes.

Methods: In this paper, we used structural equation modeling to uncover relationships between current and historical redlining practices and modern-day life expectancy, exploring two levels of potential mediating factors: (1) racial segregation and structural racism; and (2) mediating health outcomes. We analyzed data from 11,661 census tracts throughout the United States using historical redlining data from 1940, modern redlining data from 2010 to 2017, racial segregation and structural racism indices from 2010 to 2019, health outcome data from 2021 to 2022, and life expectancy data from 2010 to 2015. Historical redlining was measured using Home Owners' Loan Corporation (HOLC) ratings, which ranged from 1.0 for favorable neighborhoods ("greenlined") to 4.0 for unfavorable ("redlined") neighborhoods. Modern-day redlining was measured using Home Mortgage Disclosure Act (HMDA) data, which were transformed into four quartiles, ranging from level 1 (low mortgage rejection rates) to level 4 (high mortgage rejection rates).

Results: We found a significant relationship between historic redlining and current life expectancy, with average life expectancy decreasing steadily from 80.7 years in HOLC 1 tracts to 75.7 years in HOLC 4 tracts, a differential of 5.0 years between the greenlined and redlined tracts. We also found a significant relationship between modern-day redlining and current life expectancy, with average life expectancy decreasing steadily from 79.9 years in HMDA 1 tracts to 73.5 years in HMDA 4 tracts, a differential of 6.4 years. In the structural equation model, historical redlining had a total effect of decreasing life expectancy by 1.18 years for each increase of one in the HOLC rating. Modern-day redlining had a total effect of decreasing life expectancy by 1.89 years for each increase of one in the HMDA quartile.

Conclusion: This paper provides new evidence that the legacy of redlining is not relegated to the history books but rather is a present and pressing public health issue today.

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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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