Historic redlining in Columbus, Ohio associated with stroke prevalence

Area of Science:

• Public Health
• Health Disparities
• Urban Planning

Background:

• Racial disparities in stroke prevalence and outcomes are a significant public health concern.
• Historic racialized lending practices, indicated by Home Owners' Loan Corporation (HOLC) "redlining" scores, are examined as a potential determinant of these disparities.
• The study hypothesizes an association between census tracts with high historic redlining and elevated stroke prevalence.

Purpose of the Study:

• To investigate the association between historic redlining and current stroke prevalence at the census tract level in Columbus, Ohio.
• To explore the role of sociodemographic factors as potential mediators in this relationship.
• To quantify the difference in stroke prevalence between census tracts with varying degrees of historic redlining.

Main Methods:

• Weighted historic redlining scores (HRS) were calculated for Columbus, Ohio census tracts based on 1930s HOLC grades.
• Stroke prevalence data for adults (>=18) were obtained from the CDC's 500 Cities Project at the census tract level.
• Regression analyses were performed to evaluate the association between HRS and stroke prevalence, with and without adjustment for the proportion of residents aged 65 and older, considering sociodemographic data as potential mediators.

Main Results:

• Census tracts in the highest quartile of historic redlining scores exhibited a 1.73% higher stroke prevalence compared to those in the lowest quartile (95% CI: 0.41, 3.05), after adjusting for the elderly population proportion.
• No significant differences in stroke prevalence were observed between other interquartile ranges of historic redlining scores.
• Sociodemographic data were considered potential mediators but not controlled for in the primary regression analysis.

Conclusions:

• Historic redlining represents a form of structural racism that created geographically based disadvantages and contributed to adverse health outcomes.
• The findings demonstrate a clear disparity in stroke prevalence across Columbus, Ohio census tracts, directly correlated with the historical extent of redlining.
• This study underscores the long-term impact of discriminatory housing policies on present-day health inequities, specifically concerning stroke prevalence.