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Mediating Pathways Between Neighborhood Structural Investment and Cardiometabolic Health Across U.S. Cities.

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Historic redlining is linked to lower neighborhood investment and higher rates of obesity, diabetes, and heart disease. Neighborhood investment partially explains these health disparities across cities.

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Area of Science:

  • Public Health
  • Urban Planning
  • Health Disparities

Background:

  • Epidemiologic studies link neighborhood socioeconomic factors to health outcomes.
  • Limited research explores neighborhood structural investment's impact on cardiometabolic risk markers in urban settings.
  • This study addresses the influence of historic redlining on neighborhood investment and subsequent health.

Purpose of the Study:

  • To investigate if neighborhood structural investment differs by historic redlining.
  • To examine associations between neighborhood structural investment and prevalence of obesity, diabetes, and coronary heart disease.
  • To determine if neighborhood structural investment mediates the effect of redlining on these health outcomes.

Main Methods:

  • Neighborhood structural investment measured using a composite score (home value, rent, vacancies, building age).
  • Prevalence data for obesity, diabetes, and coronary heart disease from the CDC's 500 Cities Project.
  • Analysis of Home Owners' Loan Corporation redlining data across 16 U.S. cities, with adjustment for socioeconomic and demographic factors.

Main Results:

  • Formerly redlined neighborhoods showed lower structural investment over time.
  • Higher neighborhood structural investment correlated with decreased prevalence of obesity, diabetes, and coronary heart disease, with city-specific variations.
  • Neighborhood structural investment acted as a mediator between redlining and health outcomes, varying by city.

Conclusions:

  • Historic redlining is associated with current cardiometabolic health outcomes through neighborhood structural investment.
  • Findings suggest potential targets for urban planning and public health interventions to mitigate health disparities.