结构性种族主义,住宅隔离和暴露于创伤:红线线的持续影响
James M Bradford, Maya M Eldin1, Simin Golestani1
1Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX.
The journal of trauma and acute care surgery
|May 21, 2024
概括
德克萨斯州奥斯历史上的红线街区,今天的透性创伤伤率更高. 这些发现强调了歧视性住房政策对社区健康结果和创伤暴露的持久影响.
科学领域:
- 公共卫生 公共卫生
- 城市规划 城市规划
- 流行病学 流行病学
背景情况:
- 房屋所有者贷款公司 (HOLC) 在新政时代创建了社区地图,根据财务安全对地区进行分类.
- 少数民族聚居的社区经常被贴上"危险"或"绝对下降"的标签,导致撤资和被排除在联邦住房福利之外,这种做法被称为红线划分.
- 这项研究调查了德克萨斯州奥斯历史红线与目前穿透性创伤伤害的空间模式之间的联系.
研究的目的:
- 评估历史红线标识与德克萨斯州奥斯穿透性创伤伤害发生率之间的关联.
- 为了确定1935年由HOLC分类为"红线"的人口普查区是否比非红线区有更高的暴力透创伤入院率.
- 了解历史住房政策对当代公共卫生结果的持续影响.
主要方法:
- 一项回顾性横截面研究分析了2014年至2021年间在德克萨斯州奥斯一级创伤中心暴力透创伤入院的数据.
- 伤害地址被地理编码并与1935年的HOLC财务指标 (危险,绝对下降,仍然可取,最好,非HOLC等级) 相联系.
- 被指定为"危险"或"绝对下降"的人口普查区域被归类为"红线". 经调整的发病率比率是通过比较红线与非红线和非等级区域来计算的,并控制当前的人口统计和社会脆弱性.
主要成果:
- 在该县的920个创伤病例中,有13%发生在历史上红线人口普查区域.
- 在调整了人口和社会脆弱性因素后,历史上红线区的透性创伤伤害率显着更高 (IRR = 0.42,p = 0.03).
- 非HOLC评级地区的发病率也较高 (IRR = 0.15,p < 0.001),而非红线区的发病率较低 (IRR = 0.42,p = 0.03).
结论:
- 历史上被HOLC分类为"危险"或"绝对下降"的社区继续经历暴力透创伤的增加率.
- 这些发现表明结构性种族主义和历史性的住宅隔离对创伤暴露的持久影响.
- 该研究强调了歧视性住房政策对弱势社区的长期公共卫生后果.
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