历史上的红线对当今医院位置和规模的持续影响
Shuo Jim Huang1, Kaitlynn S Robinson-Ector1, Neil Jay Sehgal2
1University of Maryland Institute for Health Computing, 6116 Executive Blvd, Ste 200, North Bethesda, MD, 20816, USA.
Health & place
|August 28, 2025
概括
历史上的红线对当今的医院分布有很大影响. 医院集中在以前红线区,加剧了健康差异,表明需要在服务不足的社区投资.
科学领域:
- 公共卫生
- 医疗服务研究
- 城市规划
背景情况:
- 在医院接入,质量和结果方面存在持续的种族健康差异.
- 地理差异模式是矛盾的,因为医院的近距离并不保证公平的护理.
- 历史上的政府政策,如红线可能通过影响社区发展和资源分配来解释这些差异.
研究的目的:
- 调查历史房屋所有者贷款公司 (HOLC) 红线类别与当今医院位置和规模之间的联系.
- 了解过去歧视性住房政策如何影响医疗基础设施的空间分布.
主要方法:
- 使用了2023年国土基础设施基础医院数据集的医院位置数据.
- 整合了来自Mapping Inequality数据集的红线数据和类别,特别是20世纪30年代的HOLC地图.
- 使用皮尔森基平方测试,根据每个HOLC类别的土地面积比例,比较观察到的医院和病床数量与预期数量.
主要成果:
- 医院在HOLC D (红线) 地区占比高达20.5%,在HOLC A (最佳) 地区占比低达35.6%.
- 医院床位的差异更大,在D区占比超过56.5%,在A区占比低 (44.7%),B区占比低 (5.2%) 和C区占比低 (20.8%).
结论:
- 根据1930年代的HOLC红线分类,美国的医院位置和病床分布明显不均.
- 第二次世界大战后医院容量扩大可能是从历史上歧视性政策中获益的.
- 医院有很重要的机会通过增加社区利益投资来解决过去的不公正问题,
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