The term “redlining” comes from a discriminatory practice that began during the 1930’s when U.S. government maps designated the economic stability of neighborhoods using a color-coded grading system. It looked like this:

  • The best investment — green
  • Still desirable — blue
  • Definitely declining — yellow
  • Hazardous — red

Using this system, the Homeowners’ Loan Corp (HOLC), a government-sponsored program, redlined more than 200 neighborhoods. It warned that mortgage investments in these red areas were a “hazardous” investment. The redlined neighborhoods were also mostly populated by people of color and ethnic minorities.

“Historical residential policies, such as redlining, may have a long-lasting effect on community health.”

Although the government’s discriminatory practice officially ended in 1968 under the Fair Housing Act, its negative impact continues. To this day, people living in redlined neighborhoods, not only suffer economic difficulties, but also face greater health risks, too.

U.S. veterans who live in redlined areas are at higher risk for heart attacks and other cardiovascular problems, a new study published in JAMA Network Open has found.

Researchers at Case Western Reserve University, University Hospitals and the Cleveland VA Medical Center came to this conclusion after analyzing information from almost 80,000 U.S veterans. All the veterans had pre-existing cardiovascular disease and lived in census tracts originally color-coded red by the HOLC. They were also enrolled in ongoing care at the Department of Veterans Affairs Medical Centers nationwide.

The researchers’ findings revealed that over a five-year study period, those who lived in redlined neighborhoods were 14 percent more likely to suffer from an adverse cardiac event like a stroke or heart attack. The damaging “redlining” effect remained even after the researchers adjusted for known cardiovascular risk factors and other causes of health problems. Those living in redlined neighborhoods were also more likely to be Black or Hispanic and more likely to have diabetes and chronic kidney disease (CKD).

The researchers point out that their findings “underline the important fact that, despite improvements in public health, access to care — and citizen health in the United States overall — significant gaps exist between communities, and progress has not been uniform across all neighborhoods.”

“Historical residential policies, such as redlining, may have a long-lasting effect on community health,” Sadeer Al-Kindi, one of the lead authors of the study, said in a press statement. Al-Kindi is a former assistant professor at the Case Western Reserve School of Medicine and co-director of the Center for Integrated and Novel Approaches in Vascular Metabolic Disease at University Hospitals.

Co-author of the study, Salil V. Deo, from the surgical services department at Louis Stokes Veterans Hospital in Cleveland and his colleagues, offered suggestions to help improve cardiovascular health in redlined neighborhoods. They include:

  • Improve neighborhood designs by increasing greenspace.
  • Reduce access to tobacco by increasing taxes and raising the legal age for purchase.
  • Make it easier to access healthy food.
  • Develop new health care delivery models, such as mobile health units, to improve cardiovascular outcomes.