Abstract 12362: Increased Cardiovascular Mortality Rates Within Historically Redlined Neighborhoods

Abstract

Introduction: Redlining maps were developed by the Home Owners’ Loan Corporation (HOLC) in 1933 to depict perceived level of risk in home loans with ratings of best”, “still desirable”, “declining”, and “hazardous”. Neighborhoods that were “all-white” were rated as “best”, colored green, whereas Black neighborhoods were automatically assigned “hazardous” investment and colored in red, hence the term “redlining”. (Figure 1A) Living in historically redlined areas has been associated with disparities and adverse outcomes; however, their association with cardiovascular mortality rates has not been described. We sought to compare the cardiovascular mortality rates in historically redlined neighborhoods with others in Houston, Texas. Methods: Demographics and cardiovascular mortality rates reported by Department of Health and Human Services between 1999-2003 were compared between historically redlined neighborhoods and neighborhoods outside the limits of the HOLC maps in Houston, Texas. Results: Super-neighborhoods within historically redlined zones categorized as “hazardous” when compared with neighborhoods not in HOLC map zones, had a significantly higher proportion of Black residents (41.4 vs 21.1%, p=0.01), a higher proportion of residents with income less than twice the poverty level (28.1 vs 21.6%, p=0.04), significantly higher age adjusted mortality rates per 100,000 population for heart disease (304.65 vs 254.3, p=0.01), stroke ( 92.2 vs 70.5, p=0.001) and coronary heart disease (196.9 vs 164.4,p=0.01), and significantly higher years of potential life lost due to heart disease (905.6 vs 681 age-adjusted annual years of life lost per 100,000 population for <age of 65;p=0.03). (Table and Figures 1B &C) Conclusions: Living in historically redlined areas is associated with increased cardiovascular mortality rates. Future research should examine strategies to improve cardiovascular health in historically redlined neighborhoods.