UR Medicine study links redlining in Rochester to premature birth rates

UR medicine to study published Sept. 30 in the JAMA Open Network, The Red Ties, A Discriminatory Home Lending Practice, at Long-Term Premature Birth Rates.

Co-authors Dr Elaine Hill, Senior Researcher in Health and Environmental Economics at UR Medicine, and Dr Stephanie Hollenbach, an assistant professor in the UR Medicine Department of Obstetrics and Gynecology, analyzed a database of birth certificates in the Finger Lakes region from 2005 to 2018, where modern obstetric outcomes were compared to areas marked in red ranked with historical discriminatory mortgage lending practices.

The data system included patients born alive from 15 selected postal codes overlapping the red card, officially known as the 1940 Home Owners’ Loan Corporation (HOLC) card. Their results show how structural inequalities cast a shadow over today’s health outcomes.

Specifically, the article addresses the issue of preterm birth rates for non-Hispanic black women who experience a preterm birth rate at least 50% higher than that of non-Hispanic white women. This is a significant racial and ethnic disparity in the United States and is directly linked to regions of historical redlining.

The results revealed that preterm birth rates were increasing in postal codes historically defined as “unsafe” where the population had a majority of non-white residents. Overall, the periviable birth rate was three times higher in “dangerous” neighborhoods than in “best” or “most desirable” comparative neighborhoods. Poverty, education, and race at patient level were consistent in the groups most marked in red.

With the increase in extreme degrees of HOLC grades, the probabilities of severe maternal depression, diagnosed substance use disorder, and decreased odds of exclusive breastfeeding upon discharge from hospital were measured.

Overall, the results show that historically redlining continues to impose systematic racism.

“This is further evidence of the influence of a legacy of structural racism on the disproportionate burden of adverse pregnancy outcomes for black women in the United States,” Hollenbach said in a statement. item published in the URMC news. “The fact that the racially discriminatory mortgage loan models of the 1940s are associated with contemporary premature birth rates may inform us that the legacy of government sanctioned discrimination persists to this day. “