Historic redlining, a form of structural racism in the housing market, is likely one key determinant of inequalities in present day place-based social and economic resource distribution, and, as a result, neighborhood health disparities. It certainly was not the only determinant of inequality, but it is perhaps the one for which we have the best data. Between 1935 and 1940, the Home Owners’ Loan Corporation (HOLC) created residential security maps of over 200 major U.S. cities that graphically represented their assessment about the relative risk of lending in different areas over the life-span of 15- or 20-year residential mortgages. (Redlining and Health, Helen C.S. Meier)

The maps were color-coded to represent four level risk categories: 

• Green represented “A” grade, which was considered the “Best” with minimal risk 
• Blue represented “B” grade, or “Still Desirable”
• Yellow represented “C” grade, or “Definitely Declining”
• Red “D grade” indicated “Hazardous” areas with the highest perceived risk to lenders

The HOLC field agents collected data on housing conditions, access to recreational and other conveniences, and proximity of environmental burdens and benefits to inform these grades. They also collected data about the racial, ethnic, and class identities of residents where people of color, Jews, and immigrants were typically characterized as “undesirable” or “subversive” populations that compromised both short-term and long-term property values.

As it is shown below, the HOLC materials are explicit in expressing racist ideas and judging neighborhoods with African Americans or immigrants as hazardous investments because of the racial and ethnic identities of their residents.

Definitions:

• Social vulnerability – The demographic and socioeconomic factors (such as poverty, lack of access to transportation, and crowded housing) that adversely affect communities that encounter hazards and other community-level stressors. These stressors can include natural or human-caused disasters (such as tornadoes or chemical spills) or disease outbreaks (such as COVID-19). (Centers for Disease Control and Prevention)
• Social Vulnerability Index (SVI) – a measurement of social vulnerability that uses 16 U.S. Census variables from the 5-year American Community Survey (ACS) to identify communities that may need support before, during, or after disasters. These variables are grouped into four themes that cover four major areas of social vulnerability and then combined into a single measure of overall social vulnerability. (Centers for Disease Control and Prevention)
• The Social Vulnerability Index (SVI) ranges between 0 and 1, the ranking represents the proportion of tracts (or ZCTAs or counties) that are equal to or lower than a tract (or ZCTAs or county) of interest in terms of social vulnerability. (SVI FAQs) Another way to put it is a higher SVI ranking means that a specified area has a higher level of social vulnerability in comparison to other areas. A lower SVI ranking means that a specific area has a lower level of social vulnerability in comparison to other areas.

A wealth of research has shown the persistence of economic and social disadvantage in most historically redlined neighborhoods to this day. Formerly redlined neighborhoods are more likely to have higher rates of poverty, a higher percentage of a minority population, a lower median household income, a higher prevalence of renting, and lower educational attainment than non-redlined areas. (Redlining and Health, Helen C.S. Meier)

Source: Not Even Past: Social Vulnerability and the Legacy of Redlining

Using research and studies such as these have advanced our understanding about how disinvestment and concentrated disadvantage result in an accumulation of place-based risk factors for poor individual and neighborhood health that has persisted over decades.

Evidence suggests that HOLC redlined areas are associated with present-day health outcomes including:

• Mortality, pre-term birth, cancer, COVID-19 infection burden, infant mortality, poor mental health, poor physical health, cardiovascular disease, hypertension, and diabetes.
• Redlining is associated with present-day lending discrimination which is associated with poorer mental and physical health outcomes as well as higher infant mortality.

(Redlining and Health, Helen C.S. Meier)

Place-Based Approaches: 

• Improve resources in existing lower-income neighborhoods including housing and school quality, available medical care, financial services, public libraries, transportation options, better retail, and access to healthy food and air. 

• Public Down Payment Assistance 
  • Example: Neighborhood Reinvest
  • The NFC Neighborhood Reinvest Down Payment Assistance Loan Program provides down payment assistance loans to borrowers in NFC lending areas in Des Moines, West Des Moines, Windsor Heights, Urbandale and Cedar Rapids, Iowa.
• Home-Buying Education and Counseling
  • Home buyers, both first-time and repeat, who participate in education and counseling are less likely to default than those who do not. By increasing the likelihood that homeowners will sustain home ownership, these programs also contribute to neighborhood stability. 
  • Example: Home Inc. Are You Ready to Become a Homeowner?

• Savings Support Plans
  • Some nonprofit organizations administer a federal initiative that helps low-income families build assets for home purchases, education, or starting businesses. It matches up to four dollars for every dollar the applicant saves. Participants also get financial counseling and help to secure appropriate mortgages. 
  • Another federal program helps families with home buying if they receive government rental assistance. Recipients normally contribute 30% of their incomes toward rent. If their earnings rise, they pay more toward rent and need less subsidy. For participants in the savings program, public housing agencies keep the subsidy unchanged but deposit the foregone reduction in a savings account that the families can use for a down payment. Most local authorities resist doing this -they have their hands full administering their basic program – but a city’s housing official may not appreciate the great benefits, both to households and to their communities, of increased homeownership. (pg. 68)

(Just Action by Richard Rothstein and Leah Rothstein)