Abstract
Background
Racial disparities exist in stroke and stroke outcomes. In an ecologic study, using
the Home Owners’ Loan Corporation (HOLC) “redlining” scores, as indicator of historic
racialized lending practices, we hypothesized that census tracts with high historic
redlining are associated with higher stroke prevalence.
Methods
Weighted historic redlining scores (HRS) were calculated using the proportion of 1930s
HOLC residential security grades contained within 2010 census tract boundaries of
Columbus, Ohio. Stroke prevalence (adults >=18) was obtained at the census tract-level
from the CDC's 500 Cities Project. Sociodemographic census tract level data (American
Community Survey 2014-2018) were considered mediators in the causal association between
historic redlining and stroke prevalence and were not controlled for in regression
analysis. HRS and stroke prevalence associations were evaluated with and without adjustment
for proportion of census tract 65 years and older.
Results
Census tracts in the highest quartile of HRS (greater redlining) had 1.73% higher
stroke prevalence compared to those in the lowest quartile (95% CI:0.41,3.05) adjusting
for proportion 65 years and older. No other interquartile differences were observed.
Conclusions
Historic redlining practices are a form of structural racism that established geographic
systems of disadvantage and consequently, poor health outcomes. Our findings demonstrate
disparate stroke prevalence by degree of historic redlining in census tracts across
Columbus, Ohio.
Keywords
Abbreviations:
HRS (Historic redlining score), HOLC (Home Owners' Loan Corporation)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: October 27, 2022
Accepted:
October 16,
2022
Received in revised form:
October 6,
2022
Received:
June 29,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106853
Copyright
© 2022 Elsevier Inc. All rights reserved.
