Impact of 1940s redlining on self-rated health and mortality among older adults

Background Areas “redlined” by the Home Owners’ Loan Corporation (HOLC) in the 1930s against Black neighborhoods are associated with worse present day area health outcomes. We examine whether early, personal exposure to redlining close to when the maps were drawn is associated with individual level mortality hazard (accelerated failure time) and self-rated health in older adults. Methods We used mapped 1940 census enumeration districts to assign 1930s Home Owners' Loan Corporation redlining categories to Health and Retirement Study participants based on 1940 census residence. We ran a survival analysis with a parametric normal distribution MLE to account for survivorship bias, and logistic regression on self-rated health. Results 1940s redlined D exposure was significantly associated with a 32.7% reduction in expected survival time (95% CI: 2.6%, 53.5%) compared to green A in unadjusted model. Redlined D areas were also associated with 2.26 (95% CI: 1.43, 3.56) the odds of worse self-rated health compared to green A areas. Discussion 1940 census exposure to 1930s redlining is associated with increased hazards of death and decreased self-rated health in older adults between 1992 and 2018.