Study Links Historical Redlining to Higher Rates of Heart Disease and Limited Access to Healthy Foods

A groundbreaking study presented at the American Heart Association's Scientific Sessions 2024 has uncovered a troubling link between historical redlining practices and present-day cardiovascular health issues. The research, led by Dr. Rebekah J. Walker of the University at Buffalo, demonstrates that neighborhoods previously subjected to discriminatory housing policies continue to face higher rates of heart disease, Type 2 diabetes, high blood pressure, and obesity, coupled with reduced access to healthy food options.

The study analyzed data from over 11,000 U.S. Census tracts across 38 states, revealing that areas historically marked as 'hazardous' for mortgage lending—a practice known as redlining—now experience significantly higher prevalence of cardiovascular diseases and related risk factors. In redlined neighborhoods, an average of 11.8% of residents had Type 2 diabetes, 31.9% had high blood pressure, 6% had heart disease, and 31.8% were obese.

These findings underscore the enduring impact of structural racism on public health, even decades after redlining was officially outlawed by the Fair Housing Act of 1968. The study's results suggest that the legacy of these discriminatory practices continues to shape community health outcomes through various pathways, including limited access to nutritious food options.

Dr. Walker emphasized the importance of understanding these connections, stating, 'We know that redlining leads to poor health outcomes, and even though redlining has been outlawed, it is still having an impact.' The research team found both direct and indirect associations between historical redlining, reduced access to healthy foods, and higher rates of cardiovascular diseases.

The implications of this study are far-reaching, highlighting the need for targeted interventions to address health disparities in communities affected by past discriminatory policies. Improving access to healthy foods emerges as a potential strategy to mitigate the long-term health consequences of redlining.

Dr. Clyde W. Yancy, former American Heart Association volunteer president, commented on the findings, describing the residual impact of redlining a century later as 'disheartening.' However, he also expressed optimism about the potential for change, calling for 'disruptive new strategies, provocative voices, and breakthrough science applied to healthier foods' as a path forward.

The study's findings align with recent initiatives by the American Heart Association, including the 'Health Care by Food™' program, which explores the integration of healthy foods into medical treatment plans to improve health outcomes and reduce healthcare costs. This approach could be particularly beneficial in addressing the nutritional challenges faced by communities with historical disadvantages.

While the observational nature of the study limits conclusions about direct cause and effect, it provides compelling evidence of the long-lasting impact of discriminatory housing policies on community health. The research underscores the urgent need for policy interventions and community-based initiatives to improve food access and overall health in historically marginalized neighborhoods.

As the scientific community continues to uncover the complex relationships between social determinants of health and cardiovascular outcomes, studies like this serve as crucial reminders of the importance of addressing structural inequalities to achieve equitable health outcomes for all communities. The findings call for a multifaceted approach to public health that considers historical context and targets the root causes of health disparities.