Racial Segregation, Structural Racism and Health

The Home Owner's Loan Corporation was created in the 1930s to rescue the housing market in the wake of the Depression. Government backed home loans were offered, but were limited only to white Americans. Maps of urban areas were created to assess the inherent risk of investment and those areas with Black or minority populations were marked as red, leading to the colloquial "redlining" that we know today. These redlined areas did not qualify for home loans, which led to the large racial wealth gap that we see today. These redlined areas also continue to have the lowest homeownership, the highest levels of poverty, the most unemployment, and the lowest quality education.

The social determinants of health are inherently racialized because of the racist housing policies of the 1930s and their lasting impacts today. This racial residential segregation has been shown to impact outcomes and racial disparities in a variety of malignancies. For lung cancer, disparities in stage at diagnosis, surgical resection, and mortality are all impacted by racial segregation.

References

1. Aaronson D, Hartley D, Mazumder B. The Effects of the 1930s HOLC “Redlining” Maps. Fed Reserv Bank Chicago. 2019;Working pa(February).

2. Nelson RK, Winling L, Marciano R, Connolly N. Mapping Inequality. American Panorama, ed. Accessed May 1, 2020. https://dsl.richmond.edu/panorama/redlining/

3. Annesi CA, Poulson M, Mak KS, et al. The Impact of Residential Racial Segregation on Non-Small Cell Lung Cancer Treatment and Outcomes. Ann Thorac Surg. Published online 2021. doi:10.1016/j.athoracsur.2021.04.096