# The impact of redlining and place-based systemic racism on health inequalities at mid-life

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $589,657

## Abstract

Understanding the social, economic, behavioral, and institutional factors that drive place-based differences in
mid-life morbidity and mortality is critical to addressing health inequalities. Historic racist housing policies (e.g.,
federal redlining, restrictive deeds and covenants) influenced the physical, social and economic structure of
places resulting in racial and socioeconomic residential segregation in the US. The systemic denial of
homeownership opportunities through racist housing policies may be a key upstream source of mid-life health
inequities observed across the US today through restrictions wealth and place-based investment over time.
Our previous work has shown that Home Owners' Loan Corporation (HOLC) redlining from 1935-40 is
associated with high minority, low socioeconomic neighborhoods with shorter average life expectancy, higher
neighborhood prevalence of chronic diseases, and worse physical and mental health. However, few studies
have investigated the mechanisms by which historic redlining, subsequent neighborhood trajectories of
investment and disinvestment, and racial residential segregation over time have shaped place-based
inequalities in `exposure' to harmful environments (e.g., industrial toxins) and `access' to health promoting
resources (e.g., health care services) that impact individual-level morbidity and mortality.
The proposed project will address this gap by, first, harmonizing siloed data sources to produce a national
database of historical redlining, historic and current environmental hazards, housing investment, gentrification,
and longitudinal neighborhood demographics and socioeconomics. Then, we will examine structural racism as
it is embedded in neighborhoods with 1) the resulting inequalities in neighborhood `access and exposure' that
drive health opportunities (Aim 2), and 2) disparities in morbidity and mortality risk beginning in mid-life in a
nationally representative longitudinal study, the Health and Retirement Study (HRS) (Aim 3). We hypothesize
that historically redlined areas will have greater proximity to present-day environmental hazards and reduced
access to healthcare and health promoting resources, and that longitudinal neighborhood change associated
with redlining will partially mediate these associations. We further hypothesize that HRS participants living in
historically redlined areas will have greater risk of morbidity and mortality than HRS participants not living in
redlined areas and that this association will vary by present-day intensity of racial residential segregation. This
project will create actionable knowledge to address health inequities beginning in mid-life by uncovering how
macrostructural factors, including historic, racist government policies result neighborhood and individual health
disparities. Further, the data product generated in Aim 1 will be made publicly available to facilitate additional
research on the impact of place in other longitudinal studies of health...

## Key facts

- **NIH application ID:** 10757958
- **Project number:** 5R01AG080401-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Helen Carmon Spink Meier
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $589,657
- **Award type:** 5
- **Project period:** 2023-01-01 → 2027-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10757958

## Citation

> US National Institutes of Health, RePORTER application 10757958, The impact of redlining and place-based systemic racism on health inequalities at mid-life (5R01AG080401-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10757958. Licensed CC0.

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