blood ﬂow to the heart, commonly caused by the the build-up of plaque in the heart’s arteries (known as atherosclerosis). AMI = Acute Myocardial Infarction A consequence of CHD where decreased or stopped blood ﬂow causes damage to the heart muscle.
on a relatively small number of cities, and we often view them as a research site rather than an institution. We need to broaden literatures into the literal and ﬁgurative American South and produce deeper literatures on speciﬁc cities.
“Deﬁnitely Declining” D - “Hazardous” “In St. Louis, the white middle class suburb of Ladue was colored green because…it had ’not a single foreigner or negro.’” (Rothstein 2017) Rothstein, Richard. 2017. The Color of Law. New York, NY: W.W. Norton & Co.
“Deﬁnitely Declining” D - “Hazardous” Rothstein, Richard. 2017. The Color of Law. New York, NY: W.W. Norton & Co. “Lincoln Terrace was colored red because ‘it had little or no value today…due to the colored element now controlling the district’” (Rothstein 2017)
at the Extremes (ICE) provides a sub-county measure of segregation that produces scores per feature from -1 (total segregation of the marginalized group) to 1 (total segregation of the privileged group). Formula: ICEi = (Ai - Pi )/Ti Where: Ai = Privileged [white] Pi = Marginalized [Black] Ti = Total Population Massey, Douglas. 2001. “The prodigal paradigm returns: ecology comes back to sociology.” Pp. 41-48 in Does It Take a Village? Community Effects on Children, Adolescents, and Families, edited by A. Booth and A. Crouter. Mahwah, NJ: Lawrence Erlbaum Associates. Krieger, Nancy, et al. 2017. "Measures of local segregation for monitoring health inequities by local health departments." American Journal of Public Health 107(6): 903-906.
“arc” over time in the strength of the relationship between increased percent redlined and ICE values (remember -1 is highest segregation for African Americans). Year Pearson’s r with Redlining 1940 -0.141* 1950 -0.235*** 1960 -0.468*** 1970 -0.573*** 1980 -0.565*** 1990 -0.566*** 2000 -0.555*** 2010 -0.475***
moderately associated with increased segregation for Black residents (remember -1 is highest segregation for African Americans). Variable Pearson’s r with Redlining AMI Hospitalization Rate 0.145* ICE, Race (2010) -0.493*** Median Income -0.510*** % in Labor Force -0.209*** % Owner Occupied -0.543*** % Vacant 0.629***
AMI hospitalization and redlining, every so slightly stronger relationship with segregation (remember -1 is highest segregation for African Americans). Variable Pearson’s r with AMI Hosp % Redlined, 1940 0.145* ICE, Race (2010) -0.354*** Median Income -0.350*** % in Labor Force -0.395*** % Owner Occupied -0.125* % Vacant 0.384***
a moderate relationship between redlining and contemporary segregation. ▸ Question 2 - there is concentration of AMI hospitalization rates spatially, and some overlap with areas redlined by HOLC. ▸ Question 3 - redlining’s relationship remains with AMI hospitalization after accounting for other factors, but is weak. ▸ Suggests there may be some residual legacy of historical racism that continues to shape contemporary outcomes, and would be consistent with the clinical literature (reduced treatment despite increased morbidity/ mortality)
explained - potential for omitted variable bias ▸ The overlaps between redlining and AMI hospitalizations look different between St. Louis City and St. Louis County - disaggregating models is necessary ▸ Detailed, patient-level data is needed to further explore these patterns but signiﬁcant barriers remain to building such a data set.