Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Sep-Oct;126 Suppl 3(Suppl 3):102-14.
doi: 10.1177/00333549111260S315.

Institutional racism and pregnancy health: using Home Mortgage Disclosure act data to develop an index for Mortgage discrimination at the community level

Dara D Mendez  1 , Vijaya K Hogan, Jennifer Culhane
Affiliations

Institutional racism and pregnancy health: using Home Mortgage Disclosure act data to develop an index for Mortgage discrimination at the community level

Dara D Mendez et al. Public Health Rep. 2011 Sep-Oct.

Abstract

Objectives: We used Home Mortgage Disclosure Act (HMDA) data to demonstrate a method for constructing a residential redlining index to measure institutional racism at the community level. We examined the application of the index to understand the social context of health inequities by applying the residential redlining index among a cohort of pregnant women in Philadelphia.

Methods: We used HMDA data from 1999-2004 to create residential redlining indices for each census tract in Philadelphia County, Pennsylvania. We linked the redlining indices to data from a pregnancy cohort study and the 2000 Census. We spatially mapped the levels of redlining for each census tract for this pregnancy cohort and tested the association between residential redlining and other community-level measures of segregation and individual health.

Results: From 1999-2004, loan applicants in Philadelphia County, Pennsylvania, of black race/ethnicity were almost two times as likely to be denied a mortgage loan compared with applicants who were white (e.g., 1999 odds ratio [OR] = 2.00, 95% confidence interval [CI] 1.63, 2.28; and 2004 OR=2.26, 95% CI 1.98, 2.58). The majority (77.5%) of the pregnancy cohort resided in redlined neighborhoods, and there were significant differences in residence in redlined areas by race/ethnicity (p<0.001). Among the pregnancy cohort, redlining was associated with residential segregation as measured by the percentage of black population (r=0.155), dissimilarity (r=0.250), exposure (r=-0.115), and isolation (r=0.174) indices.

Conclusions: The evidence of institutional racism may contribute to our understanding of health disparities. Residential redlining and mortgage discrimination against communities may be a major factor influencing neighborhood structure, composition, development, and wealth attainment. This residential redlining index as a measure for institutional racism can be applied in health research to understand the unique social and neighborhood contexts that contribute to health inequities.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Conceptual modela of residential redlining, segregation, and pregnancy health
Figure 2.
Figure 2.
Map of residential redlining in Philadelphia County, Pennsylvania: HMDA data, 2000a
See this image and copyright information in PMC

References

    1. Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995 Spec No:80-94. - PubMed
    1. Link BG, Phelan JC. McKeown and the idea that social conditions are fundamental causes of disease. Am J Public Health. 2002;92:730–2. - PMC - PubMed
    1. Hogan VK, Njoroge T, Durant TM, Ferre CD. Eliminating disparities in perinatal outcomes—lessons learned. Matern Child Health J. 2001;5:135–40. - PubMed
    1. Blank RM. An overview of trends in social and economic well-being, by race. In: Smelser NJ, Wilson WJ, Mitchell F, editors. America becoming: racial trends and their consequences. Washington: National Academy Press; 2001. pp. 21–39.
    1. Jargowsky PA. Poverty and place: ghettos, barrios and the American city. New York: Russell Sage Foundation; 1997.

Publication types