The legacy of redlining: Associations between historical neighborhood mapping and contemporary tobacco retailer density in Ohio

Abstract

In the 1930s United States, urban neighborhoods were graded on their desirability for investment (often based on race), a process known as "redlining." This study examined how historical redlining relates to current disparities in an important health determinant: tobacco retailer density. Analyses were conducted for thirteen Ohio cities using negative binomial models that accounted for retailer spatial dependence and controlled for present-day sociodemographic characteristics. Findings indicated that as grades increased from "Best" to "Still Desirable" to "Definitely Declining" and "Hazardous," retailer density increased monotonically. These results highlight the persisting impacts of redlining and how disparities, once intentionally created, can be perpetuated over time.

Keywords: Disparities; Redlining; Tobacco retailer density.

Figure 1:

Subregions with the HOLC grade for Cleveland in Cuyahoga County; A: “Best” (green), B: “Still Desirable” (blue), C: “Declining” (yellow), and D: “Hazardous” (red). Subregions not graded by HOLC in 1940 are denoted E (gray).

Figure 2:

Boxplots of the observed log rate of tobacco retailers, per 1000 people, by city for various sociodemographic characteristics, both (a) by city (b) and by sociodemographic characteristics and HOLC grade, centering to remove the average effect for each city (b).

Figure 3:

Relative risk comparisons of the density of tobacco retailers in each subregion, among all pairs of HOLC grades. The circles denote the relative risks for a model that only contains a possible city effect and HOLC grade effect (Model 2) and the squares denote the relative risk for a model that also contains sociodemographic factors (Model 3). Note that Model 1 did not assess HOLC grades and cannot therefore be included. Black font indicates statistically-significant differences between pairs; gray font indicates no difference. Unlike Table 2, significance tests adjust for multiple comparisons. The vertical lines denote simultaneous 95% CIs for the relative risk, accounting for spatial dependence across the subregions. The HOLC grades are A: “Best”, B: “Still Desirable”, C: “Declining”, and D: “Hazardous”. Subregions not graded by the HOLC are denoted E.