Historical redlining and the epidemiology of present-day firearm violence in the United States: A multi-city analysis

• Published in: Preventive medicine Vol. 165; no. Pt A; p. 107207
• Main Authors: Mehranbod, Christina A., Gobaud, Ariana N., Jacoby, Sara F., Uzzi, Mudia, Bushover, Brady R., Morrison, Christopher N.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: Bayes Theorem; Cities - epidemiology; Firearm violence; Firearms; Housing; Humans; Redlining; Spatial epidemiology; Structural racism; United States - epidemiology; Violence; Violent death; United States; Firearm violence; Spatial epidemiology; Violent death; Redlining; Structural racism
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2022.107207

Firearm violence is a major cause of morbidity, mortality, and racial health disparities in the United States. Previous studies have identified associations between historically racist housing discrimination (i.e., redlining practices) and firearm violence; however, these studies generally have been limited to a single city and have yet to provide sufficient evidence through which to determine the extent and dynamics of the impact of this relationship across the country. The aim of our study was (1) to estimate the association of historical redlining on both violent and firearm death across the country in nested models; and (2) to examine spatial non-stationarity to determine whether the impact of historical redlining on violent and firearm death was the same across the U.S. We used multilevel Bayesian conditional autoregressive Poisson models to determine the relationship between redlining as illustrated through Home Owners' Loan Corporation maps and 2019 violent and firearm deaths at the ZIP code-level nested within 21 cities across the U.S. We found that at the ZIP code level, there was a dose-responsive relationship between HOLC grading and the incidence of present-day firearm deaths. In general, redlined ZIP codes had higher relative incidence of firearm deaths. Associations were not stable across cities. For example, associations were relatively stronger in Baltimore, MD and weaker in Los Angeles, CA. This research reinforces the findings of previous studies examining the impact of redlining on firearm death across the extent of the entire country in 21 cities and claim that HOLC grades are associated with present-day violence. •Firearm violence is a major contributor to racial health disparities in the United States.•Previous studies have operationalized structural racism through the historic redlining.•Studies found associations between redlining and present-day firearm violence in select US cities.•We find associations between HOLC grades and firearm death to be dose-responsive.•The associations do not appear to be uniform across US cities.