Historic redlining and the siting of oil and gas wells in the United States

Intersectionality and the Association Between State-Level Structural Racism, Binge Alcohol Consumption, and Smoking Status Among Black Americans

BACKGROUND

Structural racism is associated with alcohol and tobacco use among Black Americans. There is a need to understand how this relationship differs within varying groups of Black Americans. This study assessed the moderating roles of age, gender, and income in the association between structural racism and binge alcohol consumption and tobacco smoking status among Black Americans.

METHODS

A state-level index of structural racism was merged with data from a national probability sample of 1946 Black Americans. Hierarchical linear and logistic regression models tested associations between structural racism (measured by residential segregation, and economic, incarceration, and educational inequities) and binge alcohol use and smoking status among Black Americans by stratified by age, gender, and income. Moderating effects of age, gender, and income were tested using slope estimate comparisons.

RESULTS

Results indicated statistically significant positive associations between incarceration disparities and binge drinking and smoking status among Black Americans below age 65. An inverse association was detected between education disparities and smoking status among Black Americans below age 65 and among higher-income Black Americans. Age, gender, and income were not significant moderators of these associations.

CONCLUSIONS

Age, gender, and income do not moderate the association between state-level structural racism and binge alcohol or tobacco use behaviors among the current sample of Black Americans.

IMPACT

Addressing structural racism may have implications for reducing participation in binge drinking and tobacco use behaviors among Black Americans, regardless of their age, gender, or income. This has implications for healthy equity and cancer prevention and control.

Methodologic Strategies for Quantifying Associations of Historical and Contemporary Mortgage Discrimination on Population Health Equity: A Systematic Review

BACKGROUND

Mortgage discrimination refers to the systematic withholding of home mortgages from minoritized groups. In recent years, there has been an increase in empirical research investigating associations of historical and contemporary mortgage discrimination on contemporary  outcomes. Investigators have used a variety of measurement methods and approaches, which may have implications for results and interpretation.

PURPOSE

We conducted a systematic review of peer-reviewed literature that has quantified links between both historical and current mortgage discrimination with contemporary adverse environmental, social, and health outcomes. Our goals were to document the methodology used to measure and assign mortgage discrimination, to assess implications for results and interpretation, and to make recommendations for future work.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, literature searches were conducted in September 2022 using terms that combined concepts of mortgage discrimination, health, and neighborhood environment.

RESULTS

In total, 45 papers fit the eligibility criteria. In these, researchers investigated associations between mortgage discrimination and: (1) health outcomes (N = 28); (2) environmental and social exposures including heat, air pollution, greenspace, soil lead levels, and crime (N = 12); and (3) built environment features, including presence of retail alcohol, fast food, and tobacco stores (N = 5). Eleven included studies used Home Mortgage Discrimination Act (HMDA) data to identify racialized bias in mortgage discrimination or redlining, and 34 used Homeowner Loan Corporation (HOLC) maps. The construction and parametrization of mortgage discrimination or redlining and the spatial assignment of HOLC grades to contemporary addresses or neighborhoods varied substantially across studies.

CONCLUSIONS

Results from our review suggest the need for careful consideration of optimal methods to analyze mortgage discrimination such as HOLC spatial assignment or HMDA index parametrization, contemplation of covariates, and place-based knowledge of the study location.

Historical Redlining, Contemporary Gentrification, and Severe Maternal Morbidity in California, 2005-2018

Importance

Historically redlined neighborhoods may experience disinvestment, influencing their likelihood of gentrification, a process of neighborhood (re-)development that unequally distributes harms and benefits by race and class. Understanding the combined outcomes of redlining and gentrification informs how the mutually constitutive systems of structural racism and racial capitalism affect pregnancy outcomes.

Objective

To examine if historical redlining and contemporary gentrification is associated with increased severe maternal morbidity (SMM) odds.

Design, Setting, and Participants

This cross-sectional study used data from a statewide population-based sample of all live hospital births at 20 weeks' gestation or more between 2005 and 2018 in California. Analysis was conducted from March 2023 to January 2024.

Exposure

Redlining (as characterized by the federal Home Owners' Loan Corporation mortgage security maps) and displacement (using present-day sociodemographic and housing market information).

Main Outcomes and Measures

Mixed-effects logistic regression models were used to assess the association of census tract-level exposure to historical redlining and contemporary gentrification with increased SMM odds, adjusting for sociodemographic and pregnancy related factors. Outcome classification was based on the Centers for Disease Control and Prevention SMM index, which defines SMM as having any of the 21 procedures and diagnoses based on the International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes.

Results

The study sample included 1 554 837 births (median [SD] maternal age, 29.0 [6.4] years; 3464 American Indian or Alaskan Native [0.2%], 224 774 Asian [14.5%], 132 240 Black [8.5%], 880 104 Hispanic [56.6%], 312 490 White [20.1%]), with 22 993 cases of SMM (1.4%). Residents in historically redlined neighborhoods that were undergoing gentrification or displacement were more likely to be Black, Hispanic, and American Indian or Alaskan Native. Independent of individual-level characteristics, SMM odds were greater for individuals living in redlined neighborhoods that experienced displacement (OR, 1.21; 95% CI, 1.14-1.28) and in redlined neighborhoods undergoing gentrification (OR, 1.21; 95% CI, 1.13-1.29) compared with those in continuously advantaged neighborhoods.

Conclusions and Relevance

Findings from this cross-sectional study demonstrate that the legacies of redlining, intertwined with current dynamics of displacement and gentrification, affect SMM. Place-based sociopolitical mechanisms that inequitably distribute resources may be important intervention points to address structural drivers of adverse pregnancy outcomes and their racial inequities.

Qualitative and mixed methods: informing and enhancing exposure science

Addressing complex environmental health challenges necessitates the integration of multiple research methodologies to fully understand the social, economic, and health impacts of exposure to environmental hazards. Qualitative and mixed methods (QMM) are vital in uncovering the sociocultural dynamics that influence people's interactions with their environment and subsequent health-related outcomes. QMM has the potential to reveal insights that quantitative methods might overlook. However, QMM approaches have been underutilized in exposure science, with less than 1% of the studies published in the Journal of Exposure Science and Environmental Epidemiology (JESEE) from 2003 to 2023 employing these methods. JESEE studies that utilized QMM have enhanced exposure assessment, explored risk perceptions, and evaluated the impact of interventions, particularly among historically marginalized populations. QMM approaches have addressed gaps in traditional exposure assessment by allowing researchers to capture nuanced perspectives often missed by quantitative analyses, especially in understanding the lived experiences of affected communities. Exposure scientists are encouraged to adopt QMM to advance more comprehensive and inclusive approaches to studying and mitigating environmental risks. Fostering interdisciplinary collaborations that integrate the social sciences can enhance the development of robust, context-sensitive solutions to environmental health challenges.

California dreaming: Why environmental justice is integral to the success of climate change policy

In the realm of climate policy, issues of environmental justice (EJ) are often treated as second-order affairs compared to overarching sustainability goals. We argue that EJ is in fact critical to successfully addressing our national and global climate challenges; indeed, centering equity amplifies the voices of the diverse constituencies most impacted by climate change and that are needed to build successful coalitions that shape and advance climate change policy. We illustrate this perspective by highlighting the experience of California and the contentious processes by which EJ became integrated into the state's climate action efforts. We examine the achievements and shortcomings of California's commitment to climate justice and discuss how lessons from the Golden State are influencing the evolution of current federal climate change policy.

Wildfires increasingly threaten oil and gas wells in the western United States with disproportionate impacts on marginalized populations

The western United States is home to most of the nation's oil and gas production and, increasingly, wildfires. We examined historical threats of wildfires for oil and gas wells, the extent to which wildfires are projected to threaten wells as climate change progresses, and exposure of human populations to these wells. From 1984-2019, we found that cumulatively 102,882 wells were located in wildfire burn areas, and 348,853 people were exposed (resided ≤ 1 km). During this period, we observed a five-fold increase in the number of wells in wildfire burn areas and a doubling of the population within 1 km of these wells. These trends are projected to increase by late century, likely threatening human health. Approximately 2.9 million people reside within 1 km of wells in areas with high wildfire risk, and Asian, Black, Hispanic, and Native American people have disproportionately high exposure to wildfire-threatened wells.

Historical redlining is associated with disparities in wildlife biodiversity in four California cities

Legacy effects describe the persistent, long-term impacts on an ecosystem following the removal of an abiotic or biotic feature. Redlining, a policy that codified racial segregation and disinvestment in minoritized neighborhoods, has produced legacy effects with profound impacts on urban ecosystem structure and health. These legacies have detrimentally impacted public health outcomes, socioeconomic stability, and environmental health. However, the collateral impacts of redlining on wildlife communities are uncertain. Here, we investigated whether faunal biodiversity was associated with redlining. We used home-owner loan corporation (HOLC) maps [grades A (i.e., "best" and "greenlined"), B, C, and D (i.e., "hazardous" and "redlined")] across four cities in California and contributory science data (iNaturalist) to estimate alpha and beta diversity across six clades (mammals, birds, insects, arachnids, reptiles, and amphibians) as a function of HOLC grade. We found that in greenlined neighborhoods, unique species were detected with less sampling effort, with redlined neighborhoods needing over 8,000 observations to detect the same number of unique species. Historically redlined neighborhoods had lower native and nonnative species richness compared to greenlined neighborhoods across each city, with disparities remaining at the clade level. Further, community composition (i.e., beta diversity) consistently differed among HOLC grades for all cities, including large differences in species assemblage observed between green and redlined neighborhoods. Our work spotlights the lasting effects of social injustices on the community ecology of cities, emphasizing that urban conservation and management efforts must incorporate an antiracist, justice-informed lens to improve biodiversity in urban environments.

Linking environmental injustices in Detroit, MI to institutional racial segregation through historical federal redlining

OBJECTIVES

To identify the most pervasive environmental exposures driving environmental disparities today associated with historical redlining in Detroit.

METHODS

We overlaid Detroit's 1939 Home Owners' Loan Corporation (HOLC) shapefile from the Mapping Inequality project onto the EPA EJScreen and the DOT National Transportation Noise maps to analyze differences in current demographic and environmental indicators between historically redlined (D-grade) and non-redlined neighborhoods using simple linear regression and a boosted classification tree algorithm.

RESULTS

Historically redlined neighborhoods in Detroit experienced significantly higher environmental hazards than non-redlined neighborhoods in the form of 12.1% (95% CI: 7.2-17.1%) higher levels of diesel particulate matter (PM), 32.2% (95% CI: 3.3-69.3%) larger traffic volumes, and 65.7% (95% CI: 8.6-152.8%) higher exposure to hazardous road noise (LEQ(24h) >70 dBA). Historically redlined neighborhoods were situated near 1.7-times (95% CI: 1.4-2.1) more hazardous waste sites and twice as many (95% CI: 1.5-2.7) risk management plan (RMP) sites than non-redlined neighborhoods. The lifetime cancer risk from inhalation of air toxics was 4.4% (95% CI: 2.9-6.6%) higher in historically redlined communities, and the risk of adverse respiratory health outcomes from air toxics was 3.9% (95% CI: 2.1-5.6%) higher. All factors considered together, among the environmental hazards considered, the most pervasive hazards in historically redlined communities are proximity to RMP sites, hazardous road noise, diesel PM, and cancer risk from air pollution.

CONCLUSIONS

Historically redlined neighborhoods may have a disproportionately higher risk of developing cancer and adverse respiratory health outcomes from air toxics. Policies targeting air and noise pollution from transportation sources, particularly from sources of diesel exhaust, in historically redlined neighborhoods may ameliorate some of the impacts of structural environmental racism from historical redlining in Detroit.

Association of Historical Housing Discrimination and Colon Cancer Treatment and Outcomes in the United States

PURPOSE

In the 1930s, the federally sponsored Home Owners' Loan Corporation (HOLC) used racial composition in its assessment of areas worthy of receiving loans. Neighborhoods with large proportions of Black residents were mapped in red (ie, redlining) and flagged as hazardous for mortgage financing. Redlining created a platform for systemic disinvestment in these neighborhoods, leading to barriers in access to resources that persist today. We investigated the association between residing in areas with different HOLC ratings and receipt of quality cancer care and outcomes among individuals diagnosed with colon cancer-a leading cause of cancer deaths amenable to early detection and treatment.

METHODS

Individuals who resided in zip code tabulation areas in 196 cities with HOLC rating and were diagnosed with colon cancer from 2007 to 2017 were identified from the National Cancer Database and assigned a HOLC grade (A, best; B, still desirable; C, definitely declining; and D, hazardous and mapped in red). Multivariable logistic regression models investigated association of area-level HOLC grade and late stage at diagnosis and receipt of guideline-concordant care. The product-limit method evaluated differences in time to adjuvant chemotherapy. Multivariable Cox proportional hazard models investigated differences in overall survival (OS).

RESULTS

There were 149,917 patients newly diagnosed with colon cancer with a median age of 68 years. Compared with people living in HOLC A areas, people living in HOLC D areas were more likely to be diagnosed with late-stage disease (adjusted odds ratio, 1.06 [95% CI, 1.00 to 1.12]). In addition, people living in HOLC B, C, and D areas had 8%, 16%, and 24% higher odds of not receiving guideline-concordant care, including lower receipt of surgery, evaluation of ≥12 lymph nodes, and chemotherapy. People residing in HOLC B, C, or D areas also experienced delays in initiation of adjuvant chemotherapy after surgery. People residing in HOLC C (adjusted hazard ratio [aHR], 1.09 [95% CI, 1.05 to 1.13]) and D (aHR, 1.13 [95% CI, 1.09 to 1.18]) areas had worse OS, including 13% and 20% excess risk of death for individuals diagnosed with early- and 6% and 8% for late-stage disease for HOLC C and D, respectively.

CONCLUSION

Historical housing discrimination is associated with worse contemporary access to colon cancer care and outcomes.

Mapping Cumulative Risk in Delaware: Approach and Implications for Health Equity

BACKGROUND

Addressing health equity requires attention to upstream determinants of health, including environmental and social factors that act in tandem to increase communities' exposure to and vulnerability to toxicants. Cumulative risk assessment, which evaluates combined risks from environmental and social factors, is a useful approach for estimating potential drivers of health disparities. We developed a cumulative risk score of multiple indices of environmental and social conditions and assessed block group-level differences in New Castle County, Delaware.

METHODS

This cross-sectional study used choropleth maps to visualize the distribution of environmental, social, and cumulative risks and Moran's I statistics to assess spatial clustering of cumulative risk across the county and among individual block groups.

RESULTS

Findings indicate that environmental risk rarely occurs without social risk and that environmental and social risks co-occur in distinct areas, resulting in large-scale clustering of cumulative risk. Areas of higher cumulative risk had more Black residents and people of lower socioeconomic status.

CONCLUSIONS

Replicable measures of cumulative risk can show how environmental and social risks are inequitably distributed by race and socioeconomic status, as seen here in New Castle County. Such measures can support upstream approaches to reduce health disparities resulting from histories of environmental racism.

Historical Redlining Is Associated with Disparities in Environmental Quality across California

Historical policies have been shown to underpin environmental quality. In the 1930s, the federal Home Owners' Loan Corporation (HOLC) developed the most comprehensive archive of neighborhoods that would have been redlined by local lenders and the Federal Housing Administration, often applying racist criteria. Our study explored how redlining is associated with environmental quality across eight California cities. We integrated HOLC's graded maps [grades A (i.e., "best" and "greenlined"), B, C, and D (i.e., "hazardous" and "redlined")] with 10 environmental hazards using data from 2018 to 2021 to quantify the spatial overlap among redlined neighborhoods and environmental hazards. We found that formerly redlined neighborhoods have poorer environmental quality relative to those of other HOLC grades via higher pollution, more noise, less vegetation, and elevated temperatures. Additionally, we found that intraurban disparities were consistently worse for formerly redlined neighborhoods across environmental hazards, with redlined neighborhoods having higher pollution burdens (77% of redlined neighborhoods vs 18% of greenlined neighborhoods), more noise (72% vs 18%), less vegetation (86% vs 12%), and elevated temperature (72% vs 20%), than their respective city's average. Our findings highlight that redlining, a policy abolished in 1968, remains an environmental justice concern by shaping the environmental quality of Californian urban neighborhoods.

The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans

BACKGROUND

Structural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans.

METHODS

An existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates.

RESULTS

Results indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status.

CONCLUSIONS

Results suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans.

IMPACT

Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations.

Broadening the Environmental Lens to Include Social and Structural Determinants of Women's Health Disparities

BACKGROUND

Due to the physical, metabolic, and hormonal changes before, during, and after pregnancy, women-defined here as people assigned female at birth-are particularly susceptible to environmental insults. Racism, a driving force of social determinants of health, exacerbates this susceptibility by affecting exposure to both chemical and nonchemical stressors to create women's health disparities.

OBJECTIVES

To better understand and address social and structural determinants of women's health disparities, the National Institute of Environmental Health Sciences (NIEHS) hosted a workshop focused on the environmental impacts on women's health disparities and reproductive health in April 2022. This commentary summarizes foundational research and unique insights shared by workshop participants, who emphasized the need to broaden the definition of the environment to include upstream social and structural determinants of health. We also summarize current challenges and recommendations, as discussed by workshop participants, to address women's environmental and reproductive health disparities.

DISCUSSION

The challenges related to women's health equity, as identified by workshop attendees, included developing research approaches to better capture the social and structural environment in both human and animal studies, integrating environmental health principles into clinical care, and implementing more inclusive publishing and funding approaches. Workshop participants discussed recommendations in each of these areas that encourage interdisciplinary collaboration among researchers, clinicians, funders, publishers, and community members. https://doi.org/10.1289/EHP12996.

Race, Racism, and Drinking Water Contamination Risk From Oil and Gas Wells in Los Angeles County, 2020

Objectives. To evaluate the potential for drinking water contamination in Los Angeles (LA) County, California, based on the proximity of supply wells to oil and gas wells, and characterize risk with respect to race/ethnicity and measures of structural racism. Methods. We identified at-risk community water systems (CWSs) as those with supply wells within 1 kilometer of an oil or gas well. We characterized sociodemographics of the populations served by each CWS by using the 2013-2017 American Community Survey. We estimated the degree of redlining in each CWS service area by using 1930s Home Owners' Loan Corporation security maps, and characterized segregation by using the Index of Concentration at the Extremes. Multivariable regression models estimated associations between these variables and CWS contamination risk. Results. A quarter of LA County CWSs serving more than 7 million residents have supply wells within 1 kilometer of an oil or gas well. Higher percentages of Hispanic, Black, and Asian/Pacific Islander residents and a greater degree of redlining and residential segregation were associated with higher contamination risk. Conclusions. Redlining and segregation predict drinking water contamination risks from oil development in LA County, with people of color at greater risk. (Am J Public Health. 2023;113(11):1191-1200. https://doi.org/10.2105/AJPH.2023.307374).

It's electric! An environmental equity perspective on the lifecycle of our energy sources

Energy policy decisions are driven primarily by economic and reliability considerations, with limited consideration given to public health, environmental justice, and climate change. Moreover, epidemiologic studies relevant for public policy typically focus on immediate public health implications of activities related to energy procurement and generation, considering less so health equity or the longer-term health consequences of climate change attributable to an energy source. A more integrated, collective consideration of these three domains can provide more robust guidance to policymakers, communities, and individuals. Here, we illustrate how these domains can be evaluated with respect to natural gas as an energy source. Our process began with a detailed overview of all relevant steps in the process of extracting, producing, and consuming natural gas. We synthesized existing epidemiologic and complementary evidence of how these processes impact public health, environmental justice, and climate change. We conclude that, in certain domains, natural gas looks beneficial (e.g., economically for some), but when considered more expansively, through the life cycle of natural gas and joint lenses of public health, environmental justice, and climate change, natural gas is rendered an undesirable energy source in the United States. A holistic climate health equity framework can inform how we value and deploy different energy sources in the service of public health.

Temporal Trends of Racial and Socioeconomic Disparities in Population Exposures to Upstream Oil and Gas Development in California

People living near oil and gas development are exposed to multiple environmental stressors that pose health risks. Some studies suggest these risks are higher for racially and socioeconomically marginalized people, which may be partly attributable to disparities in exposures. We examined whether racially and socioeconomically marginalized people in California are disproportionately exposed to oil and gas wells and associated hazards. We longitudinally assessed exposure to wells during three time periods (2005-2009, 2010-2014, and 2015-2019) using sociodemographic data at the census block group-level. For each block group and time period, we assessed exposure to new, active, retired, and plugged wells, and cumulative production volume. We calculated risk ratios to determine whether marginalized people disproportionately resided near wells (within 1 km). Averaged across the three time periods, we estimated that 1.1 million Californians (3.0%) lived within 1 km of active wells. Nearly 9 million Californians (22.9%) lived within 1 km of plugged wells. The proportion of Black residents near active wells was 42%-49% higher than the proportion of Black residents across California, and the proportion of Hispanic residents near active wells was 4%-13% higher than their statewide proportion. Disparities were greatest in areas with the highest oil and gas production, where the proportion of Black residents was 105%-139% higher than statewide. Socioeconomically marginalized residents also had disproportionately high exposure to wells. Though oil and gas production has declined in California, marginalized communities persistently had disproportionately high exposure to wells, potentially contributing to health disparities.

The 2021 Texas Power Crisis: distribution, duration, and disparities

BACKGROUND

Precipitated by an unusual winter storm, the 2021 Texas Power Crisis lasted February 10 to 27 leaving millions of customers without power. Such large-scale outages can have severe health consequences, especially among vulnerable subpopulations such as those reliant on electricity to power medical equipment, but limited studies have evaluated sociodemographic disparities associated with outages.

OBJECTIVE

To characterize the 2021 Texas Power Crisis in relation to distribution, duration, preparedness, and issues of environmental justice.

METHODS

We used hourly Texas-wide county-level power outage data to estimate geographic clustering and association between outage exposure (distribution and duration) and six measures of racial, social, political, and/or medical vulnerability: Black and Hispanic populations, the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI), Medicare electricity-dependent durable medical equipment (DME) usage, nursing homes, and hospitals. To examine individual-level experience and preparedness, we used a preexisting and non-representative internet survey.

RESULTS

At the peak of the Texas Power Crisis, nearly 1/3 of customers statewide (N = 4,011,776 households/businesses) lost power. We identified multiple counties that faced a dual burden of racial/social/medical vulnerability and power outage exposure, after accounting for multiple comparisons. County-level spatial analyses indicated that counties where more Hispanic residents resided tended to endure more severe outages (OR = 1.16, 95% CI: 1.02, 1.40). We did not observe socioeconomic or medical disparities. With individual-level survey data among 1038 respondents, we found that Black respondents were more likely to report outages lasting 24+ hours and that younger individuals and those with lower educational attainment were less likely to be prepared for outages.

SIGNIFICANCE

Power outages can be deadly, and medically vulnerable, socioeconomically vulnerable, and marginalized groups may be disproportionately impacted or less prepared. Climate and energy policy must equitably address power outages, future grid improvements, and disaster preparedness and management.