• Nancy Krieger, Gretchen Van Wye, Mary Huynh, Pamela D Waterman, Gil Maduro, Wenhui Li, R Charon Gwynn, Oxiris Barbot, and Mary T Bassett.
• Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH.
• Am J Public Health. 2020 Jul 1; 110 (7): 1046-1053.

AbstractObjectives. To assess if historical redlining, the US government's 1930s racially discriminatory grading of neighborhoods' mortgage credit-worthiness, implemented via the federally sponsored Home Owners' Loan Corporation (HOLC) color-coded maps, is associated with contemporary risk of preterm birth (< 37 weeks gestation).Methods. We analyzed 2013-2017 birth certificate data for all singleton births in New York City (n = 528 096) linked by maternal residence at time of birth to (1) HOLC grade and (2) current census tract social characteristics.Results. The proportion of preterm births ranged from 5.0% in grade A ("best"-green) to 7.3% in grade D ("hazardous"-red). The odds ratio for HOLC grade D versus A equaled 1.6 and remained significant (1.2; P < .05) in multilevel models adjusted for maternal sociodemographic characteristics and current census tract poverty, but was 1.07 (95% confidence interval = 0.92, 1.20) after adjustment for current census tract racialized economic segregation.Conclusions. Historical redlining may be a structural determinant of present-day risk of preterm birth.Public Health Implications. Policies for fair housing, economic development, and health equity should consider historical redlining's impacts on present-day residential segregation and health outcomes.

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