Institutional Racism and Pregnancy Health: Using Home Mortgage Disclosure Act Data to Develop an Index for Mortgage Discrimination at the Community Level

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 r...

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Bibliographic Details
Published in:Public health reports (1974) 2011-09, Vol.126 (3_suppl), p.102-114
Main Authors: Mendez, Dara D., Hogan, Vijaya K., Culhane, Jennifer
Format: Article
Language:English
Subjects:
African Americans - statistics & numerical data
Attainment
Black people
Census
Census tracts
Censuses
Cohort Studies
Construction methods
Data analysis
Data processing
Disclosure
Discrimination
Ethnicity
Exposure
Female
Health
Health disparities
Health research
Health Status Disparities
Home financing
Home ownership
Housing - statistics & numerical data
Housing discrimination
Humans
Indexes
Inequality
Maternal Health Services - utilization
Minority & ethnic groups
Mortgage loans
Mortgages
Neighborhoods
Pennsylvania
Pregnancy
Pregnancy Outcome
Prejudice
Public health
Race
Racial differences
Racism
Redlining
Regulation of financial institutions
Residence
Residential areas
Residential buildings
Residential development
Residential segregation
Retirement communities
Segregation
Social behavior
Social environment
Socioeconomic Factors
Systemic racism
Trust
Wealth
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Summary: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 [Cl] 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
ISSN:0033-3549
1468-2877
DOI:10.1177/00333549111260S315