ArticleJournal of the American Heart Association2024
Historical Redlining and Heart Failure Outcomes Following Hospitalization in the Southeastern United States.
Article in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Historical Redlining and Change in Blood Pressure: The Multi-Ethnic Study of Atherosclerosis (MESA).Hypertension (Dallas, Tex. : 1979) · 2026Article
- The environmental exposome in heart failure risk and progression.Nature reviews. Cardiology · 2026Review
- Transforming Advanced Heart Failure Programs: Addressing Institutional and Systemic Drivers of Racial and Ethnic Disparities in Care.Circulation. Heart failure · 2026Review
- Leveraging Neighborhood-Level Interventions to Improve Cardiovascular Health: A Scoping Review.Circulation. Population health and outcomes · 2026Article
- Historical Redlining and Cardio-Kidney-Metabolic Disease Risk Factors, Prevalence, and Outcomes: A Scoping Review.JACC. Advances · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHistorical redlining, a discriminatory lending practice, is an understudied component of the patient risk environment following hospital discharge. We investigated associations between redlining, patient race, and outcomes following heart failure hospitalization. METHODS AND
resultsWe followed a hospital-based cohort of Black and White patients using electronic medical records for acute heart failure hospitalizations between 2010 and 2018 (n=6800). Patient residential census tracts were geocoded according to the 1930s Home Owners' Loan Corporation map grades (A/B: best/still desirable, C: declining, D: redlined). We used Poisson regression to analyze associations between Home Owners' Loan Corporation grade and 30-day outcomes (readmissions, mortality, and their composite). One-third of patients resided in historically redlined tracts (n=2034). In race-stratified analyses, there was a positive association between historically declining neighborhoods and composite readmissions and mortality for Black patients (risk ratio [RR], 1.24 [95% CI, 1.003-1.54]) and an inverse association between redlined neighborhoods and 30-day readmissions among White patients (RR, 0.58 [95% CI, 0.39-0.86]). Examining racial disparities across Home Owners' Loan Corporation grades, Black patients had higher 30-day readmissions (RR, 1.86 [95% CI, 1.31-2.65]) and composite readmissions and mortality (RR, 1.32 [95% CI, 1.04-1.65]) only in historically redlined neighborhoods.
conclusionsHistorical redlining had potentially mixed impacts on outcomes by race, such that residing in less desirable neighborhoods was associated with an elevated risk of an adverse outcome following heart failure hospitalization in Black patients and a reduced risk in White patients. Moreover, racial disparities in patient outcomes were present only in historically redlined neighborhoods. Additional research is needed to explore observed heterogeneity in outcomes.
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