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6. Investigating structural racism in Milwaukee: the legacy of historic disinvestment on current len


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Background: While home ownership is a major source of wealth accumulation in the US, communities of color have faced decades of racial discrimination in the housing market that have prevented equal access to loans. However, research evaluating the legacy of discriminatory lending practices as a structural determinant of health is limited. Methods: Weighted historic disinvestment scores for Milwaukee census tracts were calculated from 1930s Home Owners Loan Corporation residential security grades. Linear regression was used to estimate the association between historic disinvestment and 1) 2018 Home Mortgage Disclosure Act data on average rate spread (i.e., high cost loans) and 2) indicators of community health from the 2014-2018 American Community Survey, 2017 500 Cities Project and the City of Milwaukee Health Department. The association between sustained housing discrimination over time, as measured by trajectories of neighborhood historic disinvestment and rate spread, and current health was also estimated. Results: Greater historic disinvestment was associated with higher tract average rate spread (indicating more high loan costs; β=0.14, 95%CI: 0.06, 0.22) and more adults reporting poor physical (β=1.34, 95%CI: 0.40, 2.28) and mental (β=1.34, 95%CI: 0.40, 2.28) health. A graded association was observed between sustained housing discrimination and health such that neighborhoods with high historic disinvestment and high rate spread had worse current health outcomes than neighborhoods with low historic disinvestment and low rate spread (poor physical health: β=6.47, 95%CI: 4.78, 8.17; poor mental health: β=4.90, 95%CI: 3.48, 6.32; infant mortality rate: β=0.54, 95%CI: 0.21, 0.86). Conclusion: Historic disinvestment is associated with current lending practices and health in Milwaukee neighborhoods, illustrating the lasting effects of structural racism. Lending practices actively reinforce the conditions that perpetuate health inequities.



Emily Lynch, Research Assistant & Graduate Student  -
University of Wisconsin- Milwaukee

Helen C.S. Meier, 
University of Wisconsin- Milwaukee


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