Health implications of redlining practices highlight need for reparations

Illustration of people standing next to a red line separating a polluted area of the city from a clean area.
Alexander Hong/Senior Staff

In June, Senate Majority Leader Mitch McConnell stated, “I don’t think reparations for something that happened 150 years ago — for whom none of us currently living are responsible — is a good idea.”

Here, McConnell is assuming that social norms and institutional practices established during the time of slavery have been fully dismantled, that the systematic oppression of people of color has been fully eradicated and therefore requires no restitution.

However, McConnell is wrong in this assumption.

Strong evidence suggests that systematic oppression is still prevailing in our society. For instance, although heart disease mortality across the United States has been on the decline for the past 50-plus years, one study recently found that these declines were weaker in counties in the Deep South with higher historical concentrations of enslaved people. This suggests that although slavery was abolished in 1865, structural racism persists.

While important, focusing on slavery alone diminishes the subsequent decades of policy geared toward maintaining the oppression of populations of color. From school segregation to eminent domain to predatory lending, housing policies have been especially oppressive. Even President Donald Trump and his family have been sued by the federal government for discrimination against applicants of color in housing. This history paints a vivid and expansive portrait of ongoing structural racism in housing in the United States.

One example of historical structural racism is residential redlining. This was a racially discriminatory mortgage appraisal practice sanctioned by the federal government’s Home Owners’ Loan Corporation, or HOLC, and carried out in more than 200 cities across the country beginning in the mid-1930s that perpetuated segregation and codified discrimination in the housing market. Essentially, appraisers were hired by HOLC to collect investment risk information in city neighborhoods.

HOLC appraisers often considered nonwhite homeowners or those living in nonwhite neighborhoods as a “hazardous” investment risk. By compiling this information at the city level, HOLC created the color-coded maps that designated investment risk of applicants across entire neighborhoods, with red denoting the highest risk — hence the term “redlining.”

The practice of considering race as an indicator of higher mortgage risk in the years following the Great Depression meant that communities of color were divested from. Furthermore, this idea was reflected in subsequent nationwide government and private-sector mortgage lending practices. Limiting access to homeownership on the basis of race, especially in neighborhoods where home values would later appreciate, likely established wealth trends for generations to follow.

In the 20-plus years following the Great Depression and World War II, the American economy grew tremendously. If families were unable to maintain or access mortgages prior to this economic boom, their wealth growth through increases in home value was hindered. This contributed to the racial wealth gap in the United States today, in which Black families and Hispanic families, on average, own about one-tenth as much value in assets as non-Hispanic white families do.

In addition to impacting legacy wealth, the distribution of historically redlined neighborhoods in the East Bay and San Francisco mirrors the paths of Interstate 880 and Highway 101/Interstate 280, respectively, as well as the locations of Superfund toxic waste sites. This highlights the overlap between historical structural racism and exposure to environmental hazards.

Given this overlap, we must consider not only how redlining policies influence the current landscape of urban neighborhoods but also how these maps drive pervasive racial health disparities in the United States today. Asthma, being one of the most racially disparate conditions in the country, is of particular interest. Our UC Berkeley and UCSF research team recently found that people from previously redlined neighborhoods in California are more likely to end up in the emergency room because of asthma than those in non-redlined neighborhoods.

We also identified that the proportions of people of color and those living in poverty, as well as diesel exhaust levels, were twice as high in previously redlined neighborhoods. This work suggests that the boundaries drawn on these maps more than 80 years ago on the basis of race have sculpted the fabric of our neighborhoods and led to asthma health disparities.

In 1968 and 1977, congressional passage of the Fair Housing Act and Community Reinvestment Act, respectively, prohibited redlining and attempted to reverse the impacts of prior racist housing policies. Despite that, predatory lending targeting families of color continued over the time leading up to the 2008 subprime mortgage crisis. Today, people of color are still denied mortgage loans at higher rates than white applicants. Persistent real estate racism has tattooed the red shading of HOLC maps onto these communities of color across the country.

The spatial distribution of these disparities is likely to evolve with ongoing gentrification in previously redlined neighborhoods. Without active and targeted investment via reparations directly to families of color that once owned property, or still do, in previously redlined neighborhoods, these racial wealth and health disparities are likely to persist for generations to come.

So, to McConnell and all other elected officials, let us tell you where your responsibility lies. Like HOLC’s maps, its appraisers and the banking industry during the time of residential redlining, you and other government officials hold the keys to vital, equity-generating resources, and thus, we call on you to do the right thing.

And since we know that historical redlining is associated with health in California, the Bay Area and California as a whole needn’t wait for federal approval. Let’s get to work.


John Balmes is the director of the UC Berkeley-UCSF Joint Medical Program. Anthony Nardone is a third-year medical student in the UC Berkeley-UCSF Joint Medical Program.