Perinatal & Pediatric
Residing in a Neighborhood with Historical redlining and stillbirth occurrence in Arkansas Olabowale Olola* Olabowale Olola Olola Olola Olola University of Arkansas for Medical Sciences (UAMS)
Background: Historical redlining has been associated with disparities in birth outcomes. However, the specific relationship between historical redlining and stillbirth has not been studied, especially in Arkansas, a state with both a history of residential segregation and significant racial health disparities. This study examined the relationship between living in historically redlined neighborhoods and stillbirth occurrence in Arkansas.
Methods: Data were births January 1997 to December 2013 from the Arkansas Reproductive Health Monitoring System. The Homeowners’ Loan Corporation (HOLC) Security Maps, developed in the 1930s, assigned neighborhoods one of four grades: green (grade A) “Best,” blue (grade B) “Still Desirable,” yellow (grade C) “Definitely Declining,” and red (grade D) “Hazardous,” (redlined). Grade A served as the reference category. Geocoded maternal residential addresses at the time of birth were linked to the HOLC map to assign each address a grade. Logistic regression models were used to estimate unadjusted and adjusted odds ratios and 95% confidence intervals (CIs) for stillbirth outcomes, with grades B, C, and D (redlined) evaluated separately.
Results: This study included 642 stillbirths (cases) and 601 livebirths (controls). Compared with participants residing in grade A neighborhoods, those living in grade B (OR = 5.66; 95% CI: 3.58–8.94), grade C (OR = 4.85; 95% CI: 3.08–7.66), and grade D “redlined” (OR = 5.42; 95% CI: 3.74–7.85) neighborhoods had significantly higher odds of stillbirth.
Conclusion: This study reveals a strong and consistent pattern, indicating that historical redlining is associated with significantly increased odds of having a stillbirth.
KEYWORDS: Historical redlining, stillbirth, HOLC