Boston – New study results show areas of Boston that experienced redlining in the 1930s currently have higher rates of firearm violence compared to areas that were not redlined. Led by researchers at Boston Medical Center, the study demonstrates that structural racism in the form of redlining has led to these increased rates in large part due to high rates of poverty, low educational attainment, and low homeownership rates. Published in The Lancet Regional Health – Americas, the researchers highlight the need to better understand other factors at play in redlined areas in order to develop targeted interventions to reduce firearm violence.
During the 1930s, the US government utilized a discriminatory practice that refused home loans to individuals who lived in certain geographic areas. Known as redlining, this practice affected individuals and families living in inner cities, and predominantly people of color by denying them access to federally backed home loans. This severely impacted the potential for upward mobility among people of color; even today, areas that were redlined have lower home values and higher rates of poverty.
In Philadelphia, research showed that areas that were redlined have 13 times higher rates of shooting compared to other areas, which demonstrates the downstream impact of redlining. Data also shows that the leading cause of death for Black men under the age of 44 is homicide; however, there is a lack of data about broader geographic issues that may play a role in this disparity.
“This study is the first to dig into the underlying factors that contribute to higher rates of firearm violence in certain Boston neighborhoods,” said Michael Poulson, MD, a surgical resident at Boston Medical Center who is the study’s first author.
For this study, researchers collected data from the Boston Police Department for incidents classified as assaults and homicides involving a firearm between Jan. 1, 2016 through Dec. 31, 2019. The data included incidents to which police officers were dispatched to respond. They then obtained a map of Boston and color coded it to categorize how certain areas were classified for home loan applications in the 1930s: red was “hazardous”; yellow was “definitely declining”; blue was “still desirable”; and green was “best.” Next, they overlayed this map on a current Boston map that marked the location of firearm violence incidents. Using a mediation analysis, the researchers then studied the impact of poverty, education, employment and demographics on increased rates of firearm violence in redlined areas.
Shooting rates per 1,000 people were significantly higher in areas designated yellow (5.4) and red (5.3) compared to green areas, which had .5 shootings per 1,000 people. The yellow areas had the highest share of the Black population, at 31 percent, and red areas had the second highest number at 19.4 percent. Additionally, yellow and red areas had higher rates of residents who: lived below the poverty line (13.8 and 17 percent); were uninsured (3.7 and 3.6 percent); were publicly insured (39.2 and 38.4 percent); and had less than a high school degree (12.9 percent and 17 percent).
Mediating the interaction between redlining and discriminatory housing policies were poverty, poor educational opportunity, rented housing, and segregation of Black individuals (represented by Black share of the population).
“It is important for researchers and policy makers to understand the downstream impacts of structural racism and how they affect firearm violence in devalued, redlined communities,” added Poulson, who is a clinical instructor in the department of surgery at Boston University School of Medicine. “Our study results show that considering neighborhood factors such as poverty, educational attainment, and segregation are important when interventions are being developed to help decrease firearm violence in communities still feeling the effects of redlining.”
Kelly Kenzik, PhD, is an epidemiologist at the University of Alabama at Birmingham who is currently serving as the Carter Visiting Scholar in Cancer Disparities at Boston Medical Center. This study was supported in part by a National Institutes of Health T32 Training Grant (HP10028, Poulson).
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Boston Medical Center (BMC) is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. BMC offers specialized care for complex health problems and is a leading research institution, receiving more than $166 million in sponsored research funding in fiscal year 2019. It is the 13th largest funding recipient in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in Boston HealthNet – 12 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org.
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