The novel coronavirus pandemic has exacerbated many racial health inequities that existed well before this public health crisis. People of color are disproportionately contributing to COVID-19 case counts and mortality and are also more likely to have underlying health conditions that increase the risk of severe illness from COVID-19. While COVID-19 has pushed racial health inequities into the national spotlight, the underlying differences in social, economic, and environmental conditions that give rise to inequities in COVID-19 infection, transmission, and severe illness are far from new.
The twentieth century's formal and informal practices of racial residential segregation have systematically shaped characteristics of the built environment that may increase susceptibility to not only COVID-19 but other underlying health conditions that increase the susceptibility to and severity of illness from COVID-19. Racial residential segregation may impact health through poor housing conditions, disparities in educational and employment opportunities, inadequate transportation infrastructure, access to healthcare, and economic instability. Where people live impacts their exposure to health-promoting resources and opportunities (i.e., access to quality food, recreation, healthcare, etc.) as well as exposure to health-damaging threats (i.e., environmental pollutants, poor housing quality, etc.).
Among the most impactful practices that created these stark differences in neighborhood resource distribution and concentrated disadvantage was redlining: the practice of denying fair access to credit, particularly mortgages, based on the race of the residents of a neighborhood. For much of the twentieth century, the federal government encouraged redlining. In the 1930s a federal agency, the Home Owners' Loan Corporation (HOLC), graded neighborhoods in nearly 250 American cities scale neighborhoods on a four-grade scale, A to D, "Best" to "Hazardous," that were then visualized on a series of maps. Race was a key—arguably the key—variable in determining these grades. Neighborhoods of color received D or C grades with only white neighborhoods receiving A and B grades.
There is no better archive of redlining than the HOLC maps and the accompanying area descriptions. This site juxtaposes these maps from the 1930s with contemporary health disparities. In most cities, you will see striking similarities between redlining eighty years ago and health disparities today. This is a testament to the long-lasting impact of racial segregation and redlining in shaping the enduring contours of marked inequality in American cities.
One of the reasons that the HOLC materials are such a clear window into the history of structural racism in the United States is how directly and starkly racist ideas were expressed in them. Racism was not subtext; it was text. As a consequence please take note: this means that some of these historical documents contain offensive racist language.