By james art Recent study that including several researchers from the University of Wisconsin uncovered a troubling link between historical discriminatory housing practices and current rates of childhood asthma, highlighting the long-term health impacts of structural racism in American cities.
Published in the American Journal of Respiratory and Critical Care Medicine, the study found that children living in neighborhoods once designated as “high-risk” for mortgage lending — a practice known as redlining — faced a significantly higher risk of developing asthma in compared to those in other fields.
This study succeeded because of the inclusion of several cohorts: Madison, New York, and rural areas. Researcher involved in the Rural Cohort Study, Dr. Christine Serugi explained the historical context. Researchers found a staggering 79 percent increased risk of asthma in children living in homes that were part of neighborhoods that received the lowest “D” rating from the Home Owners’ Loan Corporation in the 1930s, according to study.
This government-sponsored corporation played a key role in shaping urban landscapes through its neighborhood assessment practices, often based on racial segregation, according to Seroogy.
“The red line refers to a practice that our country used in the 1930s. It was a way of rating neighborhoods in cities based on demographics and income,” Serugi said.
The study used data from the NIH-funded Children’s Respiratory and Environmental Workgroup consortium, which combined information from 13 birth cohorts in the United States, Seroogy said.
This extensive data set allowed the researchers to overlay historical redline maps with current addresses and asthma rates, Seroogy said.
“We were able to do this with the large number of children as part of CREW and then overlap that with current addresses … looking at historically delineated areas where these children live, what the asthma rates are, and could that be associated with living in a historic area with red lines,” Serugi said.
The results were clear — there was a direct link between living in areas that were previously red and increased rates of asthma in children, Serugi said.
The red line system, originally designed to prevent foreclosures, was not as effective as we had hoped. Disadvantaged communities, which were predominantly minorities, did not receive housing support. Although the practice was eventually banned, its effects lasted for generations, Serugi said.
UW professor and urban economics expert Christopher Timmins offered insight into why these health care disparities persist.
“A lot of what I think about when I think about environmental justice is actually income inequality at the societal level,” Timmins said.
Lower-income families often face difficult trade-offs between affordable housing and environmental quality. It’s not a preference for pollution, but a lack of alternatives, Timmins said.
The study’s findings extend beyond individual health concerns to broader issues of environmental justice and urban planning. A lack of infrastructure has historically put children at risk of developing asthma and other health problems, Serugi said.
Those neighborhood factors include limited access to green space, proximity to industrial areas and major roads with higher levels of air pollution and poor housing quality that lead to health disparities — including asthma, Seroogy said.
Potential policy interventions include improving access to affordable, stable and safe housing for low-income families, Serugi said.
Other suggested strategies, such as mandating affordable housing in redeveloped areas and giving current residents opportunities to buy homes at subsidized prices, would help prevent displacement, Timmins said.
But both experts acknowledged the complexity of the problem.
“We can put all the pollution in the rich neighborhood and then people will move based on that and rich people will move out of the rich neighborhood to a place where there is no pollution,” Timmins said. “Poor people will move not because they like the pollution, but because they can’t afford not to, and then you end up with the same exposures again.”
The study included data from seven US cities, including Madison. Although the link between historical flushing and asthma rates isn’t as strong in Madison compared to larger metropolitan areas like New York or Boston, the findings still highlight the need for local action, Serugi said.
Looking forward, the researchers emphasize the need for additional studies to better understand the specific environmental factors contributing to the development of asthma in these communities, Seroogy said.
Seroogy is also involved in comparative research investigating why children in rural farming communities have lower rates of asthma and allergies, hoping to uncover protective factors that can be applied to urban settings.
This study contributes to a growing body of evidence on the health impacts of structural racism, demonstrating how historical policies continue to shape public health outcomes today. As cities grapple with these legacies, the research highlights the importance of considering health equity in urban planning and development decisions, Timmins said.
“If we don’t fix income inequality, people are always going to have to make these choices to put up with these things,” Timmins said.