Summary

Residential segregation by race and ethnicity has wide-reaching effects on health and well-being, both directly and indirectly – through the embodiment of inequality that causes inflammation, stress, and poor physical and mental health, and through social determinants of health, including safe and affordable housing, living-wage employment, adequate schools, and healthful food.

Despite these significant impacts, few public health efforts have focused on redressing the effects of housing discrimination over time, a major driver of segregation.

The Center for Hunger-Free Communities, with a team consisting of researchers from the Urban Health Collaborative, the University of Pennsylvania, the University of Maryland, and Boston Medical Center, are collaborating to address this complex, yet impactful study of the multi-level, multi-generational impact of housing disparities and discrimination.

Our team posits that this history of housing discrimination is a driver of public health crises we see in many communities today.

Partners

Children’s HealthWatch; St. Christopher’s Hospital; University of Pennsylvania; University of Maryland; and Boston Medical Center. 

Research Methods

To assess the relationship between housing discrimination over time and child health outcomes, this collaboration linked publicly available spatial data documenting housing discrimination, housing quality, and neighborhood housing contexts with individual-level and household-level data on factors that affect child health. These health measures are captured through the ongoing Philadelphia Children's HealthWatch (CHW) study, which administers surveys at St. Christopher's Hospital for Children to caregivers of young children under age 4, and through medical record ICD-9/10 codes linked to the CHW survey data. These data were linked with spatial information from the Homeowner's Loan Corporation (HOLC) maps, which document historical housing discrimination; and Home Mortgage Disclosure Act (HMDA) data, which assesses contemporary housing discrimination, along with US Census data and other sources of information about the housing context of Philadelphia neighborhoods.

By incorporating the HMDA and HOLC datasets, which are underutilized in public health research, this project created a usable data atlas that will be publicly available to determine effects of housing discrimination and neighborhood disinvestment. This study allows methodological improvements in understanding spatial, historical, and policy dynamics on health, demonstrates how maps have been used to exclude and segregate, and enables the redrawing of maps to restore what has been withheld from many families in Philadelphia and across the country. Next steps include assessing the effects of housing discrimination on childhood asthma and birth outcomes.

Acknowledgements

This project was led by the Center for Hunger-Free Communities, with support from the Urban Health Collaborative. Thank you to Children's HealthWatch, the University of Pennsylvania Cartographic Modeling Lab, and St. Christopher's Hospital for Children.

Research Team

• Mariana Chilton, PhD, MPH
• Amy Hillier, PhD, MSW, University of Pennsylvania, School of Social Policy and Practice
• Megan Sandel, MD, Boston Medical Center
• Maureen Black, PhD, University of Maryland, Baltimore
• Kari Moore, MS 
• Steven Melly, MS, MA
• Molly Knowles, MPH
• Falguni Patel, MPH
• Hanna Ibrahim

Partners

• Children’s HealthWatch
• St. Christopher's Hospital
• University of Pennsylvania
• University of Maryland
• Boston Medical Center

This research was supported by Urban Health Collaborative pilot funding in 2016.