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Does time heal all wounds? Examining the lasting impact of historic redlining on contemporary racial disparities in allostatic load in Baltimore, Maryland.

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Title: Does time heal all wounds? Examining the lasting impact of historic redlining on contemporary racial disparities in allostatic load in Baltimore, Maryland.
Authors: Andrews MR; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA., Chatters LM; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.; School of Social Work, University of Michigan, Ann Arbor, MI, USA., Mehdipanah R; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA., Grogan-Kaylor A; School of Social Work, University of Michigan, Ann Arbor, MI, USA., Evans MK; Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA., Zonderman AB; Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA., Powell-Wiley TM; Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.; Intramural Research Program, National Institute on Minority Health Disparities, National Institutes of Health, Bethesda, MD, USA., Schulz AJ; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Source: Ethnicity & health [Ethn Health] 2026 Jul; Vol. 31 (5), pp. 349-365. Date of Electronic Publication: 2026 Mar 08.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Informa Healthcare Country of Publication: England NLM ID: 9608374 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1465-3419 (Electronic) Linking ISSN: 13557858 NLM ISO Abbreviation: Ethn Health Subsets: MEDLINE
Imprint Name(s): Publication: London : Informa Healthcare
Original Publication: Abingdon, Oxfordshire ; Cambridge, MA : Carfax, c1996-
MeSH Terms: Allostasis*/physiology , Black or African American*/statistics & numerical data , Neighborhood Characteristics*/statistics & numerical data , Residence Characteristics*/statistics & numerical data , Health Status Disparities* , Racism*, Aged ; Female ; Humans ; Male ; Middle Aged ; Baltimore ; Residential Segregation ; Socioeconomic Disparities in Health ; White
Abstract: Objective: To examine associations between historical residential redlining, a form of institutional racism, and contemporary allostatic load (AL), an indicator of physiologic stress, examine differences by race, and whether associations are mediated by neighborhood deprivation.
Methods: We used data from Wave 4 (2013-2017) of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study in Baltimore, MD, Home Owners Loan Corporation (HOLC) scores, and data from the American Community Survey (ACS). We conducted a multilevel analysis, controlling for individual demographic and behavioral characteristics.
Results: Compared to blue- and greenlined neighborhoods, living in a yellowlined neighborhood was positively associated with allostatic load (p < 0.05). We report a significant negative interaction between living in a yellowlined area and race (β = -0.62, p = 0.00), with African American residents showing greater reductions in allostatic load compared with whites. We also found evidence of a moderated mediation, with the indirect effect of living in a yellowlined area on AL through NDI varying by race.
Conclusions: Contemporary residents of historically yellowlined, but not redlined, neighborhoods experienced heightened physiological deterioration. The strength of this association differed by race, and was substantially explained by the contemporary neighborhood deprivation index only for African Americans in yellowlined areas. Addressing health disparities requires attention to the long-lasting impacts of historical practices of institutional racism on contemporary health outcomes.
Grant Information: Z01 AG000513 United States ImNIH Intramural NIH HHS
Contributed Indexing: Keywords: Allostatic load; Good health and wellbeing; HOLC score; health disparities; neighborhood environment; reduced inequalities; urban health
Entry Date(s): Date Created: 20260309 Date Completed: 20260710 Latest Revision: 20260723
Update Code: 20260723
PubMed Central ID: PMC13225886
DOI: 10.1080/13557858.2026.2635109
PMID: 41797227
Database: MEDLINE
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  Data: Does time heal all wounds? Examining the lasting impact of historic redlining on contemporary racial disparities in allostatic load in Baltimore, Maryland.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Andrews+MR%22&quot;&gt;Andrews MR&lt;/searchLink&gt;; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Chatters+LM%22&quot;&gt;Chatters LM&lt;/searchLink&gt;; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.; School of Social Work, University of Michigan, Ann Arbor, MI, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Mehdipanah+R%22&quot;&gt;Mehdipanah R&lt;/searchLink&gt;; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Grogan-Kaylor+A%22&quot;&gt;Grogan-Kaylor A&lt;/searchLink&gt;; School of Social Work, University of Michigan, Ann Arbor, MI, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Evans+MK%22&quot;&gt;Evans MK&lt;/searchLink&gt;; Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zonderman+AB%22&quot;&gt;Zonderman AB&lt;/searchLink&gt;; Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Powell-Wiley+TM%22&quot;&gt;Powell-Wiley TM&lt;/searchLink&gt;; Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.; Intramural Research Program, National Institute on Minority Health Disparities, National Institutes of Health, Bethesda, MD, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Schulz+AJ%22&quot;&gt;Schulz AJ&lt;/searchLink&gt;; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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  Data: Objective: To examine associations between historical residential redlining, a form of institutional racism, and contemporary allostatic load (AL), an indicator of physiologic stress, examine differences by race, and whether associations are mediated by neighborhood deprivation.&lt;br /&gt;Methods: We used data from Wave 4 (2013-2017) of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study in Baltimore, MD, Home Owners Loan Corporation (HOLC) scores, and data from the American Community Survey (ACS). We conducted a multilevel analysis, controlling for individual demographic and behavioral characteristics.&lt;br /&gt;Results: Compared to blue- and greenlined neighborhoods, living in a yellowlined neighborhood was positively associated with allostatic load (p &amp;lt; 0.05). We report a significant negative interaction between living in a yellowlined area and race (β = -0.62, p = 0.00), with African American residents showing greater reductions in allostatic load compared with whites. We also found evidence of a moderated mediation, with the indirect effect of living in a yellowlined area on AL through NDI varying by race.&lt;br /&gt;Conclusions: Contemporary residents of historically yellowlined, but not redlined, neighborhoods experienced heightened physiological deterioration. The strength of this association differed by race, and was substantially explained by the contemporary neighborhood deprivation index only for African Americans in yellowlined areas. Addressing health disparities requires attention to the long-lasting impacts of historical practices of institutional racism on contemporary health outcomes.
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Allostatic load; Good health and wellbeing; HOLC score; health disparities; neighborhood environment; reduced inequalities; urban health
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260309 &lt;i&gt;Date Completed: &lt;/i&gt;20260710 &lt;i&gt;Latest Revision: &lt;/i&gt;20260723
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        Text: English
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        StartPage: 349
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      – SubjectFull: Aged
        Type: general
      – SubjectFull: Female
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      – SubjectFull: Humans
        Type: general
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      – TitleFull: Does time heal all wounds? Examining the lasting impact of historic redlining on contemporary racial disparities in allostatic load in Baltimore, Maryland.
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              Text: 2026 Jul
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