1. Historical Redlining, Socioeconomic Distress, and Risk of Heart Failure Among Medicare Beneficiaries.
- Author
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Mentias, Amgad, Mujahid, Mahasin, Sumarsono, Andrew, Nelson, Robert, Madron, Justin, Powell-Wiley, Tiffany, Essien, Utibe, Keshvani, Neil, Girotra, Saket, Morris, Alanna, Sims, Mario, Capers, Quinn, Yancy, Clyde, Desai, Milind, Menon, Venu, Rao, Shreya, and Pandey, Ambarish
- Subjects
heart failure ,policies ,race factors ,socioeconomic disparities in health ,systemic racism ,Aged ,Humans ,Male ,Black People ,Comorbidity ,Heart Failure ,Medicare ,Socioeconomic Factors ,United States ,White People ,Financial Stress ,Neighborhood Characteristics ,Social Determinants of Health ,Black or African American - Abstract
BACKGROUND: The association of historical redlining policies, a marker of structural racism, with contemporary heart failure (HF) risk among White and Black individuals is not well established. METHODS: We aimed to evaluate the association of redlining with the risk of HF among White and Black Medicare beneficiaries. Zip code-level redlining was determined by the proportion of historically redlined areas using the Mapping Inequality Project within each zip code. The association between higher zip code redlining proportion (quartile 4 versus quartiles 1-3) and HF risk were assessed separately among White and Black Medicare beneficiaries using generalized linear mixed models adjusted for potential confounders, including measures of the zip code-level Social Deprivation Index. RESULTS: A total of 2 388 955 Medicare beneficiaries (Black n=801 452; White n=1 587 503; mean age, 71 years; men, 44.6%) were included. Among Black beneficiaries, living in zip codes with higher redlining proportion (quartile 4 versus quartiles 1-3) was associated with increased risk of HF after adjusting for age, sex, and comorbidities (risk ratio, 1.08 [95% CI, 1.04-1.12]; P
- Published
- 2023