







































Redlining was a discriminatory practice employed in the 1930s of denying loans, credit, and other services to 
families based on the economic status of their neighborhoods. !e practice began when the Home Owners’ Loan 
Corporation (HOLC) drew maps of residential neighborhoods in 239 cities across the United States between 1935 
and 1940 and assigned each neighborhood a grade. !e practice of redlining was used to target neighborhoods that 
had large minority populations, thus reducing their social mobility and quality of life and o"en leading to dramatic 
racial disparities in healthcare outcomes. !e Fair Housing Act of 1968 banned redlining, but the consequences of 
this discriminatory practice still a#ect people living in these neighborhoods today. !e purpose of this study was 
to analyze the e#ects of historical redlining on infant mortality rates in Richmond, Virginia. A literature search of 
relevant articles from electronic databases was performed from January 2010 to December 2024 to identify original 
research pertaining to the impact of historic redlining on current infant mortality-related healthcare outcomes. 
!e redlining status of all the neighborhoods in Richmond, Virginia was analyzed to $nd patterns related to infant 
mortality, and infant mortality rates were found to be signi$cantly higher in previously redlined neighborhoods due 
to less access to resources, worse environmental conditions, and racial disparities. Legislative actions to alleviate the 
e#ects of redlining such as building hospitals and healthcare facilities, improving access to educational resources, 
and increasing access to economic opportunities in these neighborhoods are recommended. 

Keywords: Redlining, Historical Discrimination, Racial Disparities, Health Inequity,  Infant Mortality, Preterm Birth

Aisthesis      Volume 16,  202533

Historical Redlining Practices: In!uences on Rising 
Contemporary Infant Mortality Rates in Richmond, 
Virginia

by Aashka Shah

Introduction
 According to the Centers for Disease Control 
and Prevention, the infant mortality rate in Virginia 
was 6.21 deaths per 1,000 births in 2020, an almost 
12% decrease since 2011. Advancements in medicine 
have led to dramatic decreases in infant mortality 
and health outcomes in general, but everyone does 
not get equal access to these bene$ts. !e infant 
mortality rate was 4.6 for the White population 
in Virginia from 2019-2021 while the rate for the 
Black population was a staggering 10.4 (Centers for 
Disease Control and Prevention, 2021). 
 Redlining is a historically discriminatory practice 
that started in 1934 and was used to deny $nancial 
services like loans and credit to people based on 
the economic status of their neighborhoods. !is 
practice started a"er the Great Depression when the 
Home Owners’ Loan Corporation (HOLC) analyzed 
hundreds of neighborhoods around the United States 
and reported how risky they were for economic 

investment. !e HOLC drew maps for over 200 cities 
around the United States of America, and they gave 
each neighborhood a letter grade corresponding 
to their risk factor. !e “best” neighborhoods that 
were predicted to grow in value were given an A 
and colored in green, “still desirable” neighborhoods 
were given a B and colored in blue, and “declining” 
neighborhoods were given a C and colored in yellow. 
Neighborhoods that were considered hazardous to 
investment had a red line drawn around them and 
were given a D. !ese neighborhoods were then 
discriminated against and deprived of access to many 
economic services and opportunities. For example, 
many people living in redlined neighborhoods 
were denied loans when individuals with similar 
credit histories in other neighborhoods were easily 
accepted for the same loan (Swope et al., 2022).
 Large minority populations were o"en targeted 
by redlining, and the government used this practice 
as a way to make racial discrimination legal. Many 



Historical Redlining Practices

Aisthesis      Volume 16,  202534

of the descriptions in the HOLC manual stated that 
a low grade was assigned to certain neighborhoods 
due to the large African American population 
residing there. Many neighborhoods with large 
minority populations and the same economic status 
as a predominantly White neighborhood were given 
much lower grades, and their houses were therefore 
considered to be of less value (Egede et al., 2023, p. 
1534). Redlining was eventually outlawed by the Fair 
Housing Act of 1968, but its e#ects are still prevalent 
with previously redlined neighborhoods o"en facing 
discrimination today. 
 An example of this disparity still existing today 
is the fact that the infant mortality rate is almost 2.4 
times greater for the Black population compared 
to the White population (Jang and Lee, 2022, p. 
257). Potential reasons for this disparity include 
inadequate access to healthcare, and education, 
poor economic stability, and discrimination. Infant 
mortality is de$ned as the death of an infant before 
their $rst birthday, and the infant mortality rate 
(IMR) is determined by measuring the number 
of infant deaths for every 1000 live births. Infant 
mortality is a good measure of general population 
health and the well-being of mothers and their 
families. Causes of infant mortality include birth 
defects, birth complications, diseases, smoking 
during pregnancy, and various other situational and 
environmental factors (Jang and Lee, 2022). 
 !e lasting impacts of redlining and speci$cally 
the correlation between redlining and infant 
mortality can be better understood by looking 
at Richmond, Virginia, the former Capitol of the 
Confederacy and a major part of the transatlantic 
slave trade. Richmond, Virginia has a long and 
complicated history of disenfranchisement, and 
previously redlined neighborhoods in Richmond 
have been found to have higher concentrations of 
Black residents, higher health risks, lower incomes, 
higher temperatures, fewer trees, and lower valued 
homes (Schmidt, 2022). Because historically 
redlined neighborhoods decrease access to resources 
and exacerbate already existing racial disparities, 
historical redlining may still a#ect current health 
outcomes, especially infant mortality, in redlined 
neighborhoods in Richmond, Virginia.  

Social and Cultural Constructs 
Education and Access to Resources
 Because redlining decreases access to resources 
and increases environmental degradation, areas that 
have historically been redlined su#er from income 
and health disparities. In a study to examine infant 
mortality’s relationship to education, Nardone et 
al. (2020) analyzed birth outcomes data from the 
California O%ce of Statewide Health Planning 
and Development between January 1, 2006 and 
December 31, 2015 and analyzed security maps for 
these neighborhoods. Nardone et al. (2020) used 
propensity score matching to help discover what 
percentage of each type of neighborhood fell into the 
di#erent educational categories (p. 6). Nardone et al. 
(2020) found that 65. 3% of pregnant women living 
in neighborhoods that were previously redlined paid 
for delivery care with Medi-Cal, 63.4% received 
the special supplemental nutrition program for 
women, infants, and children, and only 11.1% had 
bachelor’s degrees. In comparison, only 8.9% of 
women living in a neighborhood that used to have a 
grade of A used Medi-Cal, 9.5% received the special 
supplemental nutrition from the program, and 
38.3% had bachelor’s degrees (p. 8). 
 In a study analyzing the e#ect of maternal 
education on infant mortality, Okobi et al. (2023) 
used a retrospective observational design to analyze 
the trends and factors associated with infant mortality 
rate using data from 2007 to 2020 from the CDC 
WONDER database. !is study, which explored the 



Historical Redlining Practices

Aisthesis      Volume 16,  202535

e#ect of maternal education on infant mortality rate, 
found that infants born to mothers with higher levels 
of education had lower rates of infant mortality with 
a rate of 1.06 for mothers with a doctorate degree 
compared to 3.48 for mothers with no high school 
diploma in 2020 (p. 8). Krieger et al. (2020) examined 
NYC birth data from January 1, 2013, to December 
31, 2017, by analyzing the NYC DOHMH vital 
statistics birth certi$cate data (p. 1047). In this study 
of the association between census characteristics and 
redlining and infant mortality, Krieger et al. (2020) 
explained how worse HOLC grades are associated 
with worse census tract characteristics. Two percent 
of mothers in neighborhoods with an HOLC grade 
of A had less than a high school education, while 
23% of mothers in neighborhoods with an HOLC 
grade of D had less than a high school education. 
Lower rates of education have been associated with 
higher rates of preterm birth and infant mortality (p. 
1049).
 In a study of the racial, educational, and 
geographic disparities that contribute to infant 
mortality, Sing and Yu (2019) performed log-linear 
regression and inequality indices to analyze temporal 
infant mortality data from the National Vital Statistics 
System and the National Linked Birth/Infant Death 
$les according to maternal and infant characteristics 
(p. 20). Singh and Yu (2019) explained how White 
mothers with a college degree have an IMR of 2.9, 
while Black mothers without a high school diploma 
have an IMR of 13.4 (p. 23). Singh and Yu (2019) 
discussed how White mothers without a high school 
diploma had a 5.2 times greater post-neonatal 
mortality rate compared to White mothers with a 
college degree (p. 23). Krieger et al. (2020) explained 
how worse HOLC grades are associated with worse 
census tract characteristics. Two percent of mothers 
in neighborhoods with an HOLC grade of A had less 
than a high school education while 23% of mothers 
in neighborhoods with an HOLC grade of D had less 
than a high school education (p. 1049). Krieger et al. 
(2020) also explained that worse HOLC grades are 
associated with worse census tract characteristics. 
Zero percent of households in neighborhoods with 
an A were in the worst tercile for racialized economic 
segregation compared to 49% of households in 
neighborhoods with a grade of D (p. 1049). 

 Access to resources can also impact the type 
of delivery. Okobi et al. (2023) stated that hospital 
deliveries have lower mortality rates compared to 
deliveries that take place outside the hospital (2.69 
versus 3.09), and infants born through vaginal 
delivery had lower rates compared to babies born 
via cesarean sections (2.61 versus 2.86) (p. 8). Egede 
et al. (2023) analyzed the e#ects of redlining and 
proposed policies to move forward. Egede et al. 
(2023) explained how redlined communities have 
less access to hospitals and medical care due to the 
systematic closure of hospitals across historically 
redlined communities (p. 1535). 

Racial Factors
      Because redlining in the US has focused on 
racial minorities, primarily Black Americans, 
Black Americans disproportionately su#er from 
the repercussions of redlining. According to Okobi 
et al. (2023), African Americans have the highest 
infant mortality rate of 4.83 per 1000 infants with 
a p-value of 0 compared to White Americans (2.34 
per 1000 infants with a p-value of 2.34). American 
Indians had an infant mortality rate of 3.48 per 
1,000 infants with a p-value of 0.120, and Asian 
Americans had an infant mortality rate of 1.82 per 
1,000 infants with a p-value of 0.081 (p. 4). Nardone 
et al. (2020) found that the proportion of births 
delivered by non-Hispanic (NH) Black and Hispanic 
women was 5.1% and 12.1%, respectively, in grade 
A neighborhoods and 8.9% and 67.2%, respectively, 
in grade D neighborhoods. Signi$cantly more 
Black and Hispanic women gave birth in redlined 
neighborhoods, and Black and Hispanic women had 
higher rates of infant mortality, which help support 
the correlation between redlining and increased 
rates of infant mortality (p. 5). 
 Singh and Yu (2019) explained there was a slower 
decline in mortality for Black infants compared to 
White infants, leading to the racial disparity in the 
IMR increasing between 1916 and 2017. In 1916, the 
rate for Black infants was 184.9 deaths per 1,000 live 
births, 87% higher than the rate for White infants 
(99.0), in 1920, the black IMR was 43% higher than 
the White IMR, and in 2017, the Black IMR was 10.8 
per 1,000 live births, 122% higher than the White 
IMR of 4.9 (p. 22). Singh and Yu (2019) discussed 



Historical Redlining Practices

Aisthesis      Volume 16,  202536

how in 2017, the post neonatal mortality rate for 
Black infants was 151% greater than the rate for 
White infants (p. 22).  
 Singh and Yu (2019) discussed how in 2016, 
Black infants were 2.6 times more likely to die from 
perinatal conditions and had a 26% higher chance 
of dying due to birth defects compared to White 
infants (p. 23). Singh and Yu (2019) explained how 
the racial disparity grew over time because the infant 
mortality rate decreased at a faster rate for White 
infants compared to Black infants.  Singh and Yu 
(2019) helped further dive into the racial disparities 
in infant mortality that have already been established 
and further explain the reasons behind them. 65% of 
all infant deaths in 2016 were a result of congenital 
anomalies (birth defects), short gestation/low 
birthweight, sudden infant death syndrome (SIDS), 
maternal complications of pregnancy, unintentional 
injuries, cord and placental complications, and 
respiratory distress syndrome (RDS) (p. 23).
 Matoba et al. (2019) explained that interpersonal 
racism is a racial prejudice that leads to assumptions 
about people o"en based on stereotypes, and studies 
by Jones et al. (1996) and Krieger (1990) have shown 
that exposure to interpersonal racism and racially 
charged situations leads to increased stress hormones, 
higher blood pressure, and poor health outcomes 
(p. 102193). Collins et al. (2000) that found African 
American women who delivered babies weighing 
under 1500g, the marker for a very low birth 
weight, were twice as likely to report experiencing 
interpersonal racism during pregnancy compared to 
women who delivered babies over 2500 g (p. 102193). 
Matoba et al. (2019) explained that institutional 
racism, a systematic distribution of resources based 
on race, includes practices like residential redlining, 
which can result in unfair disparities in wealth, 
income, access to healthcare, education, and more (p. 
102193). Matoba et al. (2019) also note that studies 
have found correlations between redlining and poor 
health outcomes, and discuss how this disparity was 
attributed to inaccessible healthcare, lack of healthy 
food options, no safe places for physical activity, 
exposure to environmental hazards, and greater 
stress (p. 102193). 

Physical and Scienti"c Manifestations
      Because birth outcomes are inextricably linked 
to income and environmental conditions, redlined 

communities may su#er from higher infant 
mortality rates. !e Center on Society and Health 
at Virginia Commonwealth University found that 
the life expectancy for residents of low-income 
Black communities in the East End of Richmond 
is on average 20 years shorter compared to White 
residents in wealthy West End neighborhoods, 
and the Virginia Department of Health found that 
African Americans were hospitalized at 1.7 times the 
rate of White residents (Schmidt, 2022, 108).  

Preterm Birth
 Krieger et al. (2020) described how there is a 
signi$cant di#erence between rates of preterm birth 
in neighborhoods of di#erent HOLC grades. !e 
preterm birth rate is 5.0% in neighborhoods with 
an A compared to 7.3% in neighborhoods with a D 
(p. 1049). Hollenbach et al. (2021) described how a 
retrospective cohort study of patients with live births 
from 2005 to 2018 was conducted using data from 
the Finger Lakes Region perinatal and obstetric data 
system, a New York State Department of Health 
electronic birth certi$cate database (p. 2) Hollenbach 
et al. (2021) stated that the rate of periviable birth 
was 3-fold higher in the “hazardous” neighborhood 
(26 births) compared to the “best” or “still desirable” 
neighborhood (7 births) (p. 5). Hollenbach et al. 
(2021) explained how there was a graded increase 
in preterm birth with worsening HOLC designation 
with adjusted odds ratios of 1.19 (95% CI, 1.08-1.31) 
for “De$nitely Declining” (P = .001) and (95% CI, 
1.25-1.53) for “Hazardous” (P < 001) (p. 5). Matoba 
et al. (2019) described how the leading cause of infant 
mortality and morbidity in the United States was 
preterm birth despite the many advances in perinatal 
care (p. 102193). !is study explained how preterm 
birth a#ected African Americans more than White 
women, as the preterm birth rate in 2016 was 13.8% 
for African American mothers compared to 9.0% 
for White mothers (p. 102193). Matoba et al. (2019) 
explained how at $rst it seemed that individual-level 
risk factors like prenatal care utilization contributed 
to this disparity, but further research shows that 
a contribution of contextual factors like exposure 
to interpersonal and institutional racism has been 
correlated with the morbidity and mortality of 
African Americans (p. 102193). 



Historical Redlining Practices

Aisthesis      Volume 16,  202537

 In a study examining the association between 
historical redlining and preterm birth rates, 
Matoba et al. (2019) analyzed data from the Illinois 
Transgenerational Birth File and the Home Mortgage 
Disclosure Act (HMDA) database to perform a cross-
sectional, retrospective population-based study 
investigating [RB1]the association between redlining 
and preterm birth (p. 102193). !is study found that 
the preterm birth rate for African American women 
in redlined neighborhoods was 18.5%, and the 
preterm birth rate for African American women in 
non-redlined neighborhoods was 17.1% (p. 102193). 
Similarly, Hollenbach et al. (2021) performed a 
retrospective cohort study of 199,088 live births from 
2005 to 2018 using data from the Finger Lakes Region 
perinatal and obstetric data system, a New York State 
Department of Health electronic birth certi$cate 
database (p. 2). Hollenbach et al. (2021) explained 
how the prevalence of preterm birth increased with 
worse HOLC grades with a birth rate of 7.55% (217 
of 2873 births) in the “best” and “still desirable” 
neighborhoods and a birth rate of 12.38% (427 of 
3449 births) in the “hazardous” neighborhoods (p. 
4). Similarly, Hollenbach et al. (2021) explained how 
there was a graded increase in preterm birth with 
worsening HOLC designation, with adjusted odds 
ratios of 1.19 (95% CI, 1.08-1.31) for “De$nitely 
Declining” (P = .001) (95% CI, 1.25-1.53) for 
“Hazardous” (P < 001) (p. 5). Matoba et al. (2019) 
also found that the odds of preterm birth for African 
American women living in redlined neighborhoods 
compared to non-redlined neighborhoods was 1.12. 
Matoba et al. (2019) found that preterm birth rates 
were 18.2% in high-proportion African American 
redlined census tracts and 16.7% in high-proportion 
African American non-redlined census tracts (p. 
102193). 

Environmental Factors
 In a study examining the e#ect of redlining on PM 
levels, Herrera et al. (2024) performed a longitudinal 
cohort study using data from the National Institute 
of Health Environmental In&uence on Child Health 
Outcomes Programme to analyze exposure to $ne 
particulate matter (PM) and birth outcomes. A"er 
sourcing historical redlining data from overlaying 
the Inter-University Consortium for Political and 
Social Research with the HOLC mortgage security 

risk maps (p. 2), this study found that the average 
residential PM exposure during pregnancy was 
7.0 µg/m3 (p. 4). !ey also found an association 
between a redlined or ungraded census tract and 
higher exposure to PM with an increase of 0.43 
µg/m3 (with a 95% CI of 0.36 to 0.51) for redlined 
tracts and an increase of 0.59 ?g/m3 (with a 95% CI 
of 0.45 to 0.72) for ungraded tracts (p. 4). Herrera 
et al. (2024) explained that there was a decrease 
of 0.15 (with a 95% CI of -0.23 to -0.08) in birth 
weight z-scores for those living in a lower-grade 
census tract compared to those living in a higher-
grade census tract, a decrease of 0.14 (with a 95% 
CI of -0.21 to -0.06) when present-day maternal 
sociodemographic factors were controlled, and a 
decrease of 0.16 (with a 95% CI of -0.25 to -0.07) 
when tract-level characteristics were controlled (p. 
4). !ey also explained that there was a 1.24 (with a 
95% CI of 0.97 to 1.58) increase in preterm birth for 
redlined tracts compared to the non-redlined tracts, 
but these results were null, and there was an increase 
of 2.56 for the odds of a low birth weight (with a 95% 
CI of 1.31 to 5.03) compared to a non-redlined tract, 
but no statistically signi$cant associations were 
found between redlining and a low birth weight (p. 
5).
 High exposures to PM have been associated 
with poor pregnancy outcomes and lower redlining 
grades potentially due to the PM impairing the 
placental function by placing oxidative stress on the 
placenta or by creating in&ammation (Hollenbach 
et al., 2021, p. 5). Hollenbach et al. (2021) explained 
that the prevalence of preterm birth increased with 
worse HOLC grades with a birth rate of 7.55% (217 
of 2873 births) in the “best” and “still desirable” 
neighborhoods and a birth rate of 12.38% (427 of 
3449 births) in the “hazardous” neighborhoods (p. 
4). Hollenbach et al. (2021) stated that the rate of 
periviable birth was 3-fold higher in the “hazardous” 
neighborhood (26 births) compared to the “best” or 
“still desirable” neighborhood (7 births), hinting at 
a correlation between higher PM exposure, lower 
redlining grade, and worse birth outcomes. Herrera 
et al. (2024) explained how redlined census tracts 
have been documented to have less green space, 
reduced tree canopy, and increased heat (p. 5). 
 Nardone et al. (2020) found that the proportion 
of births delivered by non-Hispanic (NH) Black and 



Historical Redlining Practices

Aisthesis      Volume 16,  202538

Hispanic women was 5.1% and 12.1%, respectively, 
in grade A neighborhoods and 8.9% and 67.2%, 
respectively, in grade D neighborhoods. Nardone 
et al. (2020) also found that mean maternal age 
decreased as HOLC grade decreased from 33.8 
(±5.2 years) to 29.1 (±6.3 years) (p. 7). Okobi et al. 
(2023) reported the highest infant mortality rate 
was found in infants born to teenage mothers, with 
a rate of 6.8 for mothers under 15 and a rate of 3.52 
for mothers 15-19 in 2020, while also noting a high 
infant mortality rate of 4.74 for mothers 45-49 years 
old. !is may be due to inadequate access to prenatal 
care among teenage mothers and increased risk of 
various complications among mothers of advanced 
maternal age (p. 8). 
 Okobi et al. (2023) stated that there are many 
di#erent causes of infant mortality, including 
congenital malformations, deformations, and 
chromosomal abnormalities. Over the years, these 
values all tend to &uctuate. !e rates for congenital 
malformations and short gestation periods have 
been decreasing over time while the rates for SIDs 
have been &uctuating. In 2023, the mortality rate 
related to congenital malformations was between 
1.35-1.12, the rate due to short gestation and low 
birth weight ranges ranged from 1.13 to 0.87, and 
the rate for SIDs ranged from 0.57 to 0.38 (p. 4). 
Nardone et al. (2020) reported that the odd ratio of 
infant mortality was 0.69 in B vs. A neighborhoods, 
compared to 1.08 for D vs. C neighborhoods (p.10). 
Nardone et al. (2020) claimed that neighborhoods 
with worse HOLC grades experience higher rates 
of infant mortality and worse birth outcome data in 
general (p. 10). 

Lasting Impacts of Redlining in Richmond, Virginia
 Because Richmond, Virginia was previously 
redlined and the racial minorities faced a lot of 
legalized discrimination, large disparities still exist 
for those living in these redlined neighborhoods 
today. !ese redlined neighborhoods were mostly 
found towards the inner city, while the areas with 
grades of A and B were found towards the outside of 
the city (Schmidt, 2022, p. 105). Some neighborhoods 
that were particularly a#ected by redlining include 
Church Hill, Jackson Ward, Fulton, and Gilpin. 
 Parkhurst (2016) performed a case study on the 
gentri$cation in Church Hill and discussed how 

the HOLC stated that this neighborhood had zero 
favorable in&uence due to the “In$ltration of Negroes 
with a population of 80% Negro and increasing” 
(p. 21). However, due to Church Hill’s proximity 
to the historic St. John’s Church, a group of White 
Richmonders attempted to restore the homes in this 
neighborhood and turn it into a tourist destination (p. 
24). !e neighborhood was completely transformed 
with a 673 percent increase in value, but the residents 
living in this neighborhood could no longer a#ord to 
live there. !ese mostly Black families had to leave, 
and they were replaced by White families moving 
to this now &ourishing neighborhood. Redlining 
laid the foundation for the gentri$cation of Church 
Hill by denying the families living there access to 
credit, homeownership, and investment, resulting in 
Church Hill being incredibly undervalued. !is led 
to low property values in an urban location, which 
was attractive to developers and higher-income 
residents. As capital re-entered these neighborhoods, 
property values and living costs increased, leading to 
the displacement of the long-term Black residents 
who had been cut o# from any wealth-building 
opportunities. (p. 29). Jackson Ward and Fulton 
were two other previously redlined neighborhoods 
in Richmond, Virginia. Both of these neighborhoods 
were very well-established Black neighborhoods 
that were destroyed by the Richmond City Council. 
Jackson Ward had a very vibrant community and 
was known as the Harlem of the South, but in 
1953 the Richmond-Pestersburg Turnpike was 
built through this neighborhood, splitting it apart 
and displacing many of its residents. !e residents 
of this neighborhood led opposition to the plan, 
but the Council ignored them and destroyed the 
entire community (p. 18 & 19). !e neighborhood 
of Fulton experienced a similar destruction. Fulton 
was another African American neighborhood 
with one of the highest homeownership rates for 
working-class families, but the media labeled it as 
a slum. !e city council decided to bulldoze the 
neighborhood in order to create space for industry, 
completely destroying Fulton (p. 19). Brad Plumer 
and Nadja Popovich (2020) discuss the long-term 
e#ects of redlining in Gilpin. Gilpin was isolated 
during the building of the new highway, which led 
to high poverty rates and a lack of resources. Gilpin 
faces high amounts of pollution from the highway, 



Historical Redlining Practices

Aisthesis      Volume 16,  2025

few trees and green spaces, high temperatures, and 
no nearby grocery stores or doctor’s o%ces, leading 
signi$cantly worse health conditions and high infant 
mortality rates (Plumer and Nadja Popovich, 2020). 
 Data on infant mortality for redlined versus 
non-redlined neighborhoods was not available, but 
other factors demonstrating the large disparities and 
poor general health in previously redlined areas were 
still found. !ese disparities were found in many 
areas, including education, economic status, and 
environment. According to the Federal Reserve Bank 
of Richmond, 42.9% of Virginia’s White population 
has a bachelor’s degree while only 25.2% of the state’s 
Black population has a bachelor’s degree, and Black 
people from Virginia with a bachelor’s degree make 
on average 10% lower than their White counterparts 
with the same level of education (Schmidt, 2022, 
p. 107). Since lower levels of education have been 
associated with higher levels of infant mortality 
rates, the infant mortality rate is most likely higher 
in the previously redlined neighborhoods of 
Richmond. According to Schmidt (2022), in 2017, 
an average of 26 homes were bought by a White 
person each day while only six homes were bought 
by a Black person in Richmond, Virginia (p. 105). 
According to Schmidt (2022), on average, previously 
redlined neighborhoods in Richmond, Virginia 
are $ve degrees hotter compared to non-redlined 
neighborhoods with di#erences as high as twelve 
degrees in some areas. !is increase in average 
temperature can be attributed to the lack of tree 
cover and green spaces and the large amount of heat-
absorbing surfaces like concrete in redlined districts. 
!is is due to the decades of disinvestment in 
infrastructure and poor environmental planning in 
these areas, and elevated temperatures are associated 
with increased energy costs, heat-related illnesses, 
and poorer overall health outcomes. (p. 108). 
 !e University of Richmond’s Digital Scholarship 
Lab created an open-access project that publishes 
redlining maps of cities and the grades they had 
in their past with their present-day characteristics: 
Social Vulnerability Index, Percent Minority, Life 
Expectancy, Median Age, Percent over 65, Percent 
living in Poverty, Percent with Asthma, Percent 
with Cancer, Percent with Diabetes, Percent with 
High Blood Pressure, Percent with Kidney Disease, 
Percent with Mental Health Problems, Percent with 

Obesity, and Percent with Pulmonary Disease. !e 
data from each neighborhood in Richmond for all 
the characteristics was compiled, and the mean was 
found for each characteristic for each HOLC grade. 
!e data was extracted from the Digital Scholarship 
Lab to make these original tables. 

 When comparing neighborhoods in Richmond 
that previously received an A to neighborhoods 
that received a D, the average social vulnerability 
index increased from a 0.16 to a 0.70, the percent 
minority increased from 26.51% to 74.43%, and the 
life expectancy decreased from 80.59 years to 71.74 
years, as seen in Table 1. !e prevalence of all the 
stated health conditions increased as the grades went 
from A to D for all of the listed conditions except for 
cancer (see Table 2). 

Conclusion
 Clearly, there is a large disparity in infant 
mortality rates in Richmond, Virginia, and other 
redlined cities in the United States, and this disparity 
is at least partially due to the e#ects of historical 
redlining practices. Taking action and implementing 
policies to help close the gap and improve health 
equity is an essential next step. Redlining has been 
banned for over half a century and should no longer 
be hindering the growth of the neighborhoods 
that were unfairly subjected to this policy. Actions 
need to be taken to help ensure that redlined 
neighborhoods have access to the opportunities and 
resources that they were deprived of when the Home 
Owners’ Loan Corporation drew their maps. !ese 
include building hospitals and healthcare facilities 

39



Historical Redlining Practices

Aisthesis      Volume 16,  2025

closer to redlined neighborhoods, improving their 
access to doctors, prenatal care, and treatment 
facilities, expanding their insurance coverage, and 
improving their access to education, proper housing, 
and economic opportunities. Other essential 
changes include building more grocery stores closer 
to redlined neighborhoods, reversing implicitly 
racist policies, advocating for more green spaces 
and climate protection measures, and incentivizing 
investment in economically deprived areas (Egede et 
al., 2023, 1536).
 In Modern Day Consequences of Historic 
Redlining: Finding a Path Forward, Egede et al. 
(2023) discussed many potential policy initiatives 
to alleviate the e#ects of redlining. !ese focused 
on economic support, educational reform, 
healthcare reform, economic empowerment, and 
environmental reform. !e quality of housing 
in these neighborhoods can be improved by 
providing support through vouchers, tax credits, 
and developmental grants, and the educational 
opportunities can be improved by expanding early 
childhood schooling programs, expanding funding 
for special needs education in public schools, and 
altering the underlying public school funding 
mechanisms. Expanding Medicaid, revising value-
based care reimbursement models, standardizing 
asset limits in public bene$t programs, and o#ering 
tax incentives for the creation of employment 
opportunities would also help alleviate the impacts. 
 Murry et al. (2023) analyzed the educational 
outcomes from 667 African American families in 
Georgia undergoing the Strong African American 
Families (SAAF) e%cacy trials. SAAF is a culturally 
tailored preventative family-based program with the 
goal of preparing youth to advance academically. 
Murry et al. (2023) reported that assignment to this 
program led to improvements in parents’ academic 
racial socialization (β=0.09, p<0.05), improvements 
in youths’ racial pride (β=0.15, p<0.001) during 
pre-adolescence, youths’ racial pride at age 12, 
and increases in academic competence in middle 
adolescence (age 15; β=0.22, p<0.001). In contrast, 
exposure to racial discrimination at age 15 led 
to decreases in academic competence (β=0.24, 
p(0.001), and at age 16, increased rates of academic 
failure predicted school dropout (β=0.23, p(0.001) 
(p. 6). Implementing similar education programs for 

students living in underprivileged and previously 
redlined neighborhoods while decreasing exposure 
to racial discrimination can help the youth excel 
academically and slowly improve the opportunities 
available in these neighborhoods. 
 Reversing the e#ects of redlining will be a long 
and complicated process, but this change is long 
overdue. !e citizens living in these neighborhoods 
deserve the e#ects of redlining to be fully understood 
and for holistic action to be taken to improve their 
infant mortality rates and general well-being.  

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Aisthesis      Volume 16,  2025

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