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<p>The COVID-19 pandemic has been shown to disproportionately impact racial minorities in the United States, exacerbating exiting socioeconomic disparities and increasing vulnerability to morbidity and mortality. This study investigates the long-term impacts systematic disinvestment through historical redlining on COVID-19 mortality outcomes in Atlanta. We employed longitudinal multilevel linear regression models to analyze confirmed cumulative COVID-19 mortality rates per 1,000 people across ZIP code tabulation areas (ZCTAs) from March 17, 2020, to December 31, 2022. Our analysis revealed that redlined ZCTAs exhibited significantly higher COVID-19 mortality rates and a steeper increase in cumulative deaths over time. Furthermore, a higher proportion of Black residents in these ZCTAs was strongly associated with increased mortality, even after controlling for redlined status. These findings illustrate the persistent effects of historical segregation on health outcomes and underscore the importance of addressing interconnected socioeconomic factors to enhance health equity in vulnerable communities. Understanding these dynamics is crucial for developing effective interventions and policies aimed at mitigating disparities in health outcomes.</p>

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Historical Redlining and COVID-19 Outcomes in Atlanta, Georgia: A Multilevel Approach to Place-Based Research

  • 期刊论文

  • 发表日期：

    2025年8月13日

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  • Nikita Rao,
  • Karen Nielsen,
  • Andrew Heiss,
  • Therese Pigott,
  • Daniel Whitaker

摘要

The COVID-19 pandemic has been shown to disproportionately impact racial minorities in the United States, exacerbating exiting socioeconomic disparities and increasing vulnerability to morbidity and mortality. This study investigates the long-term impacts systematic disinvestment through historical redlining on COVID-19 mortality outcomes in Atlanta. We employed longitudinal multilevel linear regression models to analyze confirmed cumulative COVID-19 mortality rates per 1,000 people across ZIP code tabulation areas (ZCTAs) from March 17, 2020, to December 31, 2022. Our analysis revealed that redlined ZCTAs exhibited significantly higher COVID-19 mortality rates and a steeper increase in cumulative deaths over time. Furthermore, a higher proportion of Black residents in these ZCTAs was strongly associated with increased mortality, even after controlling for redlined status. These findings illustrate the persistent effects of historical segregation on health outcomes and underscore the importance of addressing interconnected socioeconomic factors to enhance health equity in vulnerable communities. Understanding these dynamics is crucial for developing effective interventions and policies aimed at mitigating disparities in health outcomes.