Dei-03 Persistent Effects of Historical Redlining on Traumatic Urologic Injuries: A Geospatial Analysis in a Southern Us City

You have accessJournal of UrologyDiversity, Equity & Inclusion Forum (DEI01)1 May 2024DEI-03 PERSISTENT EFFECTS OF HISTORICAL REDLINING ON TRAUMATIC UROLOGIC INJURIES: A GEOSPATIAL ANALYSIS IN A SOUTHERN US CITY Maya Malak Eldin, James Bradford, Tarah Woodle, Niru Ancha, Sofia Gereta, Imani Butler, Prachi Khanna, Marissa Mery, Michelle Robert, Sadia Ali, Deborah Salvo, Carlos V. Brown, and Aaron Laviana Maya Malak EldinMaya Malak Eldin , James BradfordJames Bradford , Tarah WoodleTarah Woodle , Niru AnchaNiru Ancha , Sofia GeretaSofia Gereta , Imani ButlerImani Butler , Prachi KhannaPrachi Khanna , Marissa MeryMarissa Mery , Michelle RobertMichelle Robert , Sadia AliSadia Ali , Deborah SalvoDeborah Salvo , Carlos V. BrownCarlos V. Brown , and Aaron LavianaAaron Laviana View All Author Informationhttps://doi.org/10.1097/01.JU.0001008820.69436.91.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As part of the federal housing policy during the New Deal era, the Home Owners Loan Corporation (HOLC) created maps that assessed the financial security of neighborhoods across the United States. This practice, commonly known as redlining, labeled neighborhoods with high numbers of racial and ethnic minorities as financially unstable, leading to a lack of federal investment. The focus of this research was to investigate how historical redlining within a city in the southern US is connected to the spatial distribution of traumatic injuries, specifically related to urologic cases. METHODS: This study involved analyzing data retrospectively collected from admissions for violent penetrating urologic trauma between January 1, 2013, and April 24, 2023, at a single Level 1 trauma center in a southern US city. Geographical information systems software, specifically ArcGIS, was used to geocode the addresses of injury incidents and link them to the corresponding census tracts. These tracts were classified according to the 1935 HOLC financial designations as "Hazardous," "Definitely Declining," "Still Desirable," or "Best." Tracts labeled as "Hazardous" and "Definitely Declining" were categorized as redlined areas. The study calculated the incidence rate ratio (IRR) to compare the rates of penetrating urologic trauma between historically redlined and non-redlined census tracts. RESULTS: 936 violent penetrating urologic trauma cases occurred during the study period. Of the 387 cases with valid location data for geospatial analysis, 60 incidents fell within the geographical boundaries of the 1935 HOLC map. 70% of these cases occurred in census tracts that were historically redlined. The incidence rate per 100,000 person-years in redlined areas was 8.19, in contrast to 1.63 in non-redlined census tracts (IRR=5.03, 95% CI: 2.90-8.73, p<0.001). CONCLUSIONS: Neighborhoods that were subjected to discriminatory redlining practices in 1935 continue to exhibit a fivefold higher incidence rate of violent penetrating urologic trauma today. These findings underscore the impact of structural racism and historical residential segregation on vulnerability to traumatic injuries, emphasizing the importance of addressing social determinants of health to eliminate disparities in health outcomes. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e288 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Maya Malak Eldin More articles by this author James Bradford More articles by this author Tarah Woodle More articles by this author Niru Ancha More articles by this author Sofia Gereta More articles by this author Imani Butler More articles by this author Prachi Khanna More articles by this author Marissa Mery More articles by this author Michelle Robert More articles by this author Sadia Ali More articles by this author Deborah Salvo More articles by this author Carlos V. Brown More articles by this author Aaron Laviana More articles by this author Expand All Advertisement PDF downloadLoading ...