Seeing Red: Associations between Historical Redlining and Present-Day Visual Impairment and Blindness

Ophthalmology 2023;130:404-412

中文摘要

本文探討美國的紅線(Redlining)政策對視力障礙和失明（visual impairment and blindness, VIB）的影響。紅線是一項在1933年開始的歧視性住房政策，將黑人比例高的社區視為“不受歡迎”的，因此排除人們獲得傳統的受保險抵押貸款購買房屋的機會。此外，房地產經紀人還阻止黑人在以非黑人為主的社區購房。這項研究發現，在曾經評估過紅線的社區中，VIB的比率要高於其他社區。曾經被紅線限制的社區也被發現存在犯罪率高、環境質量差、教育成就低、經濟機會不足和健康不良等問題。研究還發現，紅線政策與慢性疾病結果存在關聯，包括糖尿病、高血壓、中風、肥胖、癌症和哮喘等。在調整了年齡、性別、種族和居民比例等因素後，研究發現，紅線評分高的社區與有著更高的患病率。這項研究表明，歷史性紅線政策為“種族化空間劣勢”的產物之一，對當今的視力健康結果產生了影響。

English Abstract

The article explores the relationship between historical redlining and visual impairment and blindness (VIB) in the United States. Redlining was a discriminatory housing policy that identified neighbourhoods with high proportions of Black individuals as “undesirable” and a high risk for lending, therefore excluding people from obtaining traditional insured mortgages to purchase a home. The study investigated rates of VIB in neighbourhoods that were graded for redlining, and found that the prevalence of VIB was greater in census tracts (CTs) with worse historic redlining scores. These findings are consistent with previous studies demonstrating the associations between historical residential segregation and current neighbourhood health outcomes. The article concludes by recommending interventions to address issues that disproportionately affect redlined neighbourhoods, such as access to quality preventative eye care services.