Why 50-year-old housing practices could be linked to poor health outcomes today

By Andrea Weiler, MPHc

Did you know racist housing practices from more than 50 years ago could be linked with poor health outcomes today? The answer is complicated, but we have evidence that residential segregation, which still exists in Seattle and King County, may be a factor. In my project with Public Health’s Assessment, Policy Development and Evaluation (APDE) unit, we examined the relationship between racist real estate practices and health inequities. By mapping racial restrictive covenants and several health indicators (for example, low birth-weight and life expectancy), and comparing the maps, we were able to see a geographic relationship. Statistical analysis further supported the findings.

Even though Seattle isn’t the first city to show a relationship between health and segregation, Seattle and King County have a long history of enforcing racial residential segregation through racist real estate practices such as racial restrictive covenants and redlining. These practices are no longer legal, but the ramifications of these practices have had lasting health impacts.

What are racial restrictive covenants?
Racial restrictive covenants are previously legally enforceable “contracts” within property deeds, prohibiting people of color (or other ethnic groups, like those from the Jewish community) from buying, leasing or living on certain properties unless they were servants. Though no longer legal, these practices were common from 1926-1968. However, although deemed illegal in 1968, racial restrictive covenants were not removed from property deeds.

What is redlining?
Redlining is the practice of drawing lines on city maps to define the “ideal” locations for banks to invest and sell mortgages. Maps were drawn with blue and red areas, where blue areas were “all white” and red areas were primarily home to people of color. Banks and lenders considered the blue (white) neighborhoods to be “ideal” neighborhoods. Areas drawn in red were considered “declining” neighborhoods, and a “risky” investment, so banks and lenders typically did not loan money within those areas. (See Redlining Map, below)

Redlining made it very difficult for people of color to buy property because banks denied them loans in blue (white) neighborhoods and because redlined neighborhoods were financially “risky.” In Seattle, people of color had difficulty finding housing outside of the Central District and the International District – both were redlined areas.

And it’s still happening today? How is that possible?
The Seattle Civil Rights & Labor History Project at the University of Washington surveyed deeds and catalogued 416 racial restrictive covenants still present in deeds. It is estimated that tens of thousands of additional Seattle homeowners still have restrictive covenants in their deeds, unknowingly. While the Fair Housing Act of 1968 officially made the use of racially restrictive covenants illegal, it did not require them to be removed from property deeds. This means that while the law no longer allows these racist covenants, they still appear – almost like ghosts of the past.

redlining map 1
Blue neighborhoods were all-white neighborhoods, where people of color and sometimes Jews were unable to get a home loan, and typically unable to live. Red neighborhoods were primarily where people of color were able to find housing.
redlining map 2
Racial Restrictive Covenants are shown by the green dots. Racial Restrictive Covenants are primarily clustered in blue (white) neighborhoods.

What is the health impact of living in a segregated neighborhood?
Disinvestment in segregated neighborhoods causes communities of color to have less access to resources and services than white communities, contributing to poor health status. Concentrated poverty, poor quality of neighborhoods (housing quality or the built environment for example), and greater economic instability are only a few factors that influence health.

In Seattle, blue areas that were considered “ideal” neighborhoods (for example, Capitol Hill, Laurelhurst, Ravenna, West Seattle, Queen Anne, and Magnolia) have the fewest infant deaths per year, highest life expectancy, and lowest rates of low birth weight infants. Conversely, redlined neighborhoods including Rainier Valley, the International District, Georgetown, Columbia City, and the Central District, have the most infant deaths per year, lowest life expectancy, and highest rates of low birth weight infants.

A statistical analysis found that a 10% increase in the percent of plats with a racially restrictive covenant in property deeds is associated with a 2.2% decrease in the risk of low birth weight babies. Similarly, a 10% increase in the percent of a health reporting area considered a redlined neighborhood is associated with a 6.7% increase in the risk of low birth weight babies.

What about outside of Seattle?
The relationship between racial residential segregation and poorer health outcomes is seen throughout the United States, including Seattle. Many of these neighborhoods continue to have very different health outcomes because of historical residential segregation practices.

Studies from Oakland, Chicago, Cleveland, and Michigan have all reached the same conclusions: Living in racially segregated neighborhoods is linked to more infant deaths, more low birth weight babies, lower life expectancy and higher overall mortality. In Chicago, women living in poor, racially segregated neighborhoods had a 60% greater chance of having a low birth weight baby than those not living in racially segregated neighborhoods. In Michigan, black mothers living in segregated neighborhoods were 26% more likely to have a low birth weight infant.

What are we doing about it?
First and foremost, we’ve identified the problem and know where change needs to happen. Additionally, Public Health – Seattle & King County, King County’s Department of Community and Human Services and The Seattle Foundation are responding to health inequities through Communities of Opportunity. Communities of Opportunity is working in the areas of King County with the poorest health and highest poverty rates, focused on creating greater health, social, economic and racial equity in King County so that all people thrive regardless of race or place. An example of how Communities of Opportunity is addressing inequities is by intentionally investing in three areas of King County with the poorest health, housing and economic opportunities. Three organizations in SeaTac and Tukwila, Rainer Valley and White Center will receive funding for the next three to five years to implement strategies to address housing, health and economic opportunities.

Additional maps and details can be found here.

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Andrea Weiler is a Master of Public Health candidate at the University of Washington in the Community-Oriented Public Health Practice Program. She completed her practicum with Public Health – Seattle & King County’s Assessment, Policy Development and Evaluation Unit, evaluating the relationship between historical racist real estate practices and geographic differences in health. Public Health – Seattle & King County is fortunate to partner with academic institutions that allow students to practice applied public health and take on special projects.

6 thoughts on “Why 50-year-old housing practices could be linked to poor health outcomes today

  1. This is interesting but there’s a piece missing. You explain restrictions about neighborhoods and why people were segregated, but don’t explain WHY the infant weight and mortality rates were as they were. I was expecting something like: no one invested in the water pipes in those neighborhoods and they contained more lead, or, the sewer system leaked in those neighborhoods. Or lack of education (measuring high school dropouts), or absentee fathers (census), … or some other tangible thing.

    The closest you got was the vague paragraph:
    “Disinvestment in segregated neighborhoods causes communities of color to have less access to resources and services than white communities, contributing to poor health status. Concentrated poverty, poor quality of neighborhoods (housing quality or the built environment for example), and greater economic instability are only a few factors that influence health.”

    What does that mean? No libraries in those neighborhoods? Too much high-density housing? No decent doctor’s offices nearby? Need more 7-11’s? Need more parks? I don’t know, you tell me.

    What “resources and services” need to be “invested in?”

  2. Thank you, Denise. I had the very same question:
    “… there’s a piece missing. You explain restrictions about neighborhoods and why people were segregated, but don’t explain WHY the infant weight and mortality rates were as they were.”

  3. Environmental pollution is certainly one major cause of poor health. Heavy industrial traffic (diesel particulates, especially), lower quality of buildings (exposure to asbestos and lead), and lastly second hand smoke in homes with infants/ pregnancies with alcohol use.. Many of the red-lined areas had these obstacles. However, not all those living there were minorities. Blue collar class people from all races continue to feel the impact.

  4. From our staff: Divestment results in decreased resources, services, and opportunities for neighborhood residents, including the diverse areas of education, food, employment, transportation, and healthcare. Cumulatively, they all impact health. Studies from other parts of the US have found that racial segregation increases the chance that a baby will be born at low birth weight or not reach their first birthday. By understanding past policies, Public Health-Seattle & King County is working to increase opportunities for children and families throughout King County.

  5. I’m sure the current gentrification of many of these neighborhoods will improve these statistics and the great King County can brag about what they’ve done.

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