Mortgage discrimination and preterm birth among African American women: An exploratory study

Objective: To examine whether mortgage discrimination, or redlining, is a risk factor for preterm birth among African American women in Chicago, and how it is related to racial residential segregation. Methods: This was a retrospective cross-sectional study in Chicago, Illinois, 1989–1991. African American mothers (n = 33,586) in the Illinois Transgenerational Birth File were linked to the 1990 census and the 1990–1995 Home Mortgage Disclosure Act database. Logistic regression models assessed the relationship between redlining and preterm birth rates. Results: Preterm birth rates were higher among African American women in redlined areas (18.5%) vs. non-redlined areas (17.1%). Unadjusted and adjusted odds ratio for preterm birth among African American women in redlined neighborhoods, compared to non-redlined neighborhoods, were 1.08 (95% CI 1.03-1.14) and 1.12 (1.04-1.20), respectively. By level of racial residential segregation, preterm birth rate was elevated (18.2%) in redlined, high-proportion African American areas compared to non-redlined high-proportion African American areas (16.7%), redlined low- (16.2%) and mid-proportion (16.1%) African American areas. Conclusions: Mortgage discrimination may be an important measure of institutional racism to be used in understanding racial disparities in preterm birth.