Lasting effects of redlining: The association of historical redlining and cognitive function in older Black adults.

BACKGROUND

Residing in a formerly redlined community is often associated with worse health. Few studies have studied redlining and late-life cognition; none have examined multiple cognitive domains.

METHODS

Black older adults (N = 676, mean baseline age 74.1 [SD: 6.5] years, 78.2% female) from two cohorts in Chicago, IL completed annual cognitive assessments of episodic, semantic, and working memory, perceptual speed, and visuospatial ability. Baseline geocoded addresses were matched to historic Home Owners' Loan Corporation grades ("best," "still desirable," "definitely declining," and "redlined" [first two combined in analyses]). Grades served as place-based proxies for the culmination of decades of policies that heavily impacted redlined communities. Linear mixed-effects models tested associations between grade and change in global and domain-specific cognition, adjusting for age, sex, and years of education.

RESULTS

Compared to those in communities graded as "best/still desirable," participants in redlined communities had lower initial global cognition (β = 0.14, SE = 0.05, p = 0.01), though there were no differences for those in "definitely declining" communities, or differences in the rate of longitudinal change. For cognitive domains, those in redlined communities had lower initial episodic and working memory (β = -0.13, SE = 0.07, p = 0.04 and β = -0.17, SE = 0.08, p = 0.03, respectively), but slower decline in semantic memory (β = 0.03, SE = 0.01, p = 0.04) compared to those in "best/still desirable" communities. Results remained consistent when considering potential mediators related to health status, present-day community resources characteristics, and spatial correlations.

CONCLUSIONS

Residing in a historically redlined community is associated with cognition in older Black adults, indicating importance of historical community context, though these results are nuanced.