本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-2496

摘要内容如下：

背景

划红线始于20世纪30年代的房主贷款公司（HOLC）；这种歧视性做法限制了抵押贷款的可获得性，加剧了今天仍然存在的集中贫困。了解联邦政府批准的种族隔离对健康的潜在影响非常重要。

客观

研究历史划红线政策与当今非自杀性枪支死亡之间的关系。

设计

将房主贷款公司的地图与2014年至2022年的非自杀性枪击死亡事件的发生率进行叠加。多水平负二项回归模型测试了现代枪击死亡事件与房主贷款公司历史等级（A[“最佳”]至D[“危险”]）之间的关联，控制年份、房主贷款公司地区人口统计数据和州级因素作为固定效应和城市的随机截距。每10万人的发病率（IRS）、发病率比率（IRRs）和每个HOLC等级的调整后的IRRs（AIRRs）使用A级地区作为参考进行估计。

设置

20世纪30年代住房贷款公司对202个城市的面积进行了分级。

参与者

房主贷款公司评估的8597个地区的人口。

测量

非自杀性枪击死亡。

结果

从2014年到2022年，在HOLC分级地区共发生了41428起非自杀性枪击死亡事件。随着HOLC等级从A到D，火器致死率增加。在A级地区，每年每10万人的IR为3.78（95%CI，3.52至4.05）。在B级地区，相对于A级地区的IR、IRR和AIRR分别为每年每10万人7.43（CI，7.24至7.62）、2.12（CI，1.94至2.32）和1.42（CI，1.30至1.54）。在C级地区，这些值分别为每年每10万人11.24（CI，11.08至11.40）、3.78（CI，3.47至4.12）和1.90（CI，1.75至2.07）。在D级地区，这些值分别为每年每10万人16.26（CI，16.01至16.52）、5.51（CI，5.05至6.02）和2.07（CI，1.90至2.25）。

局限性

枪支暴力档案依赖于媒体报道和警方报告。

结论

80年前的歧视性划红线政策与今天的非自杀性枪支死亡有关。

主要资金来源

弗雷德·洛夫乔伊·豪斯研究和教育基金。

英文原文如下：

Abstracts

BACKGROUND  Redlining began in the 1930s with the Home Owners' Loan Corporation (HOLC); this discriminatory practice limited mortgage availability and reinforced concentrated poverty that still exists today. It is important to understand the potential health implications of this federally sanctioned segregation.

OBJECTIVE  To examine the relationship between historical redlining policies and present-day nonsuicide firearm fatalities.

DESIGN  Maps from the HOLC were overlaid with incidence of nonsuicide firearm fatalities from 2014 to 2022. A multilevel negative binomial regression model tested the association between modern-day firearm fatalities and HOLC historical grading (A ["best"] to D ["hazardous"]), controlling for year, HOLC area-level demographics, and state-level factors as fixed effects and a random intercept for city. Incidence rates (IRs) per 100 000 persons, incidence rate ratios (IRRs), and adjusted IRRs (aIRRs) for each HOLC grade were estimated using A-rated areas as the reference.

SETTING  202 cities with areas graded by the HOLC in the 1930s.

PARTICIPANTS  Population of the 8597 areas assessed by the HOLC.

MEASUREMENTS  Nonsuicide firearm fatalities.

RESULTS  From 2014 to 2022, a total of 41 428 nonsuicide firearm fatalities occurred in HOLC-graded areas. The firearm fatality rate increased as the HOLC grade progressed from A to D. In A-graded areas, the IR was 3.78 (95% CI, 3.52 to 4.05) per 100 000 persons per year. In B-graded areas, the IR, IRR, and aIRR relative to A areas were 7.43 (CI, 7.24 to 7.62) per 100 000 persons per year, 2.12 (CI, 1.94 to 2.32), and 1.42 (CI, 1.30 to 1.54), respectively. In C-graded areas, these values were 11.24 (CI, 11.08 to 11.40) per 100 000 persons per year, 3.78 (CI, 3.47 to 4.12), and 1.90 (CI, 1.75 to 2.07), respectively. In D-graded areas, these values were 16.26 (CI, 16.01 to 16.52) per 100 000 persons per year, 5.51 (CI, 5.05 to 6.02), and 2.07 (CI, 1.90 to 2.25), respectively.

LIMITATION  The Gun Violence Archive relies on media coverage and police reports.

CONCLUSION  Discriminatory redlining policies from 80 years ago are associated with nonsuicide firearm fatalities today.

PRIMARY FUNDING SOURCE  Fred Lovejoy Housestaff Research and Education Fund.

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