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Primary Submission Category: Structural factors
Historical Blockbusting and Contemporary Perinatal Health Disparities in California
Authors: Samantha Gailey, Richard Sadler,
Presenting Author: Samantha Gailey*
Racial and ethnic disparities in perinatal outcomes persist despite efforts to address individual-level risk factors, suggesting broader structural forces shape maternal and infant health. Scholarship on structural racism has focused predominantly on 1930s redlining, yet this represents only one component of discriminatory housing policies that shaped urban inequality. Blockbusting—real estate practices that induced rapid racial turnover in White neighborhoods during the postwar period (1950s–1980s)—profoundly restructured American cities but remains understudied in population health research. Blockbusting destabilized neighborhoods, resulting in persistent disinvestment and reduced access to resources, with potentially enduring impacts on perinatal inequities.
We examined whether residence in historically blockbusted neighborhoods corresponds with elevated risk of adverse perinatal outcomes among California births from 2007–2022 (N=6,420,047). We linked birth records to census tract-level measures of rapid mid-century racial transition and estimated odds ratios using logistic regression with robust standard errors, adjusting for individual sociodemographic characteristics and contemporary neighborhood distress.
Approximately 7% of California mothers resided in historically blockbusted tracts, with exposure highest among Black mothers (18%). After adjustment, residence in blockbusted neighborhoods corresponded with elevated odds of low birthweight (OR=1.04, 95% CI: 1.01–1.06) and preterm birth (OR=1.05, 95% CI: 1.03–1.07). Interaction models showed stronger associations between blockbusting and adverse birth outcomes among racially minoritized mothers.
These findings extend understanding of how mid-20th century discriminatory housing practices continue to shape population health inequities, suggesting that interventions addressing contemporary neighborhood conditions in historically marginalized communities may reduce perinatal disparities and inform equitable policy.