{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:08:36Z","timestamp":1789193316971,"version":"build-2803163510"},"reference-count":77,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Historically redlined neighborhoods may experience disinvestment, influencing their likelihood of gentrification, a process of neighborhood (re-)development that unequally distributes harms and benefits by race and class. Understanding the combined outcomes of redlining and gentrification informs how the mutually constitutive systems of structural racism and racial capitalism affect pregnancy outcomes.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine if historical redlining and contemporary gentrification is associated with increased severe maternal morbidity (SMM) odds.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study used data from a statewide population-based sample of all live hospital births at 20 weeks\u2019 gestation or more between 2005 and 2018 in California. Analysis was conducted from March 2023 to January 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Redlining (as characterized by the federal Home Owners\u2019 Loan Corporation mortgage security maps) and displacement (using present-day sociodemographic and housing market information).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Mixed-effects logistic regression models were used to assess the association of census tract\u2013level exposure to historical redlining and contemporary gentrification with increased SMM odds, adjusting for sociodemographic and pregnancy related factors. Outcome classification was based on the Centers for Disease Control and Prevention SMM index, which defines SMM as having any of the 21 procedures and diagnoses based on the\n International Classification of Diseases, Ninth Revision<\/jats:italic>\n and\n International Statistical Classification of Diseases and Related Health Problems, Tenth Revision<\/jats:italic>\n codes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The study sample included 1\u202f554\u202f837 births (median [SD] maternal age, 29.0 [6.4] years; 3464 American Indian or Alaskan Native [0.2%], 224\u202f774 Asian [14.5%], 132\u202f240 Black [8.5%], 880\u202f104 Hispanic [56.6%], 312\u202f490 White [20.1%]), with 22\u202f993 cases of SMM (1.4%). Residents in historically redlined neighborhoods that were undergoing gentrification or displacement were more likely to be Black, Hispanic, and American Indian or Alaskan Native. Independent of individual-level characteristics, SMM odds were greater for individuals living in redlined neighborhoods that experienced displacement (OR, 1.21; 95% CI, 1.14-1.28) and in redlined neighborhoods undergoing gentrification (OR, 1.21; 95% CI, 1.13-1.29) compared with those in continuously advantaged neighborhoods.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Findings from this cross-sectional study demonstrate that the legacies of redlining, intertwined with current dynamics of displacement and gentrification, affect SMM. Place-based sociopolitical mechanisms that inequitably distribute resources may be important intervention points to address structural drivers of adverse pregnancy outcomes and their racial inequities.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.29428","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:32:31Z","timestamp":1727091151000},"page":"e2429428","source":"Crossref","is-referenced-by-count":17,"title":["Historical Redlining, Contemporary Gentrification, and Severe Maternal Morbidity in California, 2005-2018"],"prefix":"10.1001","volume":"7","author":[{"given":"Xing","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Morello-Frosch","sequence":"additional","affiliation":[{"name":"Department of Environmental Science, Policy and 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