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Some have attributed this to socioeconomic or biologic factors; however, racism, specifically historical redlining, a U.S. discriminatory mortgage lending practice in existence between the 1930s and the 1970s, may have actuated and then perpetuated poor asthma-related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To link historical redlining (institutional racism) to contemporary environmental quality\u2013 and lung health\u2013related racial inequity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Leveraging a broadly recruited asthma registry, we geocoded 1,034 registry participants from Pittsburgh\/Allegheny County, Pennsylvania, to neighborhoods subjected to historical redlining, as defined by a 1930s Home Owners\u2019 Loan Corporation (HOLC) map. Individual-level clinical\/physiologic data, residential air pollution, demographics, and socioeconomic factors provided detailed characterization. We determined the prevalence of uncontrolled and\/or severe asthma and other asthma-related outcomes by HOLC (neighborhood) grade (A\u2013D). We performed a stratified analysis by self-identified race to assess the distribution of environmental and asthma risk within each HOLC grade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>The registry sampling overall reflected Allegheny County neighborhood populations. The emissions of carbon monoxide, filterable particulate matter &amp;lt;2.5 \u03bcm, sulfur dioxide, and volatile organic compounds increased across HOLC grades (all P\u2009\u2a7d\u20090.004), with grade D neighborhoods encumbered by the highest levels. The persistent, dispersive socioenvironmental burden peripherally extending from grade D neighborhoods, including racialized access to healthy environments (structural racism), supported a long-term impact of historical\/HOLC redlining. The worst asthma-related outcomes, including uncontrolled and\/or severe asthma (P\u2009&amp;lt;\u20090.001; Z\u2009=\u20093.81), and evidence for delivery of suboptimal asthma care occurred among registry participants from grade D neighborhoods. Furthermore, elevated exposure to filterable particulate matter &amp;lt;2.5 \u03bcm, sulfur dioxide, and volatile organic compound emissions (all P\u2009&amp;lt;\u20090.050) and risk of uncontrolled and\/or severe asthma (relative risk [95% confidence interval], 2.30 [1.19, 4.43]; P\u2009=\u20090.009) demonstrated inequitable distributions within grade D neighborhood boundaries, disproportionately burdening Black registry participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The racist practice of historical\/HOLC redlining profoundly contributes to long-term environmental and asthma-related inequities in Black adults. Acknowledging the role racism has in these outcomes should empower more specific and novel interventions targeted at reversing these structural issues.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202112-2707oc","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T11:55:56Z","timestamp":1653479756000},"page":"824-837","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":80,"title":["Historical Redlining Impacts Contemporary Environmental and Asthma-related Outcomes in Black Adults"],"prefix":"10.1093","volume":"206","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0956-4008","authenticated-orcid":false,"given":"Alexander J.","family":"Schuyler","sequence":"first","affiliation":[{"name":"University of Pittsburgh Asthma and Environmental Lung Health Institute@UPMC and"},{"name":"Department of Environmental & Occupational Health, School of Public Health, University of Pittsburgh, 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