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Impact of structural racism on hospital/clinic closures, community assets, and health outcomes in urban communities

Award Number: R01MD018012
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Impact of structural racism on hospital/clinic closures, community assets, and health outcomes in urban communities - Project Summary/Abstract Structural racism, defined as the ways in which societies foster discrimination through mutually reinforcing inequitable systems, has emerged as an important social risk factor and contributor to poor health outcomes for racial/ethnic minorities (Egede 2020, Bailey 2017). Structural racism captures upstream historic racist events (such as slavery, black code laws, Jim Crow laws, and school segregation) and more recent state sanctioned racist laws in the form of redlining. Redlining refers to the practice of systematically denying various services to residents of specific neighborhoods/communities, often based on race/ethnicity (Bailey 2020). A first important link between historic redlining and health outcomes is likely related to health care access in the form of accessible hospital and neighborhood clinics, as well as the quality of these facilities. A second important linkage between historic redlining and health outcomes is likely associated with the way in which structural racism (in the form of redlining) has systematically deprived neighborhoods of economic opportunities, and as such, of the ability to build individual and community assets in the form of housing value, employment, and educational opportunities for its residents. These linkages between structural racism, access, community assets, and health disparities, are furthermore of significant current policy relevance as recent trends indicate a growing number of hospital and clinic closures due to the COVID-19 pandemic (Ellison 2021). However, the link between historic redlining and urban hospital and clinic closures as well as community assets and community health outcomes are poorly understood. The goal of this project is to inform our understanding of the pathways between structural racism (defined as historic redlining), urban hospital and clinic closures, community assets, and health outcomes; and to further inform policies that can help reduce the impact of structural racism on health disparities caused by hospital and clinic closures. The present study seeks to accomplish this objective by using recently developed causal and interpretable machine learning methods, along with econometric counterfactual analysis, to address the following aims: 1) Examine the relationship between regional exposure to structural racism and the propensity of hospital and clinic closures. 2) Examine the relationship between hospital and clinic closures and community employment, income, and education, as well as community health outcomes. 3) Predict risk of closure among urban hospitals and clinics that are disproportionately serving racial/ethnic minorities from neighborhoods with exposure to structural racism. 4) Undertake stakeholder engagement to address prevention of future closures and/or examine ways to decrease the potential adverse community impact of hospital and clinic closures. The study is innovative in its examination of the linkages between structural racism and health outcomes; its emphasis on identifying policy channels for reducing the perpetual impact of structural racism; and its methodological use of a broad set of mixed methods to achieve these aims.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	002	2	2/14/2025	NON-COMPETING CONTINUATION	-$212,052
2025	2024	THE RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK	520 LEE ENTRANCE STE 211	AMHERST	NY	14228	ERIE	USA	Minority Health and Health Disparities Research	000	3	2/14/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2025	2024	THE RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK	520 LEE ENTRANCE STE 211	AMHERST	NY	14228	ERIE	USA	Minority Health and Health Disparities Research	003	3	2/14/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$577,252
2025	2024	THE RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK	520 LEE ENTRANCE STE 211	AMHERST	NY	14228	ERIE	USA	Minority Health and Health Disparities Research	004	3	2/24/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2025	2023	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	001	1	2/14/2025	NEW	-$365,200
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $635,889 )
2024	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	003	2	9/23/2024	NON-COMPETING CONTINUATION	-$423,837
2024	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	001	2	1/25/2024	NON-COMPETING CONTINUATION	$590,000
2024	2024	RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK, THE	520 LEE ENTRANCE STE 211	AMHERST	NY	14228	ERIE	USA	Minority Health and Health Disparities Research	004	3	9/23/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$423,837
2024	2024	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	002	2	6/4/2024	NON-COMPETING CONTINUATION	$45,889
2024	2023	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	000	1	10/24/2023	NEW	$0
														Subtotal = $635,889

Issue Date FY: 2023 ( Subtotal = $662,782 )
2023	2023	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	000	1	7/5/2023	NEW	$662,782
2023	2023	THE MEDICAL COLLEGE OF WISCONSIN, INC.	8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	MILWAUKEE	USA	Minority Health and Health Disparities Research	001	1	9/26/2023	NEW	$0
														Subtotal = $662,782

Grand Total All Awards = $1,298,671

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Impact of structural racism on hospital/clinic closures, community assets, and health outcomes in urban communities

Award Number: R01MD018012

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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