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COVID-19 exposes inequities dating back to redlining era

The COVID-19 pandemic has exposed inequities within the health care system, but inequities in health and wealth date back generations.

LOUISVILLE, Ky. — While Hikes Point and Parkland are separated by just 10 miles, the experiences of people growing up in those neighborhoods can feel worlds apart.

A real estate attorney who works with nonprofits like Habitat for Humanity and the Louisville Urban League, John Borders Jr. is an expert on home ownership and real estate transactions.

Though he often works with people in west Louisville, the Hikes Point native said he only recently began to understand the disparity of wealth between the city’s Black and white communities. 

“I was really shocked to learn that it wasn’t just racist individuals who discriminated, but it was in conjunction with the government,” Borders said. 

That discrimination is what is referred to as redlining. 

The Homeowners Loan Corporation was created under President Franklin D. Roosevelt’s New Deal to let people borrow money in order to own homes. Residential security maps were created, with the help of real estate agents, to color code different neighborhoods. 

A map of Louisville from 1938 shows neighborhoods colored green, blue, yellow and red. Green meant to invest, while red meant the area was too risky. 

Credit: Louisville Metro Government

Though the government said the designations were based on a multitude of factors, the primary factor was who lived in those communities. If neighborhoods had more Black people — or were even in closer proximity to Black people — they were marked down. 

“The government recognized that homeownership was a good thing, but the government was also filled with people who were white supremacists,” Borders said. “They created opportunities for white citizens, and they neglected opportunities for Black citizens.” 

Redlining made it extremely difficult for Black Americans to receive loans, instead giving money to white people, like Borders' parents. 

"I have the opportunities that I have today because my parents had the opportunities they had, that they gave me,” said Borders. 

While redlining may seem like a lifetime ago, homeownership is the primary way most people build wealth. If a Black family was not afforded the same opportunities a white family was, it could affect generations. 

“How do you get out of being low-income and lower than the middle class,” Borders said, “when for generations your family has been in that designation?” 

But that wasn’t the only problem to come from redlining. When the government said a neighborhood was unsuitable for investment, it could dissuade restaurants from opening there, encourage grocery stores to go elsewhere or result in fewer parks and tree canopies. 

The effects of redlining can be seen in west Louisville, a collection of predominantly Black neighborhoods still fighting to attract businesses, access fresh and affordable foods and get the health care they need. 

"It's been pretty desolate for quite a few years and that makes it difficult for everything,” said Dr. Mark V. Burns, an infectious disease specialist with UofL who grew up in west Louisville. 

Burns has been practicing medicine for more than 30 years, his journey spurred by seeing a lack of health care opportunities growing up. 

"I do remember growing up, any issues, any problems you had, everybody had to go downtown to the general hospital,” Burns said. “Health care wasn't really emphasized that much, not until you got sick and that's when you sought care." 

These days, Burns has his hands full fighting the coronavirus pandemic and working on getting people vaccinated, especially those in underserved communities like west Louisville. The pandemic, he said, highlighted a problem he’s known for decades. 

"There aren’t that many providers that are present there,” Burns said. “This has been a problem for generations.”  

Burns said the Park DuValle Community Health Center, which opened in the late 60s, was the only place people in west Louisville could get adequate medical care for much of his life. 

“When they founded the Park DuValle Center to be located predominantly in the west end, that was a godsend for so many, many families,” Burns said. 

Credit: Ann Hagan-Grigsby
Park DuValle Community Health Center's old location

Park DuValle is a federally qualified health center that offers primary care, prenatal care, dental care, psychiatry and pediatrics — in addition to a pharmacy, labs and x-rays. 

“Park DuValle Health Center helped start EMS. They had the first ambulance service,” said CEO Ann Hagan-Grigsby. 

Hagan-Grigsby has worked at the center since 1992. Growing up in Washington, DC, she understood healthcare inequity is not a problem unique to Louisville. 

"I grew up a foster child,” Hagan-Grigsby said. “Then I got adopted and I saw my own adopted mother die before she was 65 because she didn't have access to health care." 

While her center and other federally qualified health centers are a step in the right direction in providing care for underserved communities, she said more still needs to be done — especially when it comes to battling the COVID-19 pandemic. 

Hagan-Grigsby said she is in serious need of more vaccines. The center gets around 100 doses a week, which is not enough to vaccine their patients.

"One hundred doses a week is not going to meet the need,” Hagan-Grigsby said. “It would take 30 weeks to do 3,000 people."

Both she and Burns said another hurdle they have faced is hesitancy or confusion surrounding the vaccines. Much of that fear stemming from the government's Tuskegee Study of Untreated Syphilis, a study where researchers left Black Americans untreated for syphilis despite promising free medical care. 

Burns said direct outreach is key in overcoming these barriers. He said it is important to be transparent, explaining that experiments must now go through a review board to ensure it will not harm people. 

Additionally, Burns said first-hand experience will foster more trust. He said it is important for Black physicians and community leaders should show their vaccination experience to make sure every person feels safe, and make sure everyone has at least been offered the opportunity to be vaccinated.

"I am ready, willing and able to go door-to-door, person-by-person throughout the west end,” Burns said.

Borders, Burns and Hagan-Grigsby all agreed that there are more issues to tackle beyond the pandemic. While building more clinics will provide more opportunities for health care, it does not solve all of the problems redlining helped build. 

While redlining practices are illegal now, Borders noted the country saw predatory lenders encouraging Black families to take out expensive loans with high interest as recent as 2008 — eating up their equity and causing them to lose their homes after the financial crisis.  

“Poverty takes its toll on people in ways that are uncalculatable,” Borders said. “You are less likely to be physically and mentally healthy [and] well educated — and those things give you an opportunity to find a better job and better place in life.” 

Better health, more affordable housing and access to fresh foods, and better paying jobs could lead to opportunities redlined away many decades earlier.

"If we eliminate the issues of poverty, systemic racism and lack of education attainment, all of this goes away,” Hagan-Grigsby said. 

But communities redlined out of those opportunities decades ago need to be given the chance to have those opportunities.

"We can make better choices if we have more choices to make,” Burns said. 

Kentucky has opened up COVID-19 vaccines to everyone in Phase 1C, and Gov. Andy Beshear said he believes the state can open up appointments to every adult who wants one by May 1. To find more information on where to get a shot, click here

Several local organizations are working to help address inequity in homeownership. Borders recommended services offered by the Louisville Urban League, LHOME, River City Housing and Habitat for Humanity

For more information on the Park DuValle Community Health Center and its services, click here

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