How Racial Inequality Fuels Chronic Illness and Malnutrition

Nutritious food is an essential part of managing chronic illness and recovering from injury and disease. Too often, though, nutritious food is seen only as a matter of personal choice – you either eat it or you don’t. The reality is, access to healthy food has as much to do with where you live — and how much money you make — as with what’s in your refrigerator.

Environmental factors that impact health and happiness are called “the social determinants of health,” defined by the Kaiser Family Foundation as “the conditions in which people are born, grow, live, work and age.” Each has a significant impact on individual and community health. And they are all influenced by racial inequality.

Redlining: What is it and how does it impact us today?

One of the most prominent examples of systemic racial inequality that influences access to healthy food is redlining: denying services based on the neighborhood in which someone lives. Redlining is well documented in the United States.

In the early 1930s, the Federal Housing Administration (FHA) began color-coding neighborhoods in cities throughout the country to determine which communities could have access to lines of credit and which could not. State governments and private businesses willingly followed along. As a result, neighborhoods outlined in red (where the process gets its name) were cut off from services other communities took for granted including mortgage lending, healthcare and supermarkets. Neighborhoods with higher proportions of communities of color were far more likely to be redlined than white neighborhoods with similar income and housing type.

This practice is well documented across Colorado including in Denver, Colorado Springs, and Pueblo.

Communities of color throughout America found themselves cut off from access to healthy food sources. That vacuum was filled by smaller groceries with higher prices and lower quality produce or by affordable fast-food chains. A lack of public transportation in these neighborhoods compounded the problem, leaving these communities with little to no choice when it came to food.

While redlining officially ended in the late 1960s, the damage remains. Research shows how redlining increased food insecurity and became a primary driver of chronic illness.

Given that these policies were first developed 90 years ago, it’s natural to wonder if things are better now. There’s a simple answer: no.

Our commitment to collaborate

Until there is a broader understanding of the drivers of chronic illness and food insecurity on a community level, there can’t be a real effort to reverse a century’s worth of harm. That’s why we’re addressing upstream challenges to health (the systemic and societal barriers that create chronic illness and food insecurity) as part of our mission.

Before the end of this year, we will complete our next multi-year organizational strategy where we will address how this shows up in our work, and in the partnerships and collaborations we will seek to build. This is an important milestone for us. We want to be part of what keeps our clients healthy today and what helps prevent chronic illness and food insecurity to begin with.

Look for more from us on our work and the social determinants of health in the months ahead.


Caves, R.W. (2004). Encyclopedia of the City. Routledge. P 560.

Eisenhauer, E. (2001). In poor health: Supermarket redlining and urban nutrition. GeoJournal, 53, 125-133.

Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009;36(1):74‐81. doi:10.1016/j.amepre.2008.09.025

Zhang M, Debarchana G. Spatial Supermarket Redlining and Neighborhood Vulnerability: A Case Study of Hartford, Connecticut. Trans GIS. 2016;20(1):79‐100. doi:10.1111/tgis.12142