Transcript Poverty, Race, and Health: Does Place Matter?

Poverty, Race, and Health:
Does Place Matter?
Kevin M. Fitzpatrick, Ph.D. Professor and Jones Chair in Community
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Built environment studies show clear relationships between
the physical environment and mental health outcomes.
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Chronic stress increases the risk of obesity, hypertension,
diabetes, pre-term birth, and depression.
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Mortality rates among Blacks and Latinos living in high-risk
neighborhoods are 50% higher compared to low-risk
neighborhoods.
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Children living in poverty in the United States are more likely
to develop physical and mental health problems at a rate of 56 times that of their out-of-poverty counterparts.
A Model for Understanding the
Health, Race, and Place
Relationship
A. Diez Roux and C. Mair, 2010. Annals of NY Academy of Science
1186:125-45
Place-Based Health Assumptions
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Structural factors like residential segregation continue to reinforce
significant racial and ethnic inequalities in the United States.
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Racial and ethnic inequality tied to both social and physical
environments often creating hazards and risks for all residents but
tend to be greatest among the least mobile (youth, elderly, disabled).
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Some residents are better equipped at coping with these place-based
stressors than others; money (financial capital) and friends (social
capital) matter.
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Chronic disease and mental health outcomes are significantly
impacted by these neighborhood place-based “effects”.
How Segregated Can We Get?
Detroit MSA
D = 67.8
Red =White; Blue = Black; Orange = Latino
Village Creek Context and Health
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98% African-American
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33% of households living below the poverty level
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14% of housing units are vacant
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Infant mortality rates three times greater than Jefferson county
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Chronic disease and violent death rates 25% higher than Jefferson
county
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Lead paint exposure (< 5 years old) 123% higher than Jefferson
county
Are We Doing Anything About It?
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Removal Strategies
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Community Development Strategies
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Neighborhood Health Promotion
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Building a Healthier America Program