The Sick Side of Town



RACIAL AND ETHNIC health disparities are a persistent concern in the United States. These differences endure across gender, income, education, and at every point along the life course, despite national coordinated strategies to reduce them.

A growing body of innovative research from the Diversity and Health Disparities research cluster at UC Berkeley's Haas Institute for a Fair and Inclusive Society shows evidence for the missing link in our understanding of racial health disparities: neighborhood conditions. Their findings are consistent with the idea that inequality of neighborhood conditions shapes inequality in health outcomes.

Fewer trees and more asphalt creates hotter neighborhoods that endanger the health of residents who are vulnerable to extreme heat. Communities that are majority people of color and low income are exposed to greater concentrations and more kinds of harmful chemicals through the air in their neighborhoods due to their proximity to local sources of pollution. Black and white disparities in hypertension and cardiovascular disease can be explained by discrepancies in neighborhood conditions and residential segregation. Investigating the impact of neighborhood differences helps us see how health is shaped by the social and physical environment, not just medical care.

Policymakers must pay attention to the effects of all policies—not just health policies—on population health outcomes. As research shows, decisions that affect neighborhood safety, air quality, tree cover, and housing affect health, too. Similarly, policies that ignore health may unintentionally cause harm to communities that are over-burdened by preventable chronic diseases. While it may seem daunting for some government agencies to consider the health impacts of their work for the first time, evidence from municipal and state governments around the country shows that it is possible and that the outcomes are worth the effort.

Racial and ethnic health disparities are a function of the way we design social and political systems, which manifests in the way we design our neighborhoods. The place we live has the potential to harm or support our health and it is up to policymakers to enact changes that will create healthier local environments for us all.