Built Environments #16: Racial Segregation, Inequality, and Health

For the record: I wrote a paper for the health policy class in my MPH program. It fits the contents of this blog super well. This is a chunk from that paper.

The vein that runs throughout all of the federal housing policies that I described is that that they all effectively segregated American cities and intentionally forced black and Latino communities into a cycle of poverty due to their lack of housing choices and inability to pursue economic opportunities/accrue equity via housing purchases and housing choice (Godsil, 2013). Those same policies facilitated the home buying process for white Americans and facilitated the assimilation of ethnic whites into the majority (Godsil, 2013). Continuing this policy of segregation is not ethnocentrism, but the individual preferences that leave blacks, or varying incomes, as the least acceptable majority in a neighborhood and in many cases leaves blacks and black Hispanics as the least acceptable new neighbors and housing markets then reflect this bias (Charles, 2003).

Today, due largely to the Fair Housing Act, racial discrimination is not as obvious as it was during the era of redlining. However, discrimination is the housing market is still a large factor the in ability of nonwhite persons to rent or purchase housing. “Access to housing in constrained, the search process is more unpleasant (i.e., more visits, more waiting, etc.), homeseekers receive far less assistance from lenders in the mortgage application process and are more likely to have their application denied, and their moving costs are higher” (Charles, 2003). One study estimated that cumulatively blacks and Hispanics paid $4.1 billion per year higher in search costs and lost housing opportunities, including the decision of 10% of blacks, and 15% of Hispanics not to look for housing due to the warranted expectation that they will be discriminated against (Charles, 2003). Additionally, studies consistently showed that despite a higher socioeconomic status (SES) middle class black people were still living in conditions comparable to the poorest white people due to the persistence of racial segregation across black social classes and the adjacency of middle and upper-class black neighborhoods to low-income black neighborhoods, even in the suburbs (Charles, 2003) and that racial steering away from certain neighborhoods and to others is actually on the rise (Kirkland, 2008). Those studies suggest that racial segregation is not going to be alleviated without intervention.

The negative health effects associated with racial segregation are vast. Interestingly enough, in one study of 107 metropolitan statistical areas (MSA), they found that for blacks and whites the inverse association between income inequality and mortality was greater in the MSAs with high levels of black racial segregation. However, that same study found that the harmful effects of racial segregation, in this case an increase in mortality, was considerably larger for blacks in MSAs (Nuru-Jeter, 2011). Other studies found that not only is there an increase in mortality associated with racial segregation, but there is also an increase in violent injury and violent crime (Fabio, 2009).

Additionally, racial segregation has been positively associated with high poverty and low paying/status occupations among blacks, but not among whites. This would suggest that racial segregation also concentrates poverty and social/material disadvantages in neighborhoods with a high percentage of black residents. Black isolation, especially those that are low-SES, are often associated with “lower quality schools, fewer employment and economic opportunities, exposure to crime, substandard housing, exposure to toxins and pollutants, and isolation from broader social networks” (Nuru-Jeter, 2011).

The violence in urban low-SES neighborhoods has also been associated with increased rates in the occurrence and severity of asthma, especially amongst minorities in inner cities (Singer, 2003). There is also a relationship between poverty, poor childhood nutrition, and heart disease, one of the leading causes of deaths for blacks (Singer, 2003). Federal housing policy and racial prejudices created circumstances in metropolitan areas that make blacks particularly vulnerable to displacement, racial segregation, violence, and other negative health outcomes. It would stand to reason then that government is more than responsible for rectifying the conditions it has created over the course of the past eighty years.  

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