Life
Racism is hardly a hidden part of America's consciousness at the moment. On the contrary, it's increasingly visible in alt-right pockets all over the country. But racism goes deeper, as we all know, than public displays. It's systematic and structural. A huge example is modern segregation, where people of color have been consistently geographically disenfranchised, isolated, and kept in areas with fewer resources and worse quality of life. And segregation has big implications for the health of Black Americans — particularly kids.
It's time for a history lesson. Segregation, always a part of America's cultural fabric, accelerated in the early 20th century; as Black Americans moved from rural areas to cities in great numbers, municipalities were allowed up to have apartheid-esque policies about separating Black and white housing and services. This wasn't an accident, explained expert Richard Rothstein to Smithsonian Magazine earlier this year: "Segregation in every metropolitan area was imposed by racially explicit federal, state and local policy, without which private actions of prejudice or discrimination would not have been very effective." Today, segregation is not put in place by law, but rather by discriminatory housing practices (enabled originally by those explicitly racist policies).
It's a rotten part of American history, and it's still ongoing. Heavily segregated minority neighborhoods have had less access to good roads, street lighting, healthcare, commuting, groceries, schools, and everything else that matters about where you live. And, crucially, living in a segregated area has bad health outcomes, too — and we're only discovering the extent now.
Segregation Has Other Health Consequences
The science proving that segregation is particularly bad for Black health outcomes across America is significant, to put it mildly. Segregation is linked to higher blood pressure and a higher likelihood of obesity in Black adults, and has a particularly negative association with poverty. Those Black families who live in very low-income segregated neighborhoods, according to an upcoming study in Social Science & Medicine, are pretty heavily disadvantaged when it comes to health outcomes (those in higher-income segregated neighborhoods are a little more protected, though). And these effects occur across different minority groups: segregation of U.S.-born Latinxs is also linked to poor health outcomes.
The problem is also very American in scope. Research by DePaul University in 2017 compared Toronto with Chicago, one of the most historically segregated cities in the entire country, and found something interesting. Toronto's neighborhoods, regardless of their racial composition, had the same average levels of low birth weights (which is a risk factor for poor health later in life, and can be associated with poverty, alcohol and smoking). Chicago's low birth weights, however, differed radically from district to district. The more racially segregated the area, the study found, the smaller the babies. "Toronto has broken the link between segregation and low birth weight," the lead researcher told the press. The problem, they suggest, is that segregation and poor healthcare in America combine to mean something very problematic, and that has very poor results for children in particular.
Solving the issue is complex. Professor Florence Roisman at Indiana University suggested a variety of possibilities in a paper, from fixing the Fair Housing Act to withholding federal funding for communities who can't show that their neighborhoods are desegregated. But considering the current administration's priorities, it's likely we'll be dealing with the consequences of segregation across America for decades to come.