In order to deal with issues like health, don’t focus on race but place and residential segregation

Researchers examined health in two Baltimore neighborhoods and argue that it is not race that leads to different health outcomes but rather the places themselves:

LaVeist and several colleagues tested this idea by examining the counterfactual: If society weren’t segregated, would health disparities still exist? They identified a low-income community in Southwest Baltimore, spanning two census tracts, that is fairly equally divided between black and white residents (out of deference to the neighborhood, LaVeist doesn’t name it). The median household income in the area was less than $25,000 during the 2000 census. It has no pharmacy, no practicing physicians or dentists, no supermarkets, and no banks.

Within this integrated community, the researchers found that health disparities all but disappear. There was no significant difference in diabetes rates, or obesity rates among young women (a metric on which large gaps exist nationally). There did remain a difference in hypertension rates, albeit it a much narrower one than national data shows. The lone exception: Whites in this community smoked at a significantly higher rate than blacks.

This suggests that what the national statistics are really telling us is that minorities live in much higher numbers in unhealthy neighborhoods. And that means that in trying to address health disparities nationally, we’ve been looking for the answers to the wrong question. We should be asking what’s going on in these communities, not what’s going on within minority populations.

“Solutions to health disparities are likely to be found in broader societal policy and policy that is not necessarily what we would think of as health policy,” LaVeist says. “It’s housing policy, zoning policy, it’s policy that shapes the characteristics of communities.”

While this sounds like interesting research (though it only covers two neighborhoods?), haven’t sociologists been talking about this for years? In fact, Massey and Denton made just this point in American Apartheid back in the early 1990s:

Our research indicates that racial residential segregation is the principal structural feature of American society responsible for the perpetuation of urban poverty and represents a primary cause of racial inequality in the United States.

If as a country we really wanted to deal with disparities in education, jobs, opportunities, health, and more, then the problem of residential segregation is the one that needs to be tackled. Local decisions about zoning and resource allocation also matter. Simply dealing with the health concerns without addressing the whole neighborhood can only get us so far.

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