Equity Starts With Engaging Communities and Responding To Concerns
by Mike Bulger, Healthy Communities Project Coordinator, Common Ground Health, Rochester, NY
Although there is some public awareness of the higher rates of chronic disease and greater barriers to advancement that affect low-income Americans, we hear less often about how neighborhood environments are at the root of so much of the country's disparity. Emerging from historical discriminations based on race and class, and perpetuated by both conscious and unconscious ongoing biases, disadvantaged neighborhoods face a dearth of opportunities to be healthy, economically successful, and spiritually well. Inequities in infrastructure, access to affordable healthy foods and safe places to be physically active, and connectivity, far too often form walls around communities without wealth and status. It is up to planners, health professionals, academics, and policymakers, to deconstruct these walls, engage directly with individuals, and be responsive to the voices of society's most disenfranchised communities.
Inequity and engagement were recurring themes at the National Walking Summit in St. Paul, Minnesota, and for good reason. While many middle- and upper-class neighborhoods are enjoying the benefits of America’s active transportation rebirth, what speaker Charles Brown referred to as "Communities of Concern" continue to face crumbling sidewalks, faded crosswalks, blight, and isolation. Without safe places to walk, bike, or play, rates of motor vehicle crashes are startlingly higher in low-income neighborhoods. Data showing these elevated crash rates across New Jersey was presented by Mr. Brown, and is consistent with the findings of Common Ground Health in Rochester, NY. Researchers should not be surprised that these disconcerting figures are the national norm.[i] It is comparable to what we already know about the relationship between diet and income[ii], psychological trauma and income[iii], and indeed life-expectancy and zip code[iv].
In St. Paul, I walked with fellow summit attendees through the neighborhood of Rondo. Once a relatively thriving and self-sufficient African-American community, Rondo was forced to raze over 500 homes to make way for the eight-lane interstate highway that now cuts the neighborhood in half. Where railroad porters and dentists once shared a walk down residential streets to sit together in church pews, there is now a noisy thoroughfare for tractor-trailers and commuter traffic. My fellow attendees and I stood in front of one resident's house, just a few hundred feet from a school, and were forced to shout to the person next to us in order to be heard. Rondo was not the only American neighborhood subjected to the forceful will of 20th century urban planners. Today, the lasting effects of such decisions are manifest in the high rates of childhood asthma along a similarly ill-positioned trucking route in the South Bronx.[i]
People living in communities of concern continue to face public service and infrastructure inadequacies that more well-to-do neighborhoods are able to avoid. Glenn Harris, President of Race Forward, addressed the National Walking Summit with a story from his time as Manager of City of Seattle Race and Social Justice Initiative. Seattle discovered a greater prevalence of burned-out streetlights in low-income areas of the city. In response, the city’s administration was able to make a simple policy change and move streetlight replacement onto a consistent calendar, saving them money and creating a more equitable city service at the same time. In St. Paul, it was the voices of neighborhood activists from within Rondo that affected change. The community members worked together to successfully lobby for the addition of three Rondo stops to the planned light-rail route linking St. Paul and Minneapolis. The stops now connect Rondo residents with economic opportunities outside of the neighborhood, and help draw visitors to Rondo’s burgeoning collection of restaurants and businesses.
These two examples of positive change originated in different realms. The City of Seattle took an active approach to identify and address inequities among neighborhoods. In St. Paul, it was the residents of Rondo that led their own advocacy. It is incumbent upon physical activity advocates to work in both realms, and to bridge the gaps between the institutions that make infrastructure decisions and the communities that are marginalized, avoided, and neglected. This is not to say we must presume to know what is best for communities. In fact, our presuppositions about neighborhoods will often miss the mark. Instead, it is important to engage with neighborhood leaders and residents, to listen to their insight, and to involve them in planning solutions. Whether it is speeding cars, unmaintained sidewalks and crosswalks, or vacant buildings, neighbors will tell you why they don’t send kids outside to walk and play.[ii] As Rondo advocate Nieeta Presely so succinctly advised: "Don't assume. Go to the source."
[i] Smart Growth America. (2016). Dangerous by Design. Retrieved from https://smartgrowthamerica.org/dangerous-by-design/ [ii]Darmon N1, Drewnowski A. “Does social class predict diet quality?” Am J Clin Nutr. 2008 May; 87(5):1107-17. [iii] Goodman, Rachael & David Miller, M & West-Olatunji, Cirecie. (2012). Traumatic Stress, Socioeconomic Status, and Academic Achievement Among Primary School Students. Psychological Trauma: Theory, Research, Practice, and Policy. 4. 252-259. 10.1037/a0024912. [iv] Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, Morozoff C, Mackenbach JP, van Lenthe FJ, Mokdad AH, Murray CJL. Inequalities in Life Expectancy Among US Counties, 1980 to 2014Temporal Trends and Key Drivers. JAMA Intern Med. 2017; 177(7):1003–1011. doi:10.1001/jamainternmed.2017.0918 [v] New York University Medical Center and School of Medicine. "Asthma Linked To Soot From Diesel Trucks In Bronx." ScienceDaily. ScienceDaily, 30 October 2006. <www.sciencedaily.com/releases/2006/10/061017084420.htm>. [v1] Healthi Kids, “Improving Walkability around Rochester’s Schools,” Healthi Kids Report, (2015), accessed at http://www.healthikids.org/Portals/0/PortalFiles/Documents/Healthi%20Kids%20Report%20-%20Walkability%20in%20Rochester's%20Southwest%20Neighborhood.pdf.