Effects of segregation negatively impact health

St. Louis remains one of the most segregated cities in the United States, as recently discussed in a BBC documentary highlighting the “Delmar Divide” as an example. It is an issue of pressing concern in a policy brief titled “Segregation: Divided Cities Lead to Differences in Health,” explaining how segregation affects access to health-promoting resources and health outcomes such as chronic disease and death.

Written by Melody S. Goodman, PhD, assistant professor of surgery in the Division of Public Health Sciences at Washington University School of Medicine in St. Louis, and Keon L. Gilbert, DrPH, assistant professor of behavioral science and health education in the College for Public Health & Social Justice at Saint Louis University, the brief is the fourth of five from a multidisciplinary study underway called “For the Sake of All: A Report on the Health and Well-Being of African Americans in St. Louis.”

“Segregation itself is not the problem,” Goodman said. “Segregation is just people of different races living in different communities. The issue with segregation is that it often causes inequality.”

Researchers argue racial and economic residential segregation results in neighborhoods with high poverty. This is associated with fewer banks investing in these areas, lower home values and poor job opportunities.

“The long-term effects of these many challenges mean that people living in neighborhoods with higher poverty have poorer health,” Gilbert said.

For example, high-poverty neighborhoods have fewer public services and are more likely to have fast-food chains, liquor stores and convenience stores, as opposed to healthy food grocers. High-poverty neighborhoods also have greater exposure to pollution and violent crime. Research shows that communities with high proportions of racial and ethnic minorities also have less access to doctors. African-American neighborhoods, specifically, often have higher rates of poverty and death from heart disease and all cancers.

“Segregation impacts so many different aspects of life and suggests so many different challenges, which is why no one policy will be the perfect fix,” Gilbert said.

A combination of policies was recommended throughout the brief:

Invest in ensuring quality neighborhoods that promote health with safe streets and sidewalks, access to fresh, high-quality foods and recreational green space for all in St. Louis.
Promote development and housing choice without displacement.
Promote the benefits of diverse neighborhoods and safeguard fair housing.

“Segregation ultimately affects an entire community, an entire city and an entire state,” Gilbert said. “We are under-investing in our own success because of some of the effects of segregation.”

The researchers stress perseverance and partnering with universities, medical centers and major companies to revitalize the city. “We must not only remain vigilant against all forms of discrimination in housing, but also promote and celebrate diversity in our neighborhoods and communities,” the brief states.

“For the Sake of All” is funded by the Missouri Foundation for Health and includes faculty from both Washington University and Saint Louis University. WUSTL’s Institute for Public Health, the Brown School’s Policy Forum, The St. Louis American newspaper and the online news site St. Louis Beacon are partners as well.

The participating scholars from WUSTL, in addition to Goodman, are:

Jason Q. Purnell, PhD, assistant professor at the Brown School and lead researcher on the project;
Bettina F. Drake, PhD, assistant professor of surgery in Public Health Sciences at the School of Medicine;
Darrell L. Hudson, PhD, assistant professor at the Brown School; and
William F. Tate, PhD, the Edward Mallinckrodt Distinguished University Professor in Arts & Sciences and chair of the Department of Education.

In addition to Gilbert, the Saint Louis University faculty partner is: