Category Archives: Racial poverty

Role of public health institutions in public health justice

PDF of slides from talk at Johns Hopkins School of Public Health.
SPH2015march.2
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…In these times of historical and current accounting of the effect of anchor institutions in community, at home and abroad, how do we speak truth to power and forge new alliances toward justice? As the field of public health grapples with the social, political, and economic determinants of health, how has a powerful institution like JHU been influential in determining neighborhood health in East Baltimore? Has the development of the institution (and others like it) contributed to the growing wealth and health gap in East Baltimore (and elsewhere)?

Come join us for a discussion with Dr. Marisela Gomez this Wednesday, April 1st at 12pm in Room E6159 for a challenging discussion critical to the past, present, and future of health equity in Baltimore and beyond.

The history of prestigious institutions and their power to exploit those most vulnerable to grow power is vast. To be truthful participants in changing this history we must account for this history and repair it. Transparency begins to hold accountable the past transgressions and find solutions beyond what our fragile human nature has succumbed to thus far. Inequitable health outcomes, arrest rates, educational achievement, income and housing value are symptoms of inequitable communities, of power and privilege. Bridging within and across all our systems-community and economic development, education, criminal, housing, recreation- of society is a large task. How do we forge a path towards equity, while assuring everyone is at the table, and contributing?

Establishing values of inclusivity, accountability, transparency,and reflection/reflexivity in all processes is important. These values must infuse and be embedded in the tools of planning/policy development, practice/praxis, evaluation, public relations/media. And most, most importantly, WE THE PEOPLE, must be involved in all steps of the process toward justice…

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If interested in any slides of presentation, send a contact.

Contemplating peaceful and skillful means to justice,
Marisela

Connecting our struggles across identity politics: a powerful force for justice

Broad-based political organizing

While only 3 months into the Western year of 2015, we have experienced more discussion of the reality of anti-blackness in America than the entire year of 2014. For that matter, 2013 as well. The new media engagement and willingness to report on racism suggests a couple of things: they finally “get it” or there are enough folks standing up and testifying to racism openly. It is unlikely, though wishful, that the media has experienced an abrupt period of enlightenment. We are hearing more about anti-blackness because of the heightened attention of the epidemic of police brutality after the Trayvon Martin case and more recently Michael Brown and the #BlackLivesMatter movement.(1) The movement immediately offered a broad platform which galvanized support from different segregated identity politics: police brutality, criminalization and discrimination of women and children, poverty, community dis-investment, lesbian/gay/bi-sexual/transgendered rights, immigrant rights. The recent outcry from several colleges on black student isolation/segregation is the most recent witnessing of the individual and institutional anti-blackness legacy in the US. But the attention to a culture of anti-blackness is broader and deeper than we may realize: the conservative bastion of medicine in America, the New England Journal of Medicine, published a commentary on “Black lives matter”; faculty members at academic institutions are speaking out about their institutional evidence of anti-blackness; pro-black equity speakers are highlighting at various universities across the US; health departments are documenting the effects of racism and poverty as factors detrimental to health equities. This broad net of protest against the dehumanizing ways society has treated black people and other marginalized communities witnesses-state sanctioned violence, the chronic dis-investment and segregation, the anti-blackness of America. Through policy and practice anti-blackness has enforced segregation and inequity which continues today. The #BlackLivesMatter campaign, formed by three women, invite a coalition of historically oppressed populations to uplift the struggle of each other to build a stronger network of support for each struggle.

Another broad-based social movement has been growing in North Carolina since 2006, increasing public protests after the Republican take-over of the legislature in 2013: Forward Together Movement/Historic Thousands on Jones Street (HToJ). (2) Their platform includes: high-quality public education, living wages, healthcare for all, racial justice, voting rights, affordable higher education, fairness for state contracting, affordable housing, criminal justice reform, environmental justice, collective bargaining and worker safety, immigrants’ rights, a new civil rights act, and bringing the troops home. Their focus has been to challenge and change the state legislative and executive body and political machinery which recently passed legislation inhibiting voter rights and slashing of public funding for social, educational, and health programs. Their movement has spread to Georgia, South Carolina. Tennessee, and Missouri and has impacted the legislation and voting turnout. Consisting of more than 150 coalition partners they continue to stage protests called Moral Mondays at the state assembly in North Carolina.

Identity politics, their connections, and why

These broad-based coalitions emphasize the interconnectedness of identity politics: injustice and oppression mediated through those with power against those without. Communities are segregated by race, income, education, housing, employability and access to recreational and transportation resources. The chicken and the egg argument can be used to describe the segregation of communities of color and its resultant economic segregation. Cities continue to gentrify and segregate by housing cost and education. (3) Here in Baltimore we rank 13th out of 50 large cities in gentrification and the resultant segregation between those with low and higher incomes; Washington, DC took a stunning 3rd place. Even though we see the direct negative outcome on funding for public education from recent public subsidies to wealthy developers who invite more racial and economic segregation, our local and state governments continue to directly and indirectly discriminate against the marginalized. These neoliberal practices of community development: policies and practices which grow the gap between the rich and the poor, drive development in the US and beyond leading to greater segregation. As reported by The Atlantic’s CityLab recently “It is not just that the economic divide in America has grown wider; it’s that the rich and poor effectively occupy different worlds, even when they live in the same cities and metros…Race is a significant factor. Economic segregation is positively associated with the share of population that is black, Latino, or Asian, and negatively associated with the shares of white residents.” (4,5)

The growth in income inequality and the resultant segregation over the last 10 years has raised awareness for some, but most are still asleep to the causes and effects. Scientific American recently commented on the reason for this “dream-like” state that Americans are in: “At the core of the American Dream is the belief that anyone who works hard can move up economically regardless of his or her social circumstances…Sure enough, people think that moving up is significantly more likely than it is in reality…..By overemphasizing individual mobility, we ignore important social determinants of success like family inheritance, social connections, and structural discrimination…We may not want to believe it, but the United States is now the most unequal of all Western nations. To make matters worse, America has considerably less social mobility than Canada and Europe.” (6)

In the 21st century, we continue to live the myth of meritocracy, that we are equally rewarded for our hard work, there is a level playing field that values each person and community similarly. One glaring example of this is the difference in housing value in black and white neighborhoods. The Brookings Institute published a comparison of wealth in white and black neighborhoods showing “wealthy minority neighborhoods had less home value per dollar of income than wealthy white neighborhoods”…“poor white neighborhoods had more home value per income than poor minority neighborhoods.” Of the 100 metropolitan areas studied, even when homeowners had similar incomes, black-owned homes were valued at 18% less than white-owned homes. In effect, the higher the percentage of blacks in a neighborhood, the less a home is worth. This correlation begins when there is greater than 10% of black residents in a neighborhood. (7) Another example of race-based development and housing value is evident by public and private investments targeted to communities which are not majority black (less than 40%) as documented in a recent study by Harvard researchers. (8) This study confirms previous studies on race-based discriminatory community development practices. Development of areas with majority residents of color do occur. However, the displacement of the existing residents and racial gentrification usually result in the neighborhood achieving a majority white status. These practices are well documented through urban renewal in the 1950’s and subsequent government housing programs like HOPE VI and Promise Zones. The 1950‘s and current Johns Hopkins Medical Campus expansion in Baltimore into almost 150 acres are examples of mass removal of more than 1500 black families using eminent domain and tax subsidies as public support. The re-population with a different race and class was the intention of both projects, further displacing low income and black residents for majority middle and market rate residents.

Power of collective resistance

Indeed the marginalization of various political identity communities do not occur in a vacuum, separate from each other. The #BlackLivesMatter and Forward Together movements remind us that the legacy of state-sanctioned violence in all its forms continue to segregate and penalize the less powerful residents of our society. A higher percentage of black-descendant people are poor and live in communities disinvested of healthy foods, competent schools and health facilities with salaries to attract competent staff, healthy environments, safe and sanitary homes, and recreational centers. Low income people of all races/ethnicities are living in similarly disinvested communities. Low income people are employed in high-turnover jobs with little job security, career opportunity, living wages and paid sick leave or time off. The criminalization of people living in low income communities far surpass those living in moderate and higher income communities. The oppression of women, those with disabilities, and sexual minorities occur across all social and economic systems. The power of coalitions to connect across the commonality of discrimination and oppression is great. When each struggle is aware and directly and indirectly support the struggle of another, there is a stronger force moving forward against all oppressive norms and practices. From state-sanctioned segregated and disinvested communities, to disinvested schools, recreation centers, public and social services, health services, to mass incarceration, the thread is a systematic violence against people deemed inferior, of diminished worth. Broad-based movements can offer a platform for various local and national issue-specific or identity political movements to connect and coalesce. Then each small act of daily individual resistance becomes the foundation for building resistance and organizational power across multiple issues; individual organizations/movements collect together to build larger networks of resistance connecting all vulnerable and historically and currently oppressed groups. This type of network of resistance reinforces resilience – I am my sister’s keeper and she is mine. This network of resistance is necessary to resist and change the network of violence currently enforced against all our marginalized communities.

1. #BlackLivesMatter

2. Forward Together Movement, North Carolina

3. Governing. Gentrification

4. The Atlantic.City Lab. Economic segregation

5. New York Times. Income inequality is bad for your health

6. Brookings Institute. Segregation and housing value

7. Scientific American. The myth of the American Dream

8. Jackelyn Hwanga and Robert J. Sampsona. Divergent Pathways of Gentrification: Racial
Inequality and the Social Order of Renewal in Chicago Neighborhoods. American Sociological Review 2014, 79(4) 726–751

Educational and geographic segregation, generational racial poverty: can we build something different in Baltimore?

The gap between the educated and uneducated, segregated by place or geography, is not new to America. This new study by Diamond out of Stanford University however confirms that there is greater geographic segregation between those with and without education and access to resources over the past 20 years. (1) Per the report the current income gap between those with and without a college education is 75% and results in an affordability gap, in housing, education, and other amenities. This results in neighborhoods and cities becoming more segregated by education and income. “Rising college share then improves local amenities and productivity, leading to a more desirable city, which again benefits the college educated at the expense of lower skill workers forced to relocate elsewhere. These types of policies force the local policy maker to decide whether he or she wants to improve the city at the possible expense of less skilled inhabitants’ economic well-being.” The study confirms that the lack of sufficient resources in low-income neighborhoods and the resultant place-based inequities that predict health disparities. (2) What is lacking in the analysis is how racial dynamics affects this current and future segregation/gentrification of our neighborhoods and cities.

However, what we do know from the recent study by Alexander and colleagues out of Johns Hopkins University (The Long Shadow: Family Background, Disadvantaged Urban Youth, and the Transition to Adulthood) is that while those born into poverty are likely to remain in generational poverty in adulthood, African Americans born into poverty are much more likely to remain in poverty than their white counterparts born into poverty. (3) This data confirms anecdotal reports through almost 30 years of tracking of 800 children born in neighborhoods of low-income in Baltimore and represents a pattern across similar cities in America. Such patterns include a 30% employment gap between white and black men in the little remaining blue-collar jobs in Baltimore; 49% employment gap between whites and blacks who had dropped out of school; 100% income gap between low-income whites and blacks even while low-income white men had the lowest rate of college attendance or completion compared to low-income black men in the study. Findings from the study also confirm that low-income black neighborhoods were more likely than low-income white neighborhoods to be negatively impacted by urban renewal practices, resulting in displacement and severed social networks.

Many of us like the neighborhood feeling of Baltimore. But our neighborhoods are segregated and difficult to ignore, if we are a little awake. The Baltimore Neighborhood Indicator Alliance 2012 data confirms that our city is segregated:

Neighborhood Families living in poverty (%) Income (K)
Greenmount 38 21

Perkins/Middle East 27 19

Roland Park 0 90

Mt. Washington 0.8 72

Canton 2 77

Southeast 20 29

Yes, we have some historic and present day challenges. We know this from talking to folks who hold the history and we know this from research, in and outside of the city. How are we going to build a new Baltimore that is less segregated and not continuing a well-documented and current history?

The Mayor recently declared that its ‘institutional partners’ of universities will change Baltimore for the better through bringing new residents to Baltimore. We are wondering who it’s being changed for? (4) According to these studies, without clear intention to assure affordable housing, access to quality education and the resources to support a child ready to learn, and employment opportunities for low-skilled and non-college educated residents of all races, Baltimore will continue the current path of gentrification and racial inequity. One look around the gentrifying areas of Harbor East and Middle East Baltimore provides us a vision of the future of a rebuilt Baltimore: $10 latte in Harbor East and $200K luxury condominiums in Middle East tells us who we are marketing the city to.
The recent negotiations between low-wage workers at the Johns Hopkins Hospital which resulted in some workers still unable to afford health insurance and homes in neighborhoods supporting well-being, hints at a continued path of income and geographic inequity via a leading employer and institutional partner who refuses to set an example to all new businesses that Baltimore is a city that demands the right to a living wage.(5) (According to research out of MIT, a livable wage in Baltimore Maryland for one adult with one child is $22.88, with two adults and one child, $20.51; the hospital agreed to a top $15 for employees of 20 years (6)) The privatization of public housing in Baltimore with no assurance that they remain affordable in perpetuity and new development with limited time-periods for affordable housing prices places current low-wage earners at risk of future displacement. (7)

The plan to rebuild Baltimore by increasing the population- by attracting a different race and class which separates out based on education, income, and race- without a plan to prevent gentrification and further segregation commits the city toward a continued gap between the haves and have nots.

With no real government oversight to assure affordable housing and access to quality education is permanent, local hire and livable wages as mandatory rules of engagement with current and future development, it is hard to imagine how low-skilled and non-college educated residents will be able to afford the new Baltimore. We have not assessed the current rental needs of existing residents to assure that sufficient affordable housing is available. WIthout knowing the needs it is difficult to plan to assure that sufficient affordable housing is built. Targeted development dollars and tax subsidies which assure sufficient affordable housing, local business opportunity which matches the market needs of low-income residents, access to quality education and training to assure competition in the changing workforce, adequate social and health programs which prepares the workforce, and living-wage employment that assures self-sustainability must be part of a plan to rebuild a different Baltimore. Until town hall meetings, city legislation, the media outlets, neighborhood groups, education and health groups, private and government policy and funding address these vital anchors of equitable community rebuilding to assure all its residents can stay and participate in a changing Baltimore, we are simply orchestrating the disposal of the most vulnerable to attract the more powerful. Basically, we are not doing anything different.

There is wisdom in learning from history and yet our elected leaders and resourced elites, blinded by the camouflage of bright lights, new buildings, and greed, seem to have missed this opportunity for change. Is it too early to predict that another generation is being ushered into poverty even while the intellectuals continue to churn out data, theorizing the exact percentages that may escape, and why? We have the data, we have people telling their stories; we simply need the political will and the compassionate understanding that until we all have an opportunity to participate for change, nothing fundamentally changes for those absent from the negotiations. And yes, we have the resources!

1. Educational and geographic segregation
2. Segregated neighborhoods and health inequities
3.The Long Shadow
3b. The Root: White privilege extends to the poor
4. Institutional partnership to rebuild Baltimore
4b. Institutional partner rebuilds for the privileged
5. The Real News Network: Unfinished negotiations between Hospital workers and Hopkins Hospital
5b. In These Times: Hospital union claims victory in Johns Hopkins Contract Fight
6. Living Wage in Baltimore, Maryland; MIT
7. Privatizing public housing in Baltimore: RAD speak-out