Invariably, the impact falls the hardest on low-income minorities.
Chicago has remained one of the most segregated cities in America, as this map from a new report on the intersection of place, race and health in the Second City indicates. On it, each blue dot represents 500 whites (as captured in the America Community Survey between 2005-2009), while each purple dot the same number of blacks. Yellow represents the city’s Hispanics and green the Asian population (that green concentration right in the middle of the city is Chinatown).
The map, produced by the Joint Center for Political and Economic Studies, is most noteworthy for the pattern it establishes that repeats itself throughout a number of other indicators about life in Chicago. Below is another map of the census tracts with persistent poverty over the last 40 years (with the darkest shades experiencing the most long-running poverty):
Here, the dark areas represent the highest access to chain supermarkets or large independent grocery stores with at least five cash registers. Nearly all of the neighborhoods with the lowest access are located on the city’s South Side, south of Interstate 55 in the city, in an area that is almost exclusively populated by minorities.
Zooming in on that southern half of the city, we see in dark brown the census tracts with both the lowest educational attainment and the lowest access to food.
Lastly, this is a map of life expectancy in Chicago, with the darkest areas covering residents not expected to live past 70.
Add up and compare all these maps, and a couple of alarming conclusions emerge from the new report, Place Matters for Health in Cook County. Researchers with the Joint Center for Political and Economic Studies, in conjunction with the Center on Human Needs at Virginia Commonwealth University, have found that people living in Chicago neighborhoods with a median income higher than $53,000 a year have a life expectancy almost 14 years longer than Chicagoans who live in communities with a median income below $25,000.
And because of the city’s historic segregation, this also means those people with shorter life expectancies – a proxy for poor health outcomes – are invariably minorities. This research reinforces an idea we’ve written about previously: that where you live may be the most important determinant of your health.
"Place really is the fundamental [issue]," says Brian Smedley, director of the Health Policy Institute at the Center for Political and Economic Studies. "Residential segregation is really the fundamental driver of many of the health inequalities that we see."
Life expectancy in Cook County varies by as much as 33 years, depending on your census tract. And, as the report’s authors chide: "It is unacceptable in the world's wealthiest society that a person's life can be cut short by more than a decade simply because of where one lives and factors over which he or she has no control."
The researchers also frame this problem in another way: Chicagoans with the worst access to chain supermarkets and large independent grocery stores (in the bottom quintile) have an average life expectancy that's 11 years shorter than Chicagoans with the best access to food (in the top quintile).
This doesn’t mean that when grocery stores disappear, people die prematurely. Rather, the patterns on these maps reveal that numerous forces are all intersecting in the same parts of the city: Neighborhoods with high concentrations of poverty are also the neighborhoods with the lowest educational attainment and the least access to pharmacies and food, and they’re also the neighborhoods where the city’s minorities tend to be segregated, and where the health outcomes tend to be the worst. The correlations are just too strong to ignore. As the report warns: "These place-based patterns are neither arbitrary nor benign."
These communities, Smedley says, have experienced long-running patterns of disinvestment (by grocery chains, by employers, by banks, by cities), and health inequalities appear to be one result of it.