How is neighborhood stability related to personal health

by Tammy

March 20, 2025

Visitor Question: Lately our city has been making a lot of noise about how come our black residents don't have as good of health outcomes as the white citizens. So far there is just noise and no action. I am kind of sympathetic about this because this is the first time I realized that the life expectancy is a lot lower for the African Americans in one part of our city than for the whole city taken together.

I am on our planning commission and this has even been brought up by one person on the commission. He said our neighborhoods had a lot to do with how healthy people are. I can sort of see that it is further to the grocery store and that means that some people don't eat as much fresh food as those who are near the store. The other planning commissioner was a little dismissive of me when I said that was the only difference I could see. What am I missing here?

Editors Reply: Before I can answer your question, I have to make a few disclaimers here, just so we are understanding one another and so that another reader does not misunderstand.

What you call "neighborhood stability" in your title really is what we would call "neighborhood quality," I think. A stable neighborhood could be one that stubbornly stays in the lowest percentile on almost every marker of a good neighborhood. It's not true that a low-opportunity neighborhood is inherently unstable, although often that is the case in the U.S. at least.

Second, we need to be careful not to assume that all black residents live in a neighborhood that is almost exclusively or even predominantly African-American, so in your case, it would be important to ask statisticians if they can sort out what part of a variation in life expectancy is due to race and what part is due to geography. Similarly, not all African-Americans live in a low-income neighborhood by any stretch of the imagination.

Nonetheless 2020 census data showed 14 percent of people of color lived in high-poverty neighborhoods compared to 4 percent of the white population. For that reason we can think in general terms about black residents suffering from the effects of poverty in neighborhoods more than white folks, even as we are mindful of the many exceptions and variables.

With that out of the way, we can talk about how a lower-opportunity neighborhood is related to personal health. As you point out, one possibility is that such neighborhoods often don't have a traditional grocery store, which carries a full array of fresh produce, meat, seafood, and dairy products. This situation, sometimes called living in a "food desert," means that people often are eating foods found in corner convenience or liquor stores. That means a diet that is too heavy on chips, candy, and soda. If they are lucky, there might be a fresh banana or apple at the checkout counter. Probably there is some milk there too if you look hard enough. Maybe there's some bologna.

While you and I may say well, just go out of the neighborhood to a real grocery store. However, in lower-income neighborhoods, it's not unusual to see a high rate of automobile breakdowns and not enough public transportation. Regarding transit, even if there is a bus line two blocks from a residence, it's hard to carry a week's groceries for even that distance. These are the factors that may lead to a low-quality diet.

Next, if the lower-income neighborhood also experiences a high incidence of crime, a situation that unfortunately is not unusual, people may be more reluctant to go outdoors to walk or seek out other recreation and exercise possibilities in a park. Another aggravating situation that I see around where I live is that the less privileged neighborhoods often have poor quality sidewalks or sometimes no sidewalks, which further decreases the convenience and pleasure of walking. If income is limited, gym memberships usually are not in the cards.

Speaking of crime, which unfortunately correlates to some extent with lower incomes, obviously assaults have a bad effect on health outcomes. Even if an individual is not a direct crime victim, trauma can result from too much direct exposure to crime, and trauma can lead to mental health and physical health issues. In major cities, too often officials trivialize the importance of crime in what are popularly perceived as lower quality neighborhoods.

Low-income and low-opportunity neighborhoods tend to have a higher than average incidence of housing quality issues simply because money for preventive maintenance is scarce. Obviously this too can lead to health issues, if temperature control is unpredictable, rodent and insect infestations are nearly unavoidable because they are general to the neighborhood, or mold and mildew are allowed to get out of hand. Residents may not have the resources to deal with these situations when they arise or as soon as they are noticed.

Notice how these examples all would impact well-heeled black families that live in a low-income neighborhood almost as much as their neighbors who are not as well off financially. Lack of grocery stores, crime, and poor housing quality leading to diminished property values affect wealthy and poor alike. And each may lead to worse health outcomes.

Add to these neighborhood effects some of the outright discrimination that still happens in some places in our society, including in the healthcare system itself.

Altogether these are some of the factors that could account for the statistical lower life expectancy among your black population. I am glad to hear a planning commission discussing such things because certainly when it comes to long-range planning, you need to be thinking of creative ways to bust up these unfortunate patterns and create incentives for good food and healthcare systems in historically or predominantly black neighborhoods.

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