The problem. A kid growing up in a poor, minority urban neighborhood starts off at a disadvantage. We all know that, right? No news there. But exactly why should that be in a wealthy country like ours? What is it about neighborhoods that explains the persistence of racial and economic inequality? What role does violence play?
With red hair, white skin, and an upbringing by dedicated parents in the affluent Massachusetts town of Andover, Patrick T. Sharkey by countenance and biography would seem an unlikely prospect to delve into this corner of the American experience.
But, of course, appearances are often deceiving, and no more so than in the case of this young Harvard PhD, who wanted to bring light to what so many comfortable souls pass by without seeing.
An early observation. Sharkey went to Andover High School, not to be confused, he will tell you, with the high-end private prep school Phillips Andover Academy, but still an institution full of privileged youngsters—though not all high-achieving ones.
“Just like any school,” he says, “there was a distribution of students ranging from the talented and hard-working to those that were not all that bright, uninterested in school, and heavily into alcohol and drugs.” As Sharkey moved through college and into early adulthood, he saw that nearly all of his classmates did fine, “including the screw-ups.”
“Some had parents that found a way to get them into college and good jobs. Others used their networks of friends and family to find good jobs, no matter how they did in high school or college. Others spent years slacking off before they figured out that they needed to get their act together, and then had lots of opportunities made available to them.
“All of my classmates had a built-in safety net that sprung into action whenever they needed it,” says Sharkey.
This safety net was built by the families’ resources and the connections and opportunities in the community. “Their mistakes didn’t lead them into prison, and didn't preclude them from going to college.”
A lesson that resonated. Sharkey was an undergrad at Brown University when he read sociologist William Julius Wilson, PhD’s, 1987 book on inner city poverty, The Truly Disadvantaged. Wilson’s message hit home, particularly his analysis of how the ghetto environment eliminates opportunities for success in life.
“I started to make sense of all of the advantages that my classmates and I experienced, and why it was that all of us were doing pretty well no matter our individual talent or work ethic.
“The idea that the roots of inequality are located in our environments, our communities, took hold in my mind. That idea has driven much of my research in the years since.”
Indeed, after a stint as a research assistant at the Urban Institute in Washington, Sharkey entered Harvard’s PhD program in sociology and social policy. Wilson and Robert J. Sampson, PhD, like Wilson a transplant from the University of Chicago, mentored him. Working with Wilson and Sampson gave Sharkey access to data on disadvantaged neighborhoods in Chicago, other cities, and the nation as a whole.
“Everything I analyzed suggested that some of the most dramatic inequalities in American society are driven by race, and neighborhoods represent the most severe form of racial inequality.”
RWJF’s Health & Society Scholars Program: the next step. In 2007, with PhD in hand, Sharkey entered RWJF’s Health & Society Scholars postdoctoral program in population health. He spent his two-year interdisciplinary fellowship at Columbia University, one of six universities participating in the program. For more information on the program, read the Program Results Report.
Sharkey applied to Health & Society Scholars “because I began to realize how the problems I was studying were not just issues of urban poverty; they were issues of health.” The best example, he says, is community violence—a major public health problem that is concentrated in communities where disease and other markers of poor health are also prevalent.
“Violence can be understood in terms of lives lost, but it is much more than that because it affects the daily experiences of children and their parents as they take part in everyday life, while being exposed to a source of constant stress,” Sharkey says.
“Being able to interact with people who focus on how stressors like violence get into the brains and under the skin of children was one of the most valuable consequences” of the RWJF program for Sharkey. “It opened my eyes to the importance of linking social processes occurring outside the individual to physiological processes occurring within.”
Case in point: homicides and cognitive skill. At Columbia, Sharkey learned about evidence that stress affects rodents’ spatial skills. “I thought about how one might look at similar stressors that occur in children’s lives, and how they may affect performance when a child sits down to take an assessment of cognitive or academic skills.”
The upshot was that using Chicago data, Sharkey compared the reading and vocabulary scores of children tested immediately following a neighborhood homicide with the scores of children from the same neighborhood tested before the homicide.
“The results from this study were remarkable,” says Sharkey. Children tested after a homicide—regardless of whether they directly witnessed it—scored substantially lower.
His follow-up studies replicated those results, and the findings received widespread attention in the popular press. “Students take academic hit when a slaying is close to their home,” read the Chicago Tribune headline. Sharkey reported on the research in a 2010 article in Proceedings of the National Academy of Sciences (107(26): 11733–11738).
“These studies set the stage for the research I’ve been doing since,” says Sharkey, who joined New York University in 2009 and is now an associate professor of sociology. “They demonstrate just how much a community stressor like violence affects the everyday lives of children, and suggest that a lot of the inequality in academic achievement or cognitive development may arise from disparities in the types of stressors to which children are exposed on a daily basis.”
In his 2013 book Stuck in Place: Urban Neighborhoods and the End of Progress toward Racial Equality, Sharkey documents that 70 percent of the African Americans living today in poor, segregated neighborhoods are from families that lived in those same conditions in the 1970s.
“The American ghetto appears to be inherited,” he writes in his book. In this and numerous other publications, Sharkey explores the reasons for—and solutions to—this unwanted legacy. (For a brief description of Stuck in Place and citations to his journal articles, published essays and other writings, see Sharkey’s personal website.)
RWJF perspective. RWJF created the RWJF Health & Society Scholars program in 2001 to build the field of population health. “There is a growing recognition that health is the result of the interaction of multiple factors including socioeconomic and physical environmental factors and health behaviors,” said Pamela G. Russo, MD, MPH, senior program officer.
“The evidence shows that these types of factors play a much larger role in determining health at the population level than do the traditionally considered health care and biological determinants of health.”
“The program seeks to integrate paradigms and knowledge from a variety of disciplines to develop an understanding of how these determinants affect the health of populations, and thereby to design interventions with greater power to reduce health disparities,” said Russo. The final cohort of scholars for the program are entering in 2014 and will complete their fellowships in 2016.