Now Viewing: Latino or Hispanic

What’s the Connection Between Residential Segregation and Health?

Apr 3, 2018, 4:00 PM, Posted by Donald F. Schwarz

Residential segregation is a fundamental cause of health disparities. We need to take steps that will reduce health risks caused by segregation and lead to more equitable, healthier communities. 

Graphic illustration depicting residential segregation from 2016 County Health Rankings & Roadmaps.

Editor’s Note: To commemorate the 50thAnniversary of the Fair Housing Act this month, we are republishing a post that originally appeared in 2016. Be sure to also check out the 2018 County Health Rankings which provide updated information on the impact of segregation as a fundamental cause of health disparities. 

For some, perhaps the mere mention of segregation suggests the past, a shameful historic moment we have moved beyond. But the truth is, residential segregation, especially the separation of whites and blacks or Hispanics in the same community, continues to have lasting implications for the well-being of people of color and the health of a community.

In many U.S. counties and cities, neighborhoods with little diversity are the daily reality. When neighborhoods are segregated, so too are schools, public services, jobs and other kinds of opportunities that affect health. We know that in communities where there are more opportunities for everyone, there is better health.

The 2016 County Health Rankings released today provide a chance for every community to take a hard look at whether everyone living there has opportunity for health and well-being. The Rankings look at many interconnected factors that influence community health including education, jobs, smoking, physical inactivity and access to health care. This year, we added a new measure on residential segregation to help communities see where disparities may cluster because some neighborhoods or areas have been cut off from opportunities and investments that fuel good health. 

View full post

Shaking Up Systems To Achieve Health Equity

Mar 17, 2016, 10:00 AM, Posted by Catherine Malone, Dwayne Proctor

In order to achieve greater health equity in America, we need to co-create solutions aimed at transforming the many systems that influence where we live, learn, work and play.

A parent reads to a group of children.

Babies born in the shadow of Yankee Stadium are likely to be lifelong fans of the Bronx Bombers. They are also likely to live seven years less than a baby born a handful of subway stops south near Lincoln Center. The same is true in Las Vegas, where a baby born near The Strip is likely to live nine or 10 years less than someone born west of town.

When it comes to health across cities, zip codes are unequal and so are health outcomes. For example, ethnic minorities continue to experience higher rates of morbidity and mortality than whites. Among the 10 leading causes of mortality in the U.S. (e.g., heart disease, cancer or stroke), minority populations experience the highest rate of death.

We write often about the disparities between population groups and the day-to-day experiences of individuals who, for a myriad of reasons—systemic, geographic or financial—do not have the same opportunity to live as healthy a life as their fellow citizens. Our goal is greater health equity in America, a process that begins with including those most affected and co-creating solutions to improve the systems that negatively impact health. The end result should be decreased health disparities.

Here at the Foundation, we know that health disparities are more often caused by systems related to non-medical determinants of health, which is why we’ve specifically invested more than $457 million since 2014 toward eliminating these pervasive gaps in health outcomes.

View full post

Community Development For and By the Community

Jul 13, 2015, 12:37 PM, Posted by Jasmine Hall Ratliff

Many families face rising rents they can’t afford. One local developer revamped an aging historic hotel into affordable housing to transform: "community development being done TO us.. to development done BY us."

Boyle Hotel before and after renovations. Before: The Boyle Hotel in disrepair. After: The Boyle Hotel-Cummings Block Apartments bring 51 new apartments to the neighborhood, all priced for people making between 30 to 50 percent of the area’s median income.

Ten years ago, Los Angeles’ Boyle Hotel was more than down on its luck. The grand old Victorian dame, built in 1889 by an Austrian immigrant and his Mexican wife, was uninhabitable. Over the years neglect had turned the stunning building with intricate period details into a ramshackle apartment house with shared bathrooms and communal kitchens. The wiring was faulty and the pipes leaked. Mold bloomed up walls. Rats scurried along the hallways. Absentee landlords racked up housing code violations, ignoring the residents’ repeated requests for basic protections of their safety and health.

Most of the tenants were older, single men: many of them mariachi musicians scraping by from gig to gig. They’d spend their weekends across the street in the plaza, as generations had going back to the 1930s, exchanging news and waiting for word of a quinceñeara or wedding where they might play. The musicians were a cultural anchor for the neighborhood, so much so that the residence was nicknamed the Mariachi Hotel.

The hotel sits at the peak of a steep hill, and if you look just beyond it you can see the full glory of downtown LA glinting in the sun. Maria Cabildo, Co-Founder and President Emeritus of the East LA Community Corporation (ELACC) and current Chief of Staff to the LA County Supervisor, saw the writing on the wall: The Boyle Hotel was bound to be snapped up by developers, and replaced by luxury rooms with a view if nobody attempted to save it. With plans for the LA Metro to extend its new light rail into the heart of the plaza, she knew that new development wouldn’t be far behind. What would the influx of business mean for the residents – mariachi musicians and families alike – who’d long called the neighborhood home?

View full post

The Front Line of Medicine

Dec 18, 2014, 9:00 AM

For the 25th anniversary of the Robert Wood Johnson Foundation’s (RWJF) Summer Medical and Dental Education Program (SMDEP), the Human Capital Blog is publishing scholar profiles, some reprinted from the program’s website. SMDEP is a six-week academic enrichment program that has created a pathway for more than 22,000 participants, opening the doors to life-changing opportunities. Following is a profile of Juan Jose Ferreris, MD, a member of the Class of 1989.

It is easier to build strong children than to repair broken men.’

The words of abolitionist Frederick Douglass resonate for Juan Jose Ferreris, a pediatrician and assistant clinical adjunct professor at University of Texas Health Science Center. He sees a straight line between the public funds allocated for children’s care and their well-being as adults.

“Kids receive less than 20 cents of every health care dollar. Meanwhile, 80 percent goes to adult end-of-life care. Why aren’t we spending those funds on people when they’re young, when it could make a genuine difference?”

Ferreris contends that money also shapes health in less obvious ways. Salaries of primary care physicians are well below those of more “glamorous” specialists. Some fledgling MDs, burdened with medical school debt, reason that they can’t afford not to specialize. Consequently, he says, only 3 percent of medical students choose primary care.

For Ferreris, who is both humbled and inspired by his young patients, building a Culture of Health necessitates recalibrating priorities.

“Nobody’s concentrating on the whole; they’re only looking at one part. And they’re not paying attention to the human—the brain, the spirit, the soul.

“We overlook that aspect...but it’s where I believe the primary care doctor has irreplaceable value.”

View full post

Rare Mettle

Dec 9, 2014, 9:00 AM

For the 25th anniversary of the Robert Wood Johnson Foundation’s (RWJF) Summer Medical and Dental Education Program (SMDEP), the Human Capital Blog is publishing scholar profiles, some reprinted from the program’s website. SMDEP is a six-week academic enrichment program that has created a pathway for more than 22,000 participants, opening the doors to life-changing opportunities. Following is a profile of Rachel Torrez, MD, a member of the Class of 1990.

The year was 1992. Rachel Torrez, a second-year medical student, was in line waiting for coffee at the University of Washington when a White male student confronted her.

“You took my best friend’s spot because of quotas,” he sneered.

The granddaughter of Mexican migrant workers, Torrez enrolled at a time when students of color were few and some people—especially in Washington state—were questioning the fairness of affirmative action. Clarence Thomas, an outspoken opponent of affirmation action, had recently joined the Supreme Court.

“We don’t have quotas,” Torrez shot back. “I took your best friend’s spot because I was smarter.”

That mix of brains and backbone is characteristic of Torrez, who conquered severe dyslexia and cultural constraints on her way to an MD. Now a family-practice physician in the Ballard neighborhood of Seattle, Torrez gives as good as she gets.

View full post

Naming Racism

Dec 5, 2014, 7:00 AM, Posted by Thomas LaVeist

Thomas LaVeist, PhD, is founding director of the Hopkins Center for Health Disparities Solutions, and the William C. and Nancy F. Richardson Professor in Health Policy at the Johns Hopkins Bloomberg School of Public Health. He is the chair of the National Advisory Committee for the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Medical College

Yesterday I had Camara Phyllis Jones, PhD, MD, MPH, as guest lecturer for my seminar on health disparities. It was a homecoming of sorts for her. She and I first met in the early 1990s when I was a newly minted assistant professor and she was a PhD student at the Johns Hopkins Bloomberg School of Public Health. Jones’ work should be well known to readers of this blog. She has published and lectured on the effects of racism on health and health disparities for many years. She played a leading role in the Centers for Disease Control and Prevention’s work on race, racism, and health in the Behavioral Risk Factor Surveillance System.  And she was just elected president-elect of the American Public Health Association. She is a fantastic lecturer and often uses allegory to illustrate how racism affects health. 

About midway through her lecture, a student raised his hand and got her attention to ask a question about the utility of “naming racism.” My interpretation and rephrasing of his question—is it helpful to use the word racism or is the word so politically charged and divisive that it causes people to “tune you out?”

The student’s question raises a major challenge for those of us who seek to address health disparities. On one hand racism is fundamental to understanding why disparities exist and persist. I would go as far as to state that in most race disparities research, race is actually a proxy measure for exposure to racism. But, on the other hand, the word racism makes some people uncomfortable, causing them to become defensive or sometimes simply block out your message.  

View full post

What’s Your “Street Race-Gender”? Why We Need Separate Questions on Hispanic Origin and Race for the 2020 Census

Nov 26, 2014, 3:00 PM, Posted by Nancy Lopez

Nancy López, PhD, is an associate professor of sociology at the University of New Mexico (UNM). She co-founded and directs the Institute for the Study of “Race” and Social Justice at the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at the UNM. On December 5, RWJF will hold its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.

How should we measure race and ethnicity for the 2020 Census? How can health disparities researchers engage in productive dialogues with federal, state and local agencies regarding the importance of multiple measures of race and ethnicity for advancing health equity for all?  

If we depart from the premise that the purpose of race, ethnicity, gender and other policy-relevant data collection is not simply about complying with bureaucratic mandates, but rather it is about establishing communities of practice that work in concert toward the creation of pathways (from harmonized and contextualized data collection, analysis and reporting) to effective policy solutions and interventions that address the pressing needs of diverse communities across the country, then we have planted the seeds of a culture of health equity and social justice.

View full post

Every Child Counts: Stopping Infant Loss

Nov 13, 2014, 3:08 PM, Posted by Sheree Crute

A young mother holds her infant son, who has a pacifier in his mouth.

“Matthew was born big and healthy, just under eight pounds,” Carol Jordan says.

That’s why it was such a shock to her to lose him on an otherwise average Sunday afternoon.

“We had just gotten home from church. My daughter Taylor and my other son Jacob settled in with their video games,” Carol recalls. “I breastfed Matthew and lay him down on his back in his bassinet. He was 3 and ½ months old. About 30 minutes later, I went to check on him. He was on his stomach and he was not breathing.”

View full post

Babies are Dying in Rochester at Twice the National Average. Why?

Nov 7, 2014, 11:13 AM, Posted by Maria Hinojosa

Two medical professionals talk with a disabled child who sits on his mother's lap.

Rochester, N.Y., is the birthplace of Xerox, Bausch & Lomb, and Kodak, and home to two top-ranked research institutions, the University of Rochester and Rochester Institute of Technology. Nevertheless, babies die in this upstate New York city at a rate two times higher than the national average, and Rochester’s children of color are three times more likely than white infants to die before their first birthday. Why?

To come up with some answers, Futuro visited Rochester as part of its America by the Numbers series, made in partnership with Boston public TV station WGBH (check your local PBS and World Channel listings to see the series). We went knowing that the U.S. as a whole ranks 56th in the world for infant mortality, by far the lowest of any industrialized nation, despite the fact that we spend more on health care per capita than any other country, and the largest portion goes towards pregnancy and childbirth. This makes Rochester’s statistics even more tragic—an outlier in an outlier.

View full post

Expanding Horizons for Rural Young Men of Color

Sep 8, 2014, 1:55 PM, Posted by Maisha Simmons

An older student assists a younger student in school.

When we first began the Forward Promise initiative, we envisioned building the capacity and impact of organizations across the country working with boys and young men of color from every type of community and background. We wanted to identify and support a cohort of grantees that were diverse in their approach, in their geography, and in the racial, ethnic and cultural experiences of the young people that they supported. Once we began doing this work, it didn’t take long to realize we were falling short.

The simple truth is that the majority of organizations who applied for Forward Promise that had demonstrated success and were ready to expand were located in major cities. Few applicants were in the rural beltway that stretches across the Southern United States, from Alabama to Arizona. It would be easy to assume that there weren’t many young men of color there or that there was not much innovation or capacity to support young men of color in that region. But you know what they say about assumptions ...

View full post