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December 18, 2007

Urban Health Culprits: Renewal and Corporations

Our nation’s history is a long legacy of displacement, say some urban health researchers. From the land grabs perpetrated against Native Americans, to the slave trade, to the internment of Japanese-Americans during World War II, to the bulldozing of entire low-income neighborhoods in the name of urban renewal—each disturbance in social fabrics and ecosystems is perpetuated in the name of progress.

And the result? “Incessant displacement is a repeated experience for the same people,” said Mindy Fullilove, professor of Clinical Psychiatry and Clinical Sociomedical Sciences at Columbia University, speaking at an urban health workshop held on December 7 at the Johns Hopkins Bloomberg School of Public Health. In her research into the epidemics of the poor, Fullilove, MD, finds relationships between the collapse of communities and declines in public health. “We’re seeing contagious housing destruction, and it’s a result of catastrophic disinvestment,” she said, referring to the diminishing stock of low-income housing. “It’s development-induced displacement, and it uses the same intent and the same tools as urban renewal.”

Also speaking at the workshop was Nick Freudenberg, Distinguished Professor of Urban Public Health at Hunter College, who spoke about the penetration of corporations into every facet of American life, and the impact of corporate practices on morbidity and mortality. What corporations effect in American cities, where there is maximum opportunity for buying and consumption, he said, is “disease promotion,” and he cited six industries in particular—alcohol, automobile, firearm, food and beverages, pharmaceutical and tobacco—responsible for a wide range of chronic diseases, death and injury. “Cigarettes are a quintessential urban health problem,” said Freudenberg, DrPH, and he named five other products that have shaped urban health: “Malt beers, SUVs, Saturday Night Specials, fast food and Ecstasy.”

The workshop, “Health and the City: Integrating Urban Planning and Public Health,” was kicked off by Elliott Sclar, professor of Urban Planning and International Affairs at the School of International and Public Affairs at Columbia University. In his presentation, Sclar, PhD, referred to the data on the world’s 900 million slum-dwellers, and he said much of that data gets covered up. “When you break out the slum data,” he said, “you see that morbidity and mortality are substantially higher in slums than in poor rural areas.” He stressed the need for basic public health measures, such as clean water, sanitation and safe buildings, in low-income urban areas. “You can give antiretroviral therapy to people living in slums—but if they don’t have clean water, it doesn’t work.”  —Christine Grillo

“Health and the City: Integrating Urban Planning and Public Health” was organized by a group of doctoral students at the Johns Hopkins Bloomberg School of Public Health and brought together a diverse audience to explore how the fields of urban planning and public health can collaborate in order to improve the health of city residents. It was co-sponsored by the Bloomberg School’s Department of Health, Behavior and Society and the Student Assembly. The organizing students are Michal Engelman, Stephanie Farquhar, Josh Garoon, Danielle German, Amelia Greiner, Marissa Mika, Emma Tsui and Rachel Weber.