Fourth Brief: For the Sake of All
In the fourth policy brief from For the Sake of All, a collaborative, inter-disciplinary study on the health of African Americans in St. Louis and St. Louis County, researchers focused on the role segregation plays on health in the area. It is titled "Segregation: Divided Cities Lead to Differences in Health."
Previous briefs focused on poverty, education and mental health. The fifth and final brief is on chronic disease.
According to data from the 2010 Census, St. Louis is the ninth most segregated city in the nation. In 2012, BBC Magazine produced a short documentary on St. Louis' Delmar divide, highlighting the stark difference in race and income between those who live north of Delmar Boulevard and those who live south of it.
"St. Louis is doing a little bit better [with segregation] but still not that great compared to other cities," said Keon Gilbert, assistant professor in the college of public health and social justice at Saint Louis University.
He co-wrote the policy brief on segregation with Melody Goodman, assistant professor of surgery in the division for public health services at Washington University.
"What we find in predominately minority communities is that sometimes banks don't want to lend in those communities. Economic opportunity is not happening in those communities. The park may be the most unsafe place, so when we talk about physical activity - there may not be sidewalks. They're not likely to have a full-service grocery store. So those are the real differences that matter. The fact that people of different races live in different places, that's fine. It's the fact that the opportunity that exists in those different communities is really different," said Goodman.
And those differences can lead to poor health outcomes. According to the policy brief, the neighborhoods in St. Louis with the highest concentrations of African Americans are also the neighborhoods with the greatest number of deaths due to heart disease and cancer. They also have the lowest median incomes.
"The fact is that the north side has been neglected for many, many years," said Antonio French, alderman of the 21st ward of St. Louis. "The north side of the city has suffered from maybe a system of benign neglect, and some of it I would say is not even so benign, for 40 years. The fact is, you have roughly a third of the city's population living north of Delmar, and just until recently there was no urgent care facility at all."
In the midst of a discussion about health care facilities in North St. Louis, a program to bring young physicians to work in small clinics in those neighborhoods was suggested.
"And have them live there too. Don’t just send them there to work," said Will Jordan, executive director of the Metropolitan St. Louis Equal Housing Opportunity Council.
That's the heart of the brief's suggested policies - bringing resources to the communities that need them, not people to the communities that have resources.