Racial disparities might seem to be an abstract, hard-to-visualize concept. But at least in Chicago, it can be simply portrayed with a neighborhood map. The picture at left is for violent crime in 2005, but if one inserted statistics for infant mortality, diabetes, obesity, or other health issues, roughly the same pattern would repeat.
This clustering of negative attributes in Chicago neighborhoods has been observed and studied since at least 1945’s Black Metropolis, a landmark sociological study of the South Side. Subsequent studies, such as the 1965 Moynihan Report and more recent observational research, have found the same concentrations, even if their exact locations have drifted south and west in the city. The sad persistence of that pattern raises two questions, one immense, one naive: what can be done to break the tragic cycle of these neighborhoods, and why don’t the people in those neighborhoods just move out?
In “The Social Reproduction of Health Disparities,” his talk in the MacLean Center for Clinical Medical Ethics seminar series, Harvard sociologists Robert Sampson addressed those two questions with a unique data set: the Chicago Neighborhoods Project. A longitudinal study that is following 6,500 children across the Chicago area, the project is producing reams of information about the structures of neighborhoods and how they affect the people within. It’s the kind of data that takes decades to sort through, but Sampson gave attendees a taste of how neighborhoods choose people, rather than the other way around.
The project, more formally called the Project on Human Development in Chicago Neighborhoods, tracked the children and their environments from 1995 to 2002. That involved not only surveying the children and their families at three different time points, but also measuring characteristics of their home neighborhoods. Researchers videotaped Chicago streets to measure aspects of social disorder such as graffiti and broken windows, and conducted unusual field experiments such as dropping fake letters in the street to see how many were returned to a mailbox by a neighborhood’s residents.
“The idea was we’re going to study individuals and follow them through time, but we’re also going to independently assess their context,” Sampson said.
When researchers looked at their neighborhood data, they didn’t find immobility; in fact, nearly half of their subjects moved over the 7 years of data collection. But deconstructed statistically, those movements were far from random, falling into regular networks along the lines of income, education, and racial factors. The nature of mobility is socially driven, Sampson said, putting restrictions on the ability of an individual to control their “escape” from neighborhoods with failing structures.
“Yes, you’re sorting, but neighborhoods are also sorting you. The idea that we are the controlling factor is a bit misleading,” Sampson said.
But just because individuals are subject to the influence of an oft-broken invisible system doesn’t meant that it’s hopeless to try to change the distressingly stable disparities of Chicago and other cities, Sampson said. The data merely suggests that big picture interventions and experiments that address problems on a system rather than individual level may be more effective in the long run. Citing the incredible advances made on human longevity over the 20th century thanks to broad measures such as anti-smoking and auto-safety campaigns, Sampson said he was optimistic that the deep-seated neighborhood influences that result in disparities can be fixed with the right tools.
“When you change norms and macro-level processes like that, you get big effects,” Sampson said. “If you can do it for longevity, certainly we can help improve things like education, if not individual lives.”
[Each academic year, the MacLean Center for Clinical Medical Ethics organizes a series of lunchtime seminars by physicians, biologists, economists, social scientists and other experts covering the biggest questions in health care and ethics. This year’s theme is “Health Disparities: Local, National, Global,” and the series was put together with the Urban Health Initiative, the Global Health Initiative, and Finding Answers. ScienceLife will carry regular coverage of this unique series, often accompanied by video of the lectures provided by the MacLean Center.]