Most cities in the United States are made up of neighborhoods segregated by socioeconomic status. Many low SES communities also have high minority populations, thus the inequities that are present between high and low income neighborhoods become racial issues as well. People in low income neighborhoods often have limited access to resources such as grocery stores, public transportation, health care facilities, and parks. This negatively impacts the quality of life for people living in these areas especially their physical health.
Grocery Stores:
Food is a basic need. However, for some people access to food is limited because of the neighborhood that they live in. Areas of low income have much lower access to grocery stores than those in middle and high income areas. This is environmental discrimination because people have fewer options for healthy eating simply based on their socioeconomic status. This impacts the communities in a major way.
Low-income people, minorities, and rural residents suffer the highest rates of preventable, diet-related diseases linked to a lack of healthy foods.
- Low-income areas have fewer supermarkets and groceries that carry healthy foods than do predominantly white, middle/high income neighborhoods.
- Stores in low-income neighborhoods stock fewer healthy items and have significantly lower-quality fresh produce.
- The cost of fresh foods in low-income areas is often too high for residents.
- Public transportation to supermarkets is not always available.
These facts make it difficult for people living in low-income areas to maintain a healthy eating habits.
Research done by the Rudd Center for Food Policy and Obesity at Yale University (see above link and video) found that residents in low income neighborhoods are at much higher risk for health problems. This can be linked to less access to high-quality grocery stores. According to Sustainable Seattle, "Not only are there no high-quality grocery stores in South Seattle, but the average resident in this area has access to many more convenience stores than grocery stores. Convenience stores do not make up for grocery stores; they are often more expensive and offer much less variety of healthy products to consumers, especially in terms of fresh produce and lean meat." (http://www.b-sustainable.org/built-environment/access-to-local-food-by-neighborhood)
The TRF (The Reinvestment Fund) conducted a nationwide analysis to investigate which areas around the country have limited access to grocery stores. In many cities and states, these areas of low access to supermarkets coincides with low income and minority communities. A study conducted by Sustainable Seattle compared the location of grocery stores in the metro area (see map to the left) and the ability of residents with food insecurity to access a grocery store within a 30 minute trip on public transportation (see map below: pink is food insecurity, red is food insecurity and 30 minute or longer ride on public transportation).
Seattle did not exhibit a tendency toward poor access to grocery stores in low income areas within the city itself. However, there are a few regions in suburban (low income) areas south of the city with less access to grocery stores. Also, there is a tendency toward lower quality food in the low income areas of the region. This information come from a study conducted by the University of Washington Center for Obesity Research. It found that wealthy zip codes in King county had far fewer obese people than poor zip codes. "Our research shows that geography, social class, and economic standing all play huge roles in the obesity problem. Some of the most disadvantaged areas -- those hardest hit by low income, low education, and low property values -- are also the ones most affected by the obesity epidemic."There has been increased understanding about this issue. This spring there was a "Shopping for Health" conference, which brought together public health agencies, academicians, supermarket representatives and policymakers from Seattle, King County and Washington state.
Health Care:
In many of the low income neighborhoods around the country there is limited access to health care service locations. This problem is compounded by the fact that many of the people living in these areas don't have health care coverage. Most areas within the city of Seattle have adequate access to health care services, but the situation is very different out in the suburbs. Many of the low income and diverse minority population areas in the Seattle region are in the suburbs, especially north and south of the city.
A study was done by the Center for Studying Health System Change to investigate the availability of health care services for low income and uninsured people in the suburban areas of Seattle and four other metro areas. "Living in the suburbs presents a number of additional challenges that hinder low-income people’s ability to get timely, appropriate health care services, including:
- limited transportation options;
- insufficient cultural and linguistic competency of providers;
- lack of awareness of available services."
This lack of ability to access health care services severely impacts the quality of life for the people in these communities. With limited transportation to hospitals and clinics and/or no insurance to pay for services, people may not get medical attention when they need it the most. In fact, many low income people rely solely on emergency medical treatment, at which point it may be too late to prevent major health issues.However, there are people working to improve access to health care for people in low income areas, especially in suburban neighborhoods. The Center for Studying Health System Change outlined several ways in which the health care coverage in all areas can be improved:
- expanding primary care capacity;
- decreasing reliance on emergency departments;
- improving access to specialists;
- reducing transportation challenges; and
- generating revenue by pursuing higher-income patients.
If community organizations pursue these improvement in these areas, access to health care for all people can occur.
Public Transportation and Recreational facilities:
Many of the low income areas in cities have limited access to public transportation and recreational facilities. The lack of availability of these resources has a large negative impact on the health and safety of residents. As mentioned above, good public transportation in necessary to help those of low incomes to access grocery stores and health care services. Without the ability to travel to other areas of the city, people will not be able to buy certain items or have access to certain locations for health or job opportunities.
Access to recreational facilities can help promote a healthy lifestyle. One study the was conducted by the National Institute of Health found that there is a large discrepancy between the recreational facilities available in middle/high income neighborhoods and those of low income neighborhoods which often have large minority populations. They found that people in economically disadvantaged areas have access to parks with low fee recreational opportunities, but that other recreational facilities were much less dense in areas of low income or high minority populations. The fees at the recreational facilities were also cost prohibitive for households in the low income neighborhood. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254179/)
Academic Sources
http://www.yaleruddcenter.org/resources/upload/docs/what/report/RuddReportAccesstoHealthyFoods2008.pdf
Links
Interactive Map of Seattle that shows the services available in the various neighborhoods
Community organization to help bring about greater equity in access to local resources
Access to healthy foods:
http://www.yaleruddcenter.org/resources/upload/docs/what/report/RuddReportAccesstoHealthyFoods2008.pdf
Access to health care:
Access to public transportation and recreational facilities:
