I’ve wondered for a long time just how much a place can make you sick. Not just any place, but the specific place where I spent my early childhood, in what used to be the Allequippa Terrace Apartments in Pittsburgh‘s Hill District. If you’re Black and from Pittsburgh of a certain pre-gentrification era (new townhouses now sell in the $700,000s there, marketed to doctors at the nearby University of Pittsburgh), it’s a near guarantee that you had family “up Burrows,† our colloquialism for the main street running through the projects I lived in until I was 10.
Almost my entire family lived there, too, though by the 90s, most of us had moved away and by the time I graduated college, all the decrepit, three-story brick buildings had been razed. A weird thing happened though: my mother, who as early as her 30s started developing “benign” tumors—one was removed from her hand, another later from her abdomen in a major surgery. My mother eventually succumbed to “triple-negative” breast cancer in 2013. By 2017, my first cousin, one year older than me, who also lived years before in Aliquippa Terrace, died of the same four years later. Cancer, of the lungs, not the breast, took my mom’s mother in 2008.
The mother of my uncle (by marriage), who also lived there back in the 80s, was diagnosed a few years ago. I started to wonder whether Allequippa Terrace was killing us, slowly, years after we all thought we’d made it to safety.
Then yesterday, I read about a study that validates, at least slightly, the idea that not just where we all lived, but that our racial identity and public policy might have tight correlations to the health outcomes in my family and in many others where I grew up. The data specific data were about asthma, not cancer, but they reveal a significant link between race, place and policy that could well be applied to other health conditions and in other cities.
Researchers at the University of Pittsburgh School of Public Health tracked the rates at which asthma occurred in neighborhoods across Pittsburgh, overlaying that data against public policy decisions like zoning and institutional policies such as discriminatory lending. Their conclusion was sobering but not stunning: that race and place aren’t just a good tag team in a death match against Black health but that public policy decisions, specifically redlining, themselves were the catalyst for racial disparities in public health. In the researchers’ own words, “racism – rather than race – is an overarching socioenvironmental risk factor that appears to worsen” instances of asthma in Pittsburgh.
“We directly link racist loaning practices more than 80 years ago to the maintenance of poor environmental quality in the most redlined neighborhoods today,” said lead author Alexander Schuyler, an MD-Ph.D. student in Pitt’s Medical Scientist Training Program† “Our data, in turn, connects the higher pollution exposures to worsened asthma outcomes. In short, institutional racism – not race-based biology – is why many Black Pittsburghers experience severe asthma.”
Replace “diabetes” with “cancer”, and we could be talking about my family. Replace “Pittsburghers” with “New Yorkers,” “Washingtonians,” or “Chicagoans” and we could be talking about yours. Pittsburgh remains chronically stratified along racial and economic lines dictated by the kind of discriminatory lending and other policies blamed for higher rates of asthma in the study.
So do most other cities in the country.
It’s no secret that Black people disproportionately suffer from many chronic ailments conditions or that where you live can exacerbate those issues. Obesity and diabetes, for example, occur at higher rates in food deserts, which Black people tend to live in more often than whites. I, maybe like you, have often wondered if there was some secret link to the rash of fatal health problems among women in my family.
This study doesn’t definitively prove that link, but it gives me some solace that my suspicions about racism itself killing off the women I loved, the women who raised me, have validity.