The statistics are sobering and clear: Across the U.S., obesity, cancer and a slew of other health problems hit African-Americans harder than whites, ultimately cutting short millions of lives.
Fueling the cycle of disparity almost assuredly are factors dating to the founding of the nation itself: slavery, racism and discrimination that have led to segregation, creating communities that are separate and unequal in nearly every aspect of society that feeds into health, from poverty and education to housing and public safety.
“Residential segregation is as American as apple pie,” says David Williams, a public health and African-American studies professor at Harvard University. “It has these pervasive negative effects of producing social inequality and putting caps on the achievements and opportunities of African-American communities. … Virtually everything that drives health and opportunities to be healthy in American life is determined by place.”
An analysis of U.S. News Healthiest Communities data – used to assess the well-being of nearly 3,000 counties nationwide, and consisting of dozens of metrics that extend beyond insurance coverage and doctors’ visits to social determinants of health such as income, food accessibility and natural environment – reinforces this disturbing conclusion, as communities with larger shares of black residents tend to score and rank lower than those with larger shares of white residents.
Yet there are signs of progress and hope. Of 682 counties with a black population share above the 13 percent national average, 26 land among the top 500 Healthiest Communities overall. Among them are four Georgia counties – Cobb, Columbia, Fayette and Paulding – featuring common threads that have helped propel them into the upper tier.
Though these four counties are distinct – Cobb, Paulding and Fayette surround Atlanta but vary in size, while Columbia lies 130 miles east of the city known as the South’s “black mecca” – their residents have access to affordable housing and high incomes. Many also hold college degrees, indicating some economic and education factors can be more critical than race when it comes to predicting health outcomes.
Of course, even in counties that have larger African-American populations and appear to be doing better than anywhere else, longstanding Southern traditions and racial tension aren’t absent, shaping the nuanced roles race, affluence and other social factors play in creating a community’s overall quality of life.
“While Georgia does have a complex racial history, Atlanta was also home to Dr. Martin Luther King, it has tremendous educational resources such as (historically black colleges) Spelman and Morehouse, and has been known as the ‘black mecca’ for some time,” says Shivani A. Patel, an associate professor of global health at Emory University’s Rollins School of Public Health in Atlanta.
“So I think the apparent contradiction is best understood in light of the economic, educational and social opportunities for African-Americans in Atlanta, which has attracted high-achieving individuals from all over the country and supported its own. This population is spilling over into neighboring counties such as Cobb and Paulding,” she says.
That’s also been the case in Fayette and Columbia counties. But by visiting and talking with locals in all four places, it becomes clear that their health and well-being hinge on some relative intangibles as well: a sense of community, and a dedication to improving life for all.
SOURCE: Gaby Galvin and Joseph P. Williams
U.S. News & World Report