Urban study links health to surroundings
Poorer neighborhoods may result in poorer health
People who move from a poor neighborhood to a better-off one could end up thinner and healthier than those who stay behind, according to an urban housing experiment that tracked low-income residents in five major cities for 10 to 15 years.
The research, set up by the U.S. Department of Housing and Urban Development, shows that health is closely linked to the environments people live in.
The study released Wednesday by the New England Journal of Medicine took advantage of a 1990s social experiment approved by Congress primarily to track the changes in income, education and employment of people given the opportunity to move out of low-income housing in Los Angeles, Baltimore, Chicago, New York and Boston.
Researchers soon realized that the project could allow them to study residents’ changes in health as well, said study co-author Dr. Robert Whitaker, a pediatrician at Temple University in Philadelphia.
Between 1994 and 1998, the researchers randomly divided 4,498 women with children who made less than the federal poverty level into three groups. One-third were given a voucher that would pay for a portion of their rent, so long as they moved to a much better-off area in which no more than 10 percent of residents had incomes below the poverty level.
Another third were offered traditional vouchers, which would subsidize housing regardless of location. The final third served as the control group and did not receive vouchers.
Ten to 15 years later, researchers measured the women’s height, weight and blood sugar. They found that rates of extreme obesity among women given vouchers to move to less impoverished neighborhoods were about 19 percent lower than those who stayed in the low-income neighborhoods, and rates of diabetes were about 22 percent lower.
“This is one of the first studies to show that where you live – the circumstances of your neighborhood, the social characteristics of the people around you – all these things may play a role in your own health,” said Dr. Harlan Krumholz, a cardiologist at the Yale School of Medicine who was not involved in the study.
Experts have yet to identify for sure what aspects of such environments make them so damaging to health – but they do have ideas, as well as suggestions for improvement, said Dr. Michael Rodriguez, a UCLA professor of family medicine. Among them: safer ways for schoolchildren to walk home, better and safer public spaces, a focus on crime reduction, and incentives to bring healthful grocery options to low-income areas.