washu-lec

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1. Tracing the Links Between Historical Segregation and Contemporary Inequality in St. Louis Christopher Prener, Ph.D. Assistant Professor of Sociology Saint Louis University Detrimental Influences
2. Tracing the Links Between Historical Segregation and Contemporary Inequality in St. Louis Christopher Prener, Ph.D. Assistant Professor of Sociology Saint Louis University Detrimental Influences
3. Acknowledgments Saint Louis University Office of the Vice President of Research Washington University in STL Living Earth Collaborative Especially Yusan Yang, PhD, William Farfan-Rios, PhD, and Brett Seymoure, PhD Institute of Clinical and Translational Sciences
4. AGENDA 1. Preface 2. Fundamental Causes & Racism 3. Racism, Redlining, and AMI 4. Measuring Health and Place 1. PREFACE
5. ▸ Medical and urban sociologist with an interest in spatial and computational methods ▸ Affiliations: • SLU’s Advanced HEAlth Data Research Institute • SLU’s Institute for Healing Justice and Equity • Northeastern University’s Institute for Health Equity and Social Justice Research 1. PREFACE “HI, I’M CHRIS”
6. 1. PREFACE INTELLECTUAL TRAJECTORY
7. 1. PREFACE “DETRIMENTAL INFLUENCES”
8. 1. PREFACE “DETRIMENTAL INFLUENCES” Language used to describe the people and social problems that were seen as tarnishing neighborhoods’ reputations. Forthcoming funding from ICTS via NIH CTSA UL1TR002345 NIMHD R01 currently under review; NSF under revision Subject of a book proposal currently under development What are early 20th century racism’s longterm consequences for contemporary urban life and health? Core motivation for research initiative that launches July ‘22
9. 1. PREFACE “DETRIMENTAL INFLUENCES” What are heart disease rates like right here? What about here?
10. 2 FUNDAMENTAL CAUSES & RACISM
11. 2. FUNDAMENTAL CAUSES & RACISM FUNDAMENTAL CAUSE THEORY segregation (Williams & Collins 2001 and Sewell 2016) structural racism (Gee & Ford 2011) systematic racism (Phelan & Link 2015) racial capitalism (Pirtle 2020)
12. FOR THE PROBLEM OF THE TWENTIETH CENTURY IS THE PROBLEM OF COLOR LINE W.E.B. Du Bois The Souls of Black Folk (1903) Wikimedia Commons
13. 2. FUNDAMENTAL CAUSES & RACISM FOCUSING ON SOUTHERN CITIES Urban sociology has focused on a relatively small number of cities, and we often view them as a research site rather than an institution. We need to broaden literatures into the literal and figurative American South and produce deeper literatures on specific cities.
14. A LABORATORY FOR RACISM INDIGENOUS EXPULSION THE MISSOURI COMPROMISE DRED SCOTT BLEEDING KANSAS Clockwise from Upper-left: Author’s Work; Smithsonian Institution; Wikipedia; Wikipedia
15. A LABORATORY FOR RACISM Clockwise from Upper-left: Author’s Work; Smithsonian Institution; Wikipedia; Wikipedia THE MISSOURI COMPROMISE
16. A LABORATORY FOR RACISM Clockwise from Upper-left: Author’s Work; Smithsonian Institution; Wikipedia; Wikipedia INDIGENOUS EXPULSION
17. A LABORATORY FOR RACISM Clockwise from Upper-left: Author’s Work; Smithsonian Institution; Wikipedia; Wikipedia BLEEDING KANSAS
18. A LABORATORY FOR RACISM Clockwise from Upper-left: Author’s Work; Smithsonian Institution; Wikipedia; Wikipedia DRED SCOTT
19. A LABORATORY FOR RACISM INDIGENOUS EXPULSION THE MISSOURI COMPROMISE DRED SCOTT BLEEDING KANSAS Clockwise from Upper-left: Author’s Work; Smithsonian Institution; Wikipedia; Wikipedia
20. A LABORATORY FOR RACISM DEED COVENANTS EXCLUSIONARY ZONING “SLUM” CLEARANCE REDLINING Clockwise from Upper-left: Erenow; Google; Wikipedia; Missouri Bar Association
21. A LABORATORY FOR RACISM Clockwise from Upper-left: Erenow; Google; Wikipedia; Missouri Bar Association EXCLUSIONARY ZONING
22. A LABORATORY FOR RACISM Clockwise from Upper-left: Erenow; Google; Wikipedia; Missouri Bar Association DEED COVENANTS
23. A LABORATORY FOR RACISM Clockwise from Upper-left: Erenow; Google; Wikipedia; Missouri Bar Association REDLINING
24. A LABORATORY FOR RACISM Clockwise from Upper-left: Erenow; Google; Wikipedia; Missouri Bar Association “SLUM” CLEARANCE
25. REDLINING A - “Best” B - “Still Desirable” C - “Definitely Declining” D - “Hazardous”
26. REDLINING A - “Best” B - “Still Desirable” C - “Definitely Declining” D - “Hazardous” “In St. Louis, the white middle class suburb of Ladue was colored green because…it had ’not a single foreigner or negro.’” (Rothstein 2017) Rothstein, Richard. 2017. The Color of Law. New York, NY: W.W. Norton & Co.
27. REDLINING A - “Best” B - “Still Desirable” D - “Hazardous” C - “Definitely Declining” “‘infiltration of a lower grade population’” (Hillier 2005:217) Hillier, Amy. 2005. “Residential Security Maps and Neighborhood Appraisals.” Social Science History 29(2):207-233.
28. REDLINING A - “Best” B - “Still Desirable” C - “Definitely Declining” D - “Hazardous” Hillier, Amy. 2005. “Residential Security Maps and Neighborhood Appraisals.” Social Science History 29(2):207-233. “‘detrimental influences in a pronounced degree,’ and ‘undesirable population or an infiltration of it’” (Hillier 2005:217)
29. REDLINING A - “Best” B - “Still Desirable” C - “Definitely Declining” D - “Hazardous” Rothstein, Richard. 2017. The Color of Law. New York, NY: W.W. Norton & Co. “Lincoln Terrace was colored red because ‘it had little or no value today…due to the colored element now controlling the district’” (Rothstein 2017)
32. Relationship with Redlining: r = 0.750 (p < 0.001)
33. 2. FUNDAMENTAL CAUSES & RACISM MEASURING SEGREGATION The Index of Concentration at the Extremes (ICE) provides a sub-county measure of segregation that produces scores per feature from -1 (total segregation of the marginalized group) to 1 (total segregation of the privileged group). Formula: ICEi = (Ai - Pi )/Ti Where: Ai = Privileged [white] Pi = Marginalized [Black] Ti = Total Population Massey, Douglas. 2001. “The prodigal paradigm returns: ecology comes back to sociology.” Pp. 41-48 in Does It Take a Village? Community Effects on Children, Adolescents, and Families, edited by A. Booth and A. Crouter. Mahwah, NJ: Lawrence Erlbaum Associates. Krieger, Nancy, et al. 2017. "Measures of local segregation for monitoring health inequities by local health departments." American Journal of Public Health 107(6): 903-906.
35. 2. FUNDAMENTAL CAUSES & RACISM CORRELATIONS There is an “arc” over time in the strength of the relationship between increased percent redlined and ICE values (remember -1 is highest segregation for African Americans). Year Pearson’s r with Redlining 1940 -0.141* 1950 -0.235*** 1960 -0.468*** 1970 -0.573*** 1980 -0.565*** 1990 -0.566*** 2000 -0.555*** 2010 -0.475***
36. Relationship with Redlining: r = -0.525 (p < 0.001)
37. FOUR ‘PECULIAR’ INSTITUTIONS Instituion Form of Labor Core of Economy Dominant Social Type Slavey (1619-1865) Unfree fixed labor Plantation Slave Jim Crow (South,1865-1965) Free fixed labor Agrarian and extractive Sharecropper Ghetto (North, 1915-1968) Free mobile labor Industrial manufacturing Menial worker Hyperghetto and Prison (1968-) Fixed surplus labor Postindustrial services Welfare recipient and criminal Loïc Wacquant (2002) argues that there are four successive institutions - particular to the U.S. - that link slavery with contemporary racial inequality. Wacquant, Loïc. 2002. “From Slavery to Mass Incarceration.” New Left Review 13:41-60.
38. FOUR ‘PECULIAR’ INSTITUTIONS Instituion Form of Labor Core of Economy Dominant Social Type Slavey (1619-1865) Unfree fixed labor Plantation Slave Jim Crow (South,1865-1965) Free fixed labor Agrarian and extractive Sharecropper Ghetto (North, 1915-1968) Free mobile labor Industrial manufacturing Menial worker Hyperghetto and Prison (1968-) Fixed surplus labor Postindustrial services Welfare recipient and criminal Loïc Wacquant (2002) argues that there are four successive institutions - particular to the U.S. - that link slavery with contemporary racial inequality. Contemporary Disparities Wacquant, Loïc. 2002. “From Slavery to Mass Incarceration.” New Left Review 13:41-60.
39. These layers form the structure on which health disparities are built. Unsplash
40. They also identify the mutually constitutive relationship between racism and our economy. Unsplash
41. FOUR ‘PECULIAR’ INSTITUTIONS Instituion Form of Labor Core of Economy Dominant Social Type Slavey (1619-1865) Unfree fixed labor Plantation Slave Jim Crow (South,1865-1965) Free fixed labor Agrarian and extractive Sharecropper Ghetto (North, 1915-1968) Free mobile labor Industrial manufacturing Menial worker Hyperghetto and Prison (1968-) Fixed surplus labor Postindustrial services Welfare recipient and criminal Loïc Wacquant (2002) argues that there are four successive institutions - particular to the U.S. - that link slavery with contemporary racial inequality. Contemporary Disparities Wacquant, Loïc. 2002. “From Slavery to Mass Incarceration.” New Left Review 13:41-60.
42. 2. FUNDAMENTAL CAUSES & RACISM RACIAL CAPITALISM W.E.B. Du Bois and - much more recently - Cedric Robinson (and others) have argued that racism and our economy are inextricably linked to each other. Racial and economic exploitation therefore exist hand-in-hand, with the development of racially segregated spaces in cities also enabling poverty and socioeconomic inequality.
43. 3 RACISM, REDLINING, AND AMI
44. 3. RACISM, REDLINING, AND AMI KEY TERMS CHD = Coronary Heart Disease Reduced blood flow to the heart, commonly caused by the the build-up of plaque in the heart’s arteries (known as atherosclerosis). AMI = Acute Myocardial Infarction A consequence of CHD where decreased or stopped blood flow causes damage to the heart muscle.
45. 3. RACISM, REDLINING, AND AMI CHD + AMI disparities for African Americans in risk factors (Graham 2015) higher rates of CHD morbidity (Singh et al. 2015) higher rates of CHD mortality (Nasir et al. 2007) higher rates of AMI (Chi et al. 2020)
46. 3. RACISM, REDLINING, AND AMI FOCUSING ON RACISM While the literature on CHD+AMI does note that racial disparities exist, these are not framed as consequences of racism itself (leaving open the door to a biological explanation). Even when social determinants are acknowledged (e.g. highway proximity), the connection between racism and those determinants is also unexplored.
47. DATA & METHODS 2011-15 AMI Hospitalization Rates (MOPHIMS) 1940 HOLC Boundaries (Gordon 2009) 2011-15 ACS Demographic Data Data Sources Descriptive Mapping Analytical Steps Analysis Platform Local Spatial Autocorrelation (LISA) Correlations OLS Models* * No Residual Autocorrelation
50. OLS MODELS (1) (2) (3) % Redlined, 1940 0.016* (0.006) -0.004 (0.007) -0.015* (0.007) ICE, Race -2.236*** (0.372) -0.142 (0.482) Median Income -0.0001*** (0.00001) % in Labor Force -0.131*** (0.027) % Owner Occupied 0.083*** (0.015) % Vacant 0.125*** (0.032) Constant 8.830*** (0.306) 9.993*** (0.349) 14.976*** (2.201) AIC 1723.054 1690.667 1648.426 BIC 1734.185 1705.509 1648.426 Observations 302 302 302 Adjusted R2 0.018 0.120 0.316 Residual Std. Error 4.167 (df = 300) 3.943 (df = 299) 3.478 (df = 295) F Statistic 6.424* (df = 1; 300) 21.617*** (df = 2; 299) 24.159*** (df = 6; 295) Note: * - p < 0.05; ** p < 0.01; *** - p < 0.001
51. 4 MEASURING HEALTH AND PLACE
53. 4. MEASURING HEALTH AND PLACE PULLING COVID DATA TOGETHER New York Times COVID-19 Database (via GitHub) County Public Health Zip Code Data (via scrapers+API calls) Missouri COVID Tracking Data Sets State of Missouri and Illinois (via scrapers) CMS Nursing Home Data & HHS Hospitalization Data (via API) Census Bureau (via API)
55. Limited updates - not only are there lags, but data sources are often limited in longitudinal scope or receive (at best) yearly updates Problematic areal units - ZIP codes remain too common despite the known drawbacks Announcement Text CHALLENGES 4. MEASURING HEALTH AND PLACE Recency of data - MOPHIMS is comically out of date, and other data sources often run a year or more behind
56. Data are isolated - Analyses look within a single hospital system or within a certain subset of payor sources CHALLENGES 4. MEASURING HEALTH AND PLACE Announcement Text Data accessibility - Just downloading and working with these data can be incredibly challenging Announcement Text Data costs - Significant barriers to entry mean that a limited subset of researchers can realistically access data that do exist
57. CHALLENGES 4. MEASURING HEALTH AND PLACE Announcement Text Data costs - Significant barriers to entry mean that a limited subset of researchers can realistically access data that do exist Who are we doing this work for?
58. 4. MEASURING HEALTH AND PLACE “DETRIMENTAL INFLUENCES” How can existing but currently difficult-to-access claims data be extended to help create small area estimates for disease? ? How can we use these data to highlight disparities, engage community partners, and focus our attention on neighborhoods most harmed by structural racism? ? What are early 20th century racism’s longterm consequences for contemporary urban life and health?
59. 4. MEASURING HEALTH AND PLACE “DETRIMENTAL INFLUENCES” How can existing but currently difficult-to-access claims data be extended to help create small area estimates for disease? ? How can we translate this information into clinical practice? What are early 20th century racism’s longterm consequences for contemporary urban life and health?
60. Slides available via SpeakerDeck https://speakerdeck.com/chrisprener/washu-lec chris.prener@slu.edu chris-prener.github.io LEARN MORE THANKS FOR COMING! @chrisprener chrisprener.substack.com