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Social Determinants of Health
Mindy Thompson Fullilove, MDNYSPI at Columbia University
November 18, 2011
Environmental foundation of health: Disease rates fall before antibiotics or
vaccines
www.inequality.org
www.inequality.org
www.inequality.org
How is inequality created?
• Segregation• Dispossession• Profits over people
– Moving industry to low wage places– Cutting taxes for wealthy– Shifting costs to working people
Segregation
• Urban ghetto is a location within which members of a group must live
• Not synonymous with slum• First ghetto in Italy forced Jews to live in
a walled sector of the city• People survived by making strong
communities that could stand up for them and solve problems
Two parts of segregation
• Spatial separation• Repeated forced displacement
Segregation in Pittsburgh
Redlining
• System of preferential investment• Investment “most likely to succeed” if directed at
“green area”: white people and new buildings• Investment downgraded if directed at red area: old
buildings and non-white people• Differences in investment compound leading to very
large differences over time• Redlining triggers a cascade of other policies that
injure cities
Redlining inSyracuse
HILL DEMOLITION
Becoming Strong Again
Beginning of the fight against eminent domain in Brooklyn, June, 2004.
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