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.