Social Determinants of Health Mindy Thompson Fullilove, MD NYSPI at Columbia University November 18, 2011
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.