The voices of Urban Institute's researchers and staff
October 24, 2011

Can Your Neighborhood Make You Sick?

October 24, 2011

Obesity and diabetes threaten more and more Americans, especially those who can’t afford good medical care.  And as Sue Popkin has noted, residents of distressed public housing projects suffer at unusually high rates. The anxiety and stress of living amid crime and violence, lack of nearby grocery stores selling healthy, affordable foods, and the absence of safe places to exercise all undermine people’s health.

Now comes compelling new evidence that moving away from severely distressed neighborhoods can boost health.  Last week, a New England Journal of Medicine study reported on the decade-long Moving to Opportunity (MTO) experiment, which offered poor families the chance to leave distressed public housing projects and move into low-poverty neighborhoods.  Families who volunteered were randomly assigned to “treatment” and “control” groups and their well-being was monitored over many years.  So the case that living in a distressed neighborhood is bad for your health is particularly strong.

Unfortunately, just telling poor people that – along with eating right and getting more exercise – moving  to better neighborhoods would make them healthier isn’t enough.  Most low-income families are already struggling to afford today’s high rents, and moderately-priced housing is scarce in healthy neighborhoods.

How can public policies respond?  Here are three recommendations:

  1. The federal housing voucher program should help participants find neighborhoods where crime and violence are low and where healthy foods and exercise opportunities are abundant. It should discourage them from using precious housing subsidies in dangerous, unhealthy neighborhoods.
  2. Cities should give priority to community development investments that make low-income neighborhoods healthier.  That means targeting violent crime, providing affordable sources of healthy food, and operating fun, safe parks and recreation programs.
  3. The scarce public subsidies available for rental housing construction should go toward expanding affordable housing options in healthy neighborhoods, not further concentrating poor families in neighborhoods that are making them sick.

Obesity and diabetes don’t just degrade people’s quality of life.  They make it harder to get and keep a job. And they cost a lot to treat.  Investing in prevention, research shows, can yield big savings over time.  Now that we know how much where you live matters, we should craft our housing and community development policies to help rather than hurt.

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