The Expert View
Expert View - Summer 2011
Angela Glover Blackwell
Founder and CEO

Angela Glover Blackwell
Let's Build Healthier Environments for All

By Sandy Graham

EDITOR'S NOTE: CEO Angela Glover Blackwell founded PolicyLink in 1999 and continues to drive its mission of economic and social equality. The Oakland, Calif.-based organization is a leader in the movement to use public policy to improve access and opportunity for all low-income people and communities of color, particularly in areas of health, housing, transportation, education and infrastructure. Blackwell has written and spoken extensively on poverty and equitable development issues. She formerly worked for The Rockefeller Foundation. She holds a bachelor's degree from Howard University and a law degree from the University of California, Berkeley.

What role does the built environment play in people's health?

At PolicyLink, we are concerned about promoting policies that allow just and fair inclusion into society so everyone can participate and prosper. Sadly, where you live in America is a proxy for opportunity. When I think about the built environment, I think about a 2008 study by the Alameda County (Calif.) Health Department that showed residents of the more affluent Oakland Hills had a 10- to 15-year longer life expectancy than poorer people in West Oakland flatlands. In the hills, people have places to exercise, safe sidewalks on which to walk, parks in the neighborhood, less polluted air, access to fresh fruits and vegetables and public transportation. In the flatlands, those amenities are scarce.

I think the built environment has more to do with health, well-being and longevity than almost anything else. We do low-income people a great disservice by fussing at them for the choices they make in diet and physical exercise when they don't live in an environment that makes good choices very easy.

Why are people in lower-income neighborhoods less likely to have the built environment that supports them in their efforts to live healthy lives?

Let's be frank. It's because they are low-income communities of color. Now, I know there are places where there are concentrations of people who are white and poor and the same inequities may exist there, too. But in urban areas today, however, you do not find concentrations of poor white people. Studies have shown that poor white people are more likely to be dispersed throughout urban communities while poor black or Latino people are likely to live in concentrated areas.

If you'd look back prior to 1954, you'd find many more black and Latino people who lived in economically diverse neighborhoods. Once the Supreme Court ruled against segregated schools in Brown v. the Board of Education in 1954, things began to change. First, white people bused their children to the suburbs; then they moved to the suburbs, taking their political clout, businesses and jobs. When black middle-class families had opportunities, they moved out, too. In the neighborhoods they left, parks were neglected, schools closed, crime grew. Black people didn't bring those things. It was disinvestment – disinvestment due to our refusal to deal honestly with issues of race in America and running away from opportunities for integration for black families.

This lives on today. We are continuing to see disinvestment in communities that are predominantly black and Latino – even as many cities are working successfully to revive the urban core.

Can we measure the health impact of inadequate built environments?

There are plenty of studies. "Designed for Disease," PolicyLink's study published in 2008 with UCLA and the California Center for Public Health Advocacy, looked at 43,000 Californians and found that people who live near an abundance of fast-food restaurants and convenience stores have a significantly higher prevalence of obesity and diabetes compared with people who live near full-service grocery stores and fresh produce vendors. The highest rates of obesity and diabetes were found among people who live in lower-income communities where they had poorer food environments. It's a perfect example of how the environment affects health and how the absence of good food is more likely to occur in the low-income community.

What can we do to increase access to healthy foods?

I consider it a national scandal that so many low-income Americans have little or no access to fresh fruits and vegetables. Pennsylvania's Fresh Food Financing Initiative, a grant and loan program, has been very successful in bringing healthy food retailers into underserved communities. (See PDF icon  "Greening Food Deserts," Health Elevations, Winter 2010, for more about Pennsylvania's work.) PolicyLink is working to get a similar financing plan created at the national level. It has had the support of President Obama, but has not passed Congress. The good news is many states are moving ahead on their own.

Are policymakers getting the message that they can improve overall community health by their actions?

We are working to help policymakers in many communities become more self-conscious and proactive about the effect of their decisions on health. Richmond, Calif., is one of the first communities to really focus on a health element in the city's general plan for growth and development. We have worked very closely with them. We also are advising the Health in All Policies Task Force created last year by then-Gov. Arnold Schwarzenegger to advance programs, policies and strategies to improve the health of Californians under the auspices of the state's Strategic Growth Council. We've also worked with Minneapolis and other communities in developing health impact assessments, which measure how new development does or doesn't support good health, and making sure they understand the importance of health equity.

Why are parks and green spaces so important in supporting communities' health?

Good parks and green spaces are where children play, where families spend time together and where people of all ages can exercise and relax. The opposite is also true: In poorly designed and poorly maintained parks, children and families stay away, illicit activities proliferate and parks become eyesores. We are working with the San Joaquin River Parkway and Conservation Trust and community members, especially Latinos and Asian immigrants, to plan an expansion of the river parkway in the Fresno (Calif.) area. In other communities, we're helping them look at joint use of parks and green space between schools and communities.

How do you regard Colorado's efforts in the built environment and health?

I've heard a lot about LiveWell Colorado [dedicated to stopping obesity by encouraging physical activity and healthy eating] and the $3.7 million it distributed to 22 communities around the state in 2010. I know there are a lot of people across the country watching that.

We work with the Robert Wood Johnson Foundation on preventing childhood obesity and I was frankly surprised to see Colorado's childhood obesity rates among Latino and black children were so high, although there are worse rates in other states. I see Colorado still has challenges despite its image as a healthy state.

At a time of extreme fiscal challenges, how do you make a case for spending money on the built environment?

I don't think the nation realizes that the lack of investment in low-income communities of color is hurting everybody. It's not just the right and morally proper thing to do. Given the changing demographics of the nation, if we continue to have these inequities, the United States will no longer be a nation that is competitive in the 21st century.

I would say to policymakers at every level, from the school board to the President of the United States, don't be shortsighted. Don't try to solve the fiscal crisis on the backs of the poorest Americans. We have to have a long-term vision and long-term plan, and approach them responsibly.