The neighborhoods and environments people live in can impact their health and the way they age and can create health inequities especially for people of color.
A Michigan State University researcher is taking part in a study to understand how what’s known as structural racism can lead to worse health outcomes for Black Americans.
The National Institutes of Health - National Institute on Aging is awarding $3.7 million to the project led by MSU professor Dick Sadler and a professor at Rutgers University. They plan to analyze longitudinal health data belonging to hundreds of Black and white Baltimore residents.
WKAR's Sophia Saliby talked to Sadler about the research.
Interview Highlights
Interview Transcript
Sophia Saliby: The neighborhoods and environments people live in can impact their health and the way they age and can create health inequities especially for people of color.
A Michigan State University researcher is taking part in a study to understand how what’s known as structural racism can lead to worse health outcomes for Black Americans.
Dick Sadler joins me now to talk about his research. Thank you for being here.
Dick Sadler: Yeah. Thank you so much, Sophia.
Saliby: What can structural racism look like when it comes to your research on aging and health?
Sadler: Yeah, so neighborhoods don't change or decline at the same rate, and we might expect them to in the absence of things like structural racism. And so, throughout the 20th century, there are a whole host of patterns of the ways that we disinvested in cities, the way we plowed freeways through them and practiced urban renewal, and the way that white flight impacted cities like Flint and Detroit.
And so, the pathways that are created is that neighborhoods decline unevenly. And so you see way more vacant properties in some neighborhoods and more crime and more environmental exposures, and so that drives decline more strongly in some places than in others. And the fundamental underpinnings of a lot of those patterns relate to the ways that people are racist against, in particular, against Black Americans and against other minority groups.
Saliby: You've said that these inequities don't just come from historic redlining or segregation. Can you explain more of what you mean by that?
While we recognize that discriminating against populations and housing is technically illegal, it's been able to continue on in these more kind of subversive ways.
Sadler: Redlining has become really popular, especially in like public health research, for understanding one element of historical racism that impacts on the landscape differentially today. But redlining was outlawed in 1968 and even though there's still other kind of insidious ways that neighborhoods have been, again, unevenly disinvested from or declined, the fact that we have these other patterns means that we need to study not just redlining, but again, the patterns of white flight and urban renewal and freeway construction and predatory lending, other ways that while we recognize that discriminating against populations and housing is technically illegal, it's been able to continue on in these more kind of subversive ways.
Saliby: I think, regardless of background or race, there's a mentality in America that maintaining good health or aging well mainly comes down to personal choices like diet or exercise. But it sounds like to you, it's more than that.
Sadler: Yeah. I mean, you could take two identical people, even, like, twin studies exist on this topic. I actually have a colleague who's doing a twin study on this broad topic. You take two identical people and you plop them in different neighborhoods, and one kid can walk to school and feel safe and go to the park, and the other kid lives in a community where it's dangerous to walk to school for one reason or another, and they don't go outside and they don't play.
And it's relatively easier or harder to practice healthy lifestyles, depending on where you live. I mean, even look at adults who live in distant suburbs and don't have the same kinds of social connections that someone may have if they live in a small town or a city.
Saliby: You're going to explore health inequities between a group of Black and white Baltimore residents. Why was Baltimore your city of choice for this project?
Sadler: Baltimore is the site of a longitudinal study of aging adults called the Healthy Aging in Neighborhoods of Diversity across the Life Span study. This is a National Institute on Aging intramural study. So in other words, the NIA created this study more than 20 years ago and has been following the same group of adults. And longitudinal research is important for understanding the actual causes underpinning this, because if we do a survey of one group of people one time, we don't understand how they're changing over time.
But by having this group that's been studied over multiple waves, we can see the onset of different kinds of aging endpoints, and then we can line up the neighborhoods they lived in across their lifespan or life course, as we say, and we can understand, okay, so this person lived in a neighborhood where this kind of disinvestment occurred, and they lived there for 40 years. And this other person that's otherwise pretty similar, lived in a series of different kinds of neighborhoods where there were more amenities and there were fewer environmental exposures.
We hope that we'll be able to tease out the potential impact of these patterns of neighborhood disinvestment and decline on these premature aging endpoints, so cognitive decline, physical frailty.
And we hope that we'll be able to tease out the potential impact of these patterns of neighborhood disinvestment and decline on these premature aging endpoints, so cognitive decline, physical frailty, stuff like that.
Saliby: What do you hope the impact of your research is? Or maybe, how can the results of whatever you find be applied to make policy changes?
Sadler: Yeah, again, this idea that neighborhoods we would think would decline in approximately similar pathways, but knowing that they don't. You compare a neighborhood in East Detroit in the 1950s or built in the 1940s, 1950s to a neighborhood in say, like Ferndale built around the same time, and they've gone through very different pathways over time.
And so ideally, we would want to structure neighborhoods in a way that everyone can have access to the same, not exactly the same, right, people are different, but everyone has access to healthy neighborhoods and opportunities to send their kids along walking to school and walking or biking to work if they choose. This idea of having everything you need relatively closer by instead of needing to drive out to the mall for everything.
Saliby: Dick Sadler is an MSU professor co-leading a study exploring the impacts of structural racism on aging and health. Thank you for joining me.
Sadler: Yeah. Thank you.
This conversation has been edited for clarity and conciseness.
