Housing disparity is the root cause of inequality
Green et al 2021 – (Kaye-Alese Green- Green received her bachelor’s degree in psychology and master’s degree in urban education and public health from the University of Central Florida and joined the racism in Medicine Vertical Integration Group (VIG), Allison Bovell-Ammon is the Director of Policy and Communications and leads federal policy work of Children’s HealthWatch as well as health care systems integration of housing and food. Megan Sandel, MD, is a professor of pediatrics at the Chobanian and Avedisian School of Medicine as well as a professor of environmental health at the Boston University School of Public Health.) 8/18/21, "Housing and Neighborhoods as Root Causes of Child Poverty," Academic Pediatrics, https://www.academicpedsjnl.net/article/S1876-2859(21)00437-X/fulltext//mish
In addition to the deleterious impact of systematic disinvestment and systemic racial inequity on individual children and family’s health and wellbeing, many communities exhibit racially based inequity in upward mobility. The statistically significant variance in intergenerational social mobility is strongly correlated to the intersection of race, gender, place, and wealth accumulation, which, in United States is most commonly related to home ownership.8 These compounding factors create intergenerational income gaps, a form of intergenerational inequality defined as “racial differences in income distributions conditional to parental income.”8 Without intentional investment in communities, neighborhoods can become disenfranchised and become centers of inequality. Neighborhood level inequality can be seen in occupational segregation, degradation of the built environment (such as poor lighting, lack of green space, and increased levels of environmental toxins), poor educational opportunities, and incarceration of adolescents and young adults. 8,18,32−34 These factors are buttressed by historical drivers of systemic racism and form a feedback loop that generates persistent inequity.18 This obstinate neighborhood level inequality is also exemplified by the negative impact it has on children and family’s health and wellness outcomes such as asthma exacerbations and average depression scores for caregivers.4,16,18,34 A multitiered and multifaceted approach is needed to dismantle the inequitable housing structures that induce and sustain health disparities for families with low incomes, especially for those in communities of color. The four tiers that will be examined in this manuscript are 1) Family/Primary Care Pediatrician Level; 2) Clinic Level Practices; 3) System/Anchor Institution Level; 4) Policy Level − the tertiary prevention strategies that address upstream drivers of inequity (Table). [table omitted]