First aid for ailing communities

Richmond,Va., is an urban city of approximately 205,000 residents, of which about one in four live in poverty. The city is surrounded by suburban counties--Chesterfield and Henrico--that are much larger in terms of geography and population and where poverty levels range from 5 percent to 10 percent.

The city has a poor showing on many health status indicators and outcomes. Within the city, however, there are neighborhoods of $1 million homes and moderate income neighborhoods. At the same time, practically all the region’s large public housing complexes are in Richmond.

It’s been established that “place matters” to health. What, I wonder, are the mental and physical effects of living in cramped quarters with worries about crime. There are also low-income neighborhoods with so many so many boarded-up buildings that they make public housing developments look good.

These inadequacies are not lost on the residents. Students in a Photo Voice project assigned to take pictures of things in their neighborhoods they’d like to change showed images of a corner market’s fast food counter (too much fried food) and a run-down house. One student wished for a community garden like one in a nearby neighborhood.

My project will take a look at health status by ZIP code, census tract or neighborhood. How much different is morbidity and mortality in Gilpin Court, a large housing development, compared to Midlothian in suburban Chesterfield, for example? The challenge will be to get adequate data down to a meaningful level.

Richmond leaders have launched an initiative to get residents more active and improve health. But can anything short of demolishing the swaths of blight even start to make a difference? Others argue that the city (and its poorest residents) will forever be at a disadvantage because the city simply doesn’t have the tax base of the suburban counties. There is also an “us” versus “them” mentality that makes meaningful regional cooperation unlikely.