Thursday, September 20, 2012

How Bloomberg Housing and Education Policies Contribute to Health Disparities in the Bronx

Since everybody in the Bronx knows me as Notorious Phd, I have to begin my remarks with a line from one of the Bronx’s greatest rappers, Big Pun, whose life and early passing symbolizes many of the issues we are confronting here today. The line--”Iverson crossover, cheese doodles, grape soda” is one part of a litany of cultural practices which Pun found on the streets of the Bronx, some of which condemned people to an early death. This is certainly true of eating practices in Bronx neighborhoods, many of them places where it is almost impossible to find fresh fruits and vegetables, and where residents would have difficulty affording them even if they could find them. The Bronx is not only the poorest of New York’s 62 counties, it has been rated the unhealthiest, and has the highest rates of both hunger and obesity among New York’s five boroughs. Despite all the heroic efforts health professionals and community activists to bring healthier food to the people of the Bronx, and promote healthier lifestyles, the forces activists are up against, some of them political, some of them market driven, are making that task extremely difficult.In the remarks that follow, I will argue that the health problems of the Bronx are not primarily a result of poor choices on the part of its residents, but of policies which accentuate the poverty of Bronx residents and make their lives more difficult and stressful. And while I fully support community based health programming, I also urge people to turn their attention to policies shaped by powerful forces outside the borough which undermine the health of Bronx residents. There are three different dynamics currently affecting the health status of Bronx residents in a negative way, each of which is rarely discussed in the medical literature—Gentrification, Housing and urban planning policies which promote hyper-segregation; and Test driven education policies which undermine health and fitness of public school students. I will discuss how each of these shape life in Bronx neighborhoods, and intensify health problems that were serious even before their effects became visible. First, let us look at Gentrification. The Bronx has been the site of a demographic revolution in the last 20 years, with people from West Africa, the Dominican Republic, and Mexico moving to the borough in large numbers. But this has not been an entirely voluntary migration. According to Greg Jost, deputy director of the University Neighborhood Housing Progam “ New York’s poorest renters are being priced out of other boroughs and are moving to the West Bronx one of the last bastions of affordable housing in the borough.” When in the Bronx, Jost adds, many of these new residents are paying over half their income in rent, putting a huge dents into funds available for things like health care, food and recreation. And that is not all. According to community activists I have spoken to, the exodus from gentrifying neighborhoods like Harlem, Washington Heights, the Lower East Side and Williamsburgh, has resulted in immense housing overcrowding in many sections of the Bronx, with families doubling and tripling up in apartments, people renting out rooms, and even couches to boarders, and spanking new townhouses being subdivided into illegal rooming houses where immigrants can rent rooms with communal bathrooms and kitchens at prices they can afford. These crowded conditions accentuate the risk of fires and communicable diseases, while the income pressures inhibit families abilities to purchase health food. You cannot realistically address healthy conditions in the Bronx, in my judgment, without looking at housing overcrowding, and housing affordability; both of which are at crisis levels in the Bronx The second factor is housing and planning policies which promote hyper-segregation and accentuate the concentration effects of poverty. During the last ten years, almost every vacant lot in the South Bronx has been the site of new housing construction, some of it in the form of town houses, some of it in the form of large apartment complexes. This has definitely increased the supply of affordable housing in the borough, not enough to offset the impact of gentrification related migration, but still an impressive contribution. But while all of this new housing has gone up, it has not been accompanied by the construction of new youth or recreation centers, raising the question, where are the young people living in these new buildings going to go to get exercise or supervised recreation? If the local public schools were open to the community for this purpose, that would be different, but because ofbudget cuts, some of them stemming back to the fiscal crisis of the 70’s some of them more recent;, those gymnasiums are almost entirely unused in after school hours. And the result is a recreation crisis- felt most acutely by youth= fostered by planners who concentrate affordable housing in already poor-segregated neighborhoods without providing the new recreation resources these residents will need. Most Bronx neighborhoods are not only FOOD DESERTS, they are RECREATION and EXERCISE DESERTS. The dangers of the double whammy should be apparent to everyone in this room. And they can only be corrected by changes in city policy regarding the relationship between housing and recreation space in all new development The final force, shaped by political interests outside the borough, negatively affecting the health of Bronx residents, is school policies shaped at the City, State and National level which rate teacher performance, and the fate of entire schools, on the basis of student results on standardized tests. In New York City today, both as a result of Bloomberg Administration policy, and as a condition of accepting Race to the Top Money, schools who do not meet certain performance targets on standardized tests must be closed and half of their teaching staffs removed. More than 144 such school closing have taken place already, many of them in the Bronx, despite the protests of students, parents and community members, with more slated for the future. Along with this, new procedures have been approved at the state level requiring public ratings of teachers, 40 percent of which is based on students test scores, with several years of bad ratings requiring that the teacher be removed. These two policies have created an atmosphere of near panic in the schools of the Bronx, where many of the students are children of immigrants, and a high portion have special needs. And the results have been devastating for the physical and emotional health of these students. To make sure students test well, many schools have taken time once used for gym or recess and use them for test prep; while converting after school recreation programs into study halls. The result is that already recreation starved youngsters in the Bronx get almost no physical activity in their schools and sit at their desks all day. This in my judgment, is a public health disaster, but you cannot address it without reducing the impact of high stakes testing on the careers of Bronx educators. It is a policy problem that has to be addressed at it’s source, City Hall, the State Capital in Albany, and the US Department of Education. I am not pointing out these larger forces to undermine the valuable work everyone here is doing to improve health opportunities and health choices for Bronx residents. Everything you are doing builds communities and saves lives. But we also have to try to change policies at the city and national level which make this work more difficult- and build the kind of alliances necessary to do that. The people of the Bronx did not create the conditions they live in; and while they can organize to make their lives better it they will need help from both markets and government who thus far have done more to accentuate their hardships than relieve them.

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