Thursday, December 13, 2007

Health and the City

Images from East Baltimore

Last week I attended a workshop at the Bloomberg School of Public Health called Health and the City: Integrating Urban Planning and Public Health. It was organized by a group of graduate and PhD students interested in exploring how our surroundings impact our physical and mental health and how the fields of public health and urban planning could work more in tandem. They brought in several panelists, including Mindy Fullilove, a research psychiatrist who studies the impact of the built environment on our physical well being. I've seen Fullilove speak before and her lectures are always really dynamic. She spoke about the concepts and research behind her book Root Shock: How Tearing Up City Neighborhoods Hurts America, and What We Can Do About It. In it, Fullilove analyzes how "home" is an integral part of our psychological stability and how the destruction of home has a staggering ripple effect on the individual and the community at large. She explains it this way:

Root shock is the traumatic stress reaction to the destruction of all or part of one’s emotional ecosystem. This metaphor is taken from botany. Plants suffer from root shock when they are relocated from one place to another. The loss of the familiar soil—with its particular texture and balance of nutrients—and the inevitable damage to the root system cause the plant injury or early death.

The Bloomberg School of Public Health [yes, named for THAT Bloomberg] is part of the Johns Hopkins University medical campus in the East Baltimore neighborhood. Most of the students travel around the globe to help address some of the most entrenched health issues, like AIDS in Africa. I've always found it interesting that this school sits on a hill surrounded by one of the sickest communities in Baltimore. Mostly black and poor, East Baltimore has suffered the well-storied tale of decline in a post-industrial city. Drug addiction, AIDS, violence...inspiration for episodes of The Wire, which is frequently filmed here.

Johns Hopkins is now expanding its East Baltimore medical campus to include a major Biotech Park. For the last several years, a public-private partnership known as the East Baltimore Development Initiative has taken homes through eminent domain in order to achieve their expansion. A resident recently told me that other major institutions in the area who are a part of this plan admitted to her community association that they had been landbanking homes for years, essentially creating vacancies and adding to the subsequent violence and unrest that comes from a shrinking neighborhood.

Sitting there listening to Fullilove, it struck me again just how disconnected our planing process is from the people who are impacted by those plans. Cities today have reverted back to the urban renewal of yore, that 1950s mindset that believed the "experts" knew best. In Baltimore, and in places around the country, we are again seeing massive-scaled projects that forcibly alter the landscape and scatter the residents who have struggled through the lean times.

Jane Jacobs wrote about this in her book The Death and Life of Great American Cities, published in 1961 just as that first phase of urban renewal was coming into full fruition. In the introduction, Jacobs tells the story of a public housing tower in New York's East Harlem neighborhood. Jacobs heard stories about the residents' hatred of a green lawn and she wondered why something as seemingly innocuous as a patch of green space so enraged and frustrated this community.

The neighborhood in question had recently been leveled to make way for those housing towers (the solution du jour for housing the urban poor). The residents had little voice in the vision for their community and few had a choice over where to live. Some were relocated to other sections of town, some were forced to move into the new buildings. The residents hated the lawn because it represented an official vision of progress. But it didn't feel much like progress to them.

One resident explained it this way:
Nobody cared what we wanted when they built this place. They threw our houses down and pushed us here and pushed our friends somewhere else. We don't have a place around here to get a cup of coffee or a newspaper...But the big men come down and look at the grass and say, "Isn't is wonderful! Now the poor people have everything."

Jacobs went on to observe that:

There is a quality meaner than outright ugliness or disorder and this meaner quality is the dishonest mask of pretended order, achieved by ignoring or suppressing the real order that is struggling to exist and to be served.

We have gotten so far afield from the true need that is struggling to be served. How do we honor the community and still allow for progress and growth? Props to the students who organized this workshop. I give them credit for stimulating this difficult dialogue in their own backyard.