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Cover image of Unequal Cities
Cover image of Unequal Cities
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Unequal Cities

Structural Racism and the Death Gap in America's Largest Cities

edited by Maureen R. Benjamins and Fernando G. De Maio
foreword by Julie Morita, Former Commissioner, Chicago Department of Public Health

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Across the United States, Black people have shorter life expectancies than white people—reflecting structural racism and deep-rooted drivers of population health. But are some cities more equal than others?

The elimination of racial and ethnic inequities—differences that are avoidable, unnecessary, and unfair—has been one of the overarching health-related goals of the United States for decades. Yet dramatic differences in health outcomes between Black people and white people persist, rooted in structural and social determinants of health. Nationally, a Black baby can expect to live four years...

Across the United States, Black people have shorter life expectancies than white people—reflecting structural racism and deep-rooted drivers of population health. But are some cities more equal than others?

The elimination of racial and ethnic inequities—differences that are avoidable, unnecessary, and unfair—has been one of the overarching health-related goals of the United States for decades. Yet dramatic differences in health outcomes between Black people and white people persist, rooted in structural and social determinants of health. Nationally, a Black baby can expect to live four years less than a white baby. But mortality outcomes and inequities vary widely across cities. In Washington, DC, for example, the average life expectancy for Blacks is twelve years less than that of whites. But in other cities, mortality differences between races are less striking or nonexistent. If health equity can be achieved in some cities, why not all? This is arguably the most important health equity issue of our time.

In Unequal Cities, Maureen R. Benjamins and Fernando G. De Maio gather a team of experts to explore these racial inequities, as well as the ten-year gap in life expectancy between our healthiest and unhealthiest big cities. Rigorous analyses give readers access to previously unavailable data on life expectancy, mortality from leading causes of death, and related Black-white inequities for the country's 30 biggest cities. The theoretically grounded essays also explore how characteristics of cities, including their levels of income inequality and racial segregation, impact overall health and Black-white inequities.

The first book to specifically examine racial health inequities within and across US cities, Unequal Cities offers a social justice framework for addressing the newly identified inequities, as well as specific case studies to help public health advocates, civic leaders, and other stakeholders envision the steps needed to improve their cities' current health outcomes and achieve racial equity. A powerful call to action for health equity advocates and city leaders alike, this book is essential reading.

Contributors: David Ansell, Darlene Oliver Hightower, Jana Hirschtick, Sharon Homan, Ayesha Jaco, Emily LaFlamme, Brittney S. Lange-Maia, Kristin Monnard, Nikhil G. Prachand, Pamela T. Roesch, Michael Rozier, Nazia Saiyed, Eve Shapiro, Abigail Silva, Veenu Verma, the West Side United Metrics Working Group, Ruqaiijah Yearby

Reviews

Reviews

An illuminating book packed with eye-opening insights, lessons learned, and an unprecedented blueprint for how we can transform our communities into healthy, equitable, and inclusive places. Unequal Cities is a must-read for those who are ready to move beyond merely nibbling around the edges of the problem of health inequities.

Unequal Cities is a seminal treatise that skillfully documents the root cause of health inequities, describing how racism and discrimination limit access to the very opportunities and resources each of us need for optimal health and well-being. The authors are to be commended for demanding that we use this information to act.

Unequal Cities lays bare the intergenerational and systemic effects of disinvestment and dehumanization on the life span and health of marginalized and minoritized communities in a digestible way. The authors eloquently and impressively describe the imperative of progress from mere data analysis to action through a health equity lens.

About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
336
ISBN
9781421440996
Illustration Description
3 halftones, 35 line drawings
Table of Contents

Foreword by Julie Morita, Former Commissioner, Chicago Department of Public Health
Acknowledgments
Introduction. A Path to Health Equity for Cities
Part I. Entrenched Racial Health Inequities in the

Foreword by Julie Morita, Former Commissioner, Chicago Department of Public Health
Acknowledgments
Introduction. A Path to Health Equity for Cities
Part I. Entrenched Racial Health Inequities in the United States
Chapter 1. Context for Entrenched Racial Health Inequities
Chapter 2. Theorizing the Causes of Health Inequities
Part II. Racial Inequities in US Cities: An Analysis of Mortality Data
Chapter 3. Inequities in All-Cause Mortality, Life Expectancy, and Premature Mortality
Chapter 4. Inequities in the 10 Leading Causes of Death
Chapter 5. Inequities in Selected Causes of Death: HIV, Homicide, and Opioid
Part III. Epidemiological Patterns and Sociological Explanations
Chapter 6. Understanding Mortality Patterns and Inequities across US Cities
Part IV. Translating Data into Action: Practical Approaches to Health Equity
Chapter 7. Using a Social Justice Framework to Help Achieve Health Equity
Chapter 8. Data Are Not Enough: Moving toward Solutions-Focused Communication
Chapter 9. Mobilizing to Action: Overcoming Chicago's 16-Year Life Expectancy Gap
Conclusion. Next Steps on the Path to Health Equity
Appendix
About the Authors
Index

Author Bios
Featured Contributor

Maureen R. Benjamins, PhD

Maureen R. Benjamins is a senior research fellow at the Sinai Urban Health Institute. She is the coeditor of Urban Health: Combating Disparities with Local Data.
Featured Contributor

Fernando G. De Maio PhD

Fernando G. De Maio is a professor in the Department of Sociology at DePaul University and the director of health equity research and data use at the American Medical Association Center for Health Equity. He is the coeditor of Community Health Equity: A Chicago Reader.