Health problems avoid to escape from very poor neighborhoods

Do health problems really occur more often in very poor neighborhoods compared to wealthy neighborhoods, and if so, what are the effects? A recently published study, co-authored by a professor at the US-based Massachusetts Institute of Technology (MIT) means it is also harder for families to move out of poverty if they live in high-poverty neighborhoods and if their children have health problems. “If families started out with a sick child in the home, they were much less likely to be able to move to a low-poverty neighborhood,” says Mariana Arcaya, an assistant professor in MIT’s Department of Urban Studies and Planning (DUSP) and co-author of a new paper detailing the study’s results.

The underlying data for this study are information from the federal government’s Moving to Opportunity (MTO) Program. Within the framework of this program, launched in 1994, poor families got the opportunity to move to new neighborhoods through the support of a voucher. In this way, it was maybe easier to improve their financial situation if they live in more wealthy districts. The study considered 5,000 American families in Baltimore, Boston, Chicago, Los Angeles, and New York. The results are indicating a coherence between the occurrence of child-health problems and the number of families moving to less poor areas. Fifty percent of families without health issues were using the chance to move from high-poverty to low-poverty neighborhoods. But only 38 percent of families with a child-health problem were moving too. Moreover, families with child illnesses who did move settled into neighborhoods where the poverty rate was 2.5 percentage points higher, on average, than the places where families without child-health problems settled.

“Movers that had a sick child were moving to slightly poorer neighborhoods,” Arcaya says. “Having that additional challenge in the family restricted people’s options.”

These findings are an important issue and should not be neglected relating to sustainable urbanization. Environmental protection but also economic development and social development are essential pillars of sustainability. These three pillars of sustainability are an important foundation for numerous sustainability standards and certification systems in recent years.

Based on the provided data the researchers are not really sure why families with a sick child were less moving. But Arcaya has some ideas. “One is a bandwidth issue,” she says. “It’s a lot of work to try to find new housing in a different and more expensive neighborhood. It takes a lot of visiting and transportation and coordinating.” Indeed, it is more strenuous to move with a sick child.

Also the removal expenses might be higher because they need cost-intensive support to provide care for their children. “People who have complicated challenges like caring for a sick child may be cobbling together support from informal sources,” Arcaya notes. Grandparents, relatives, and neighbors may all be instrumental in looking after kids. “Taking that system and saying, ‘We’re going to move,’ is a really challenging thing.”

Higher renting costs are the third barrier to use their given chance. The higher the rent, the less financial resources for unexpected health care costs. The fear of lost earnings because of a break that comes with caring for a sick child is strengthening the third barrier. “There might be some risk aversion,” Arcaya adds. “There’s this well-understood phenomenon, you get sick and that causes individual financial problems. … The risk of moving may be a little bit too much [for some families] if they are trying to maintain instrumental social networks and save money for when illness-related expenses arise.”

Further investigations are needed for a better understanding of the causes of these results. After this study, Arcaya hopes for more attention. “If health affects neighborhood choice, we need to know that,” Arcaya says. And maybe more urban planners and policymakers consider the findings. According to the study, we may constantly “undervalue direct investment in healthcare as a poverty deconcentration tool that could give poor families more social and economic choices,” at least in urban areas.

The study was partly supported by National Science Foundation, and the Robert Wood Johnson Foundation.