FLINT, Mich. — A baby born in Flint, Mich., where I am a pediatrician, is likely to live almost 20 fewer years than a child born elsewhere in the same county. She’s a baby like any other, with wide eyes, a growing brain and a vast, bottomless innocence — too innocent to understand the injustices that without her knowing or choosing have put her at risk.
Some of the babies I care for have the bad luck to be born into neighborhoods where life expectancy is just over 64 years. Only a few miles away, in a more-affluent community, the average life span is 84 years. The ravages of Covid-19, which disproportionately affect low-income families and people of color, are surely widening this gap even further.
Throughout the United States, geography defines and describes inequities in health, wealth, mobility and longevity. The reasons for this are both visible and hidden. Life in a distressed neighborhood means limited access to health care and healthy food. It means living with violence, racism, poverty and uncertainty. It means bearing the brunt of environmental injustice — not having safe and affordable water, as Flint knows too well, or living in the shadow of a polluting factory. More air pollution increases rates of respiratory disease and reduces student achievement as well as life span. We are also beginning to understand the interplay of water access and air quality with Covid-19 severity.
These disparities between neighborhoods are rarely accidental; they are the product of purposeful policies and practices that have widened gaps in income, opportunity and equality. Over the decades, city inhabitants have been battered by deindustrialization; racist banking and real estate practices; white flight and population loss; austerity cuts to public education, public health and safety net programs; the corporate-driven weakening of unions; dilution of environmental regulations; housing and nutrition insecurity; and racially driven mass incarceration. And so much more.
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