Across the United States, Black Americans experience significant disparities on almost every health indicator in comparison to white Americans. In Philadelphia, specifically, the average life expectancies of people living in poor, predominantly Black neighborhoods are 20 years lower than those living in nearby affluent, majority white neighborhoods. Many Black Americans are subject to racial health disparities as a result of societal systems that continue to perpetuate oppressive cycles of social and economic disadvantage. In addition, systematic disinvestment has contributed to deteriorating environmental conditions and led to acute economic insecurities, both of which research has shown to be strongly associated with poor health outcomes.

Courtney Boen, Assistant Professor of Sociology and PSTC affiliate, is part of a University of Pennsylvania-based research team that was awarded a $10 million NIH grant to conduct a controlled trial of concentrated investment in Black neighborhoods in Philadelphia, in order to assess and address structural racism’s impact on health. 

Previous research trials have primarily targeted individual-level behaviors and single social determinants of health but in doing so, their interventions fail to address the other factors that contribute to health inequities for Black Americans. As a result, many interventions and policies do not significantly improve community-level health outcomes. 

In Philadelphia, the project is investing in a series of interventions designed to improve the environmental and financial well-being of 720 adults across 60 Black neighborhoods. By introducing a multi-level investment policy at the community, organizational, household, and individual level, the team can address the various forms of structural racism that hinder the health of Black Americans. 

At the community level, the team is implementing vacant lot greening, abandoned house remediation, tree planting, and trash cleanup. At the organizational level, community-based financial empowerment providers assist in developing cross-organizational infrastructure to improve their reach and efficiency. At the individual level, increased access to public benefits, financial counseling services, and emergency cash assistance for households is provided. The team theorizes that these resources and interventions will significantly improve the overall health outcomes of the residents of these Black neighborhoods and positively affect trends in blood pressure, psychosocial distress, food insecurity, social connectedness, and violence.

This innovative suite of interventions has the potential to impart more substantial and lasting effects on Black health in different geographical contexts throughout the country. Collectively addressing the multi-level mechanisms of structural racism will help disrupt the cycles that disadvantage Black Americans. The team hopes that this project will provide scalable evidence to assist policymakers, communities, and healthcare systems in developing meaningful strategies to reduce racial health disparities.