The Built Environment: The Source of Inequities in Health, Wellbeing, and Feminist Activism in Communities of ColorCherise Charleswell I Women's Issues I Analysis I April 3rd, 2014
Public health specialists and other social scientists would describe the built environment as a human-made space, where people live, work, and recreate, that consists of buildings, structures, and other products created or modified by people. Thus, it includes but refers to much more than a geographic location. The built environment includes one's neighborhood and all of its available resources - parks, bike lanes, libraries, schools, clinics/hospitals, full service grocery markets, etc., one's home and family unit, as well as their place of employment.
Traditionally, research and interventions carried out by public health specialists working in conjunction with legislators, city planners, engineers, and architects have primarily focused on housing, transportation, and physical neighborhood characteristics. However, there is a growing body of evidence that is emerging which suggests that physical and mental health problems -anxiety, depression, attention deficit disorder, substance abuse, aggressive behavior, asthma, heart disease, diabetes, and obesity - are linked to an unsupportive built environment, particularly to poor urban planning and inadequate housing.
A critical point when considering the built environment is the impact that it has on resident's health, particularly when keeping in mind that health comprises far more than the absence of disease and injury. Health also encompasses one's wellbeing. Thus, the circumstances within a built environment can greatly contribute to inequities in health outcomes, as well as diminish opportunities to become involved in feminist activism and any other activity that would require the commitment of valuable time and resources. Communities of color are those where the built environment is more likely to be plagued with barriers to health and wellbeing; and, for that reason, they also have the highest rates of social inequity and health disparities. Helping to mitigate these barriers may aid in increasing the number of women directly involved in feminist and social activism. The assumption is that concerns surrounding the procurement of food and housing, along with the burden of a reduced health status, will ultimately monopolize the time of women of color living within these socially constructed environments. Therefore, feminist organizing and analytics must include a focus on the role of the built environment in the lives of women, along with its affect on their physical and mental health.
Intersectionality and the Built Environment
Intersectionality, a term coined by feminist legal scholar, Kimberle Crenshaw, is a feminist sociological theory which takes a critical look at varying and multiple dimensions of social relationships. The theory essentially describes the ways in which oppressive institutions are interconnected and thus cannot be examined separately from one another. It has become an accepted and well respected research and policy paradigm.1 The central tenets of intersectionality include: (1) that human experiences cannot be accurately understood by prioritizing any one single factor or constellation of factors, (2) that social categories/locations, such as race, ethnicity, gender, class, sexuality, and ability are socially constructed, fluid and flexible, and (3) that promotion of social justice and equity are paramount.2,3 The theory of intersectionality serves as a tool for analyzing the ways dimensions of difference - e.g. race, gender, ethnicity, class, sexuality, ability, age - can form interlocking inequalities and must, therefore, be simultaneously considered if we are to understand accurately how people shape their environments and negotiate their everyday lives within the contexts of ideological, political, and economic systems of power.4
The built environment may be viewed as a sum of all of these various intersections, or as a site where they all convene. The built environment itself is socially constructed and has historically been formed and maintained through residential segregation. Racial segregation may be defined as the physical separation of the races by enforced residence in certain areas, which serves as an institutional mechanism of racism, which was initially designed to protect whites from social interactions with blacks and other populations of color.4 When discussing societal oppressive institutions, it must be made clear that, racial segregation has long been identified as the central determinant of the creation and perpetuation of racial inequalities in America.4 The Spatial Mismatch theory, first proposed in 1960 by John F. Kain, explains the correlation between residential segregation and economic performance for residents living in these socially excluded communities of color: "Black enclaves are often physically separated from employment opportunities. As a result, residents of these neighborhoods face high commuting costs and may lack information about new job openings, or the means to actually get to those jobs."5
Racial segregation is the keenest form of social exclusion, and concentrates poverty and excludes and isolates communities of color from the mainstream resources needed for success.6 The problem of social exclusion remains a clear and present reality for communities of color. In fact, poor African Americans were 7.3 times as likely to live in high poverty neighborhoods as poor white Americans in 2000, followed by Latinos, who were 5.7 times more likely.7 These rates of exclusive poverty actually doubled since 1960. Moreover, in understanding the relationship between intersectionality and the built environment, it is important to realize that factors which act as focal points in intersectionality include those that are multi-level forces. These external and often distant forces, such as policies and legislation, shape the built environment by acting upon it and influencing those who live within its boundaries. Thus, there is a realization that policies do not simply 'impact' people, instead they 'create' people" . 8 In other words discriminatory, unjust, and unethical policies help to create marginalize populations and low income wage earners, or the working poor. Furthermore, these external forces take primacy in making the lives of women unequal.
This speaks to the fact that women of color are directly impacted by the racial wealth divide and women's wealth divide. A 2010 report by the Insight Center for Community and Economic Development revealed that single Black and Hispanic women have one penny of wealth for every dollar of wealth owned by their male counterparts and a fraction of a penny for every dollar of wealth owned by single white women.9 This race and gender wage gap that compounds the lives of women of color is attributed to the fact that women of color are less likely to benefit from the "wealth escalator", as they represent the group that is most often without the intangible items that translate into wealth, such as workplace fringe benefits. In addition, women of color are excluded from fringe benefits because they work in larger numbers in service industries, which do not offer these benefits. The Insight Report also provided data to substantiate this claim. It reported that 28% of Black women and 31% of Latinas, compared to 12% of white men and 19% of white women, work in service jobs.9
For African American, Latina, and indigenous women, gender is a part of a large pattern of unequal social relations, but how it is experienced depends on their race and how it interjects with other inequalities.10 Further, the intersections experienced within the built environment promote or constrain opportunities for health, socioeconomic advancement, and social/feminist activism. In terms of looking at gaps in educational achievement, residential segregation has led to highly segregated schools and may be viewed as the fundamental cause of racial differences in the quality of education. 4 This disparity is attributed to the fact that physical residence determines which public schools one can attend, and those living within a built environment with a deficit in resources will predictably receive less support. For older women of color, institutional discrimination grounded in residential segregation severely restricts employment opportunities and income levels. Thus, for women of color, the critical intersection of race in the built environment is a prominent concern due to the direct impact on health. Racism, primarily through racial segregation, influences how people are treated, what resources are available to them, how they live, how the world perceives them, what environmental exposures they are exposed to, and what opportunities they have in order to thrive and reach their full potential. 6
Ultimately, a feminist and interdisciplinary approach to health inequities must include the consideration of all of the intersections within the various spaces that women occupy, which negatively impact their livelihood. Therefore, this approach must identify and examine the connections between disadvantage and health, and the distribution of power. 11 Additionally, in creating these disadvantages, the roles of race and gender must be closely scrutinized, particularly when considering how these circumstances act as barriers to the engagement and mobilization of women of color in feminist organizing.
Barriers and Realities
Barriers, whether they are cultural, physical, economic, or social - including discriminatory practices and circumstances - make it difficult for women of color to successfully navigate themselves towards a feminist ideology that is robust and able to embrace all aspects of their experiences. Cultural norms and how they dictate the way in which women are treated within families and communities helps to determine our understanding of womanhood, and the place of women in the world. 12 Further, cultural norms and practices are a significant part of the built environment, and represent an intersection that greatly influences the lives of women. Also, culture can directly, as well as negatively, impact the health and wellbeing of women, and thus consequently acts a as barrier to feminist discourse. An example of how cultural norms can act as a barrier to both health and feminist activism is provided when looking at female illiteracy in culture's that disvalue or do not allow women to actively pursue education, especially a higher education. This lack of education translates into the inability to assume employment outside of a service industry or outside of a household, and thus locks one into lower wages and ensures that they will be segregated into residential areas that have low resources, particularly in regards to health care. Researchers have already identified socioeconomic status as a fundamental cause of observed social inequalities in health. 13,14,15 The culminate effect is reduced health outcomes and a lowering of quality of life and well-being, which involves working many hours or multiple jobs, and thus having little time or ability to be actively involved in women's and social justice movements or political activism.
The sentiments shared by anthropologist, Patricia Williams Lessane, in her report on the panel discussions and roundtables referred to as the Women's "F" Series, which was a collaborative effort developed by the Chicago Foundation for Women and the Columbia College Center for the Study of Gender in the Media and Arts, helps to add credence to the argument that barriers in the built environment, the intersections that influence the lives of women - particularly women of color - diminishes their efforts and involvement in feminist organizing and discourse: "The experience of struggle was the core of many of the speaker's experiences. For some, the day-to-day struggle to get an education, find a job, and raise a family left no space for participating within an organized feminist movement."12
There is indeed a centrality of race to the formation of the North American built environment, as well as others in which societies are made up of diverse racial and ethnic populations, and it is imperative that we use feminist analytics, including the theory of intersectionality, to study these relationships and put forth efforts to address blatant inequities in built environments that reduce the quality of life and well-being for women of color, as well as act as a barrier to their engagement in feminist discourse and organizing. In short, when women are faced with the mounting challenges within their built environment, they are unable to readily identify time to take part in efforts that will help to improve their social conditions.
The Built Environment's Impact on Health
In terms of organizing and advocacy, health and well being will always remain the priority. Consequently, the higher rates of health disparities resulting from realities within the built environment unfairly help to diminish the involvement, advancement, and prominence of women of color in feminist discourse. The following rhetorical question posed by anthropologist William Dressler exemplifies the importance of taking into account non-biological or genetic factors role in health outcomes and mortality rates:
"So many medical conditions are differently distributed to African Americans - heart disease, diabetes, hypertension, low birth weight babies - are we to believe that Black people were so evolutionary unlucky that they got all the genes that predisposed them to every malady?"6
Of course, we are not to believe that all of these maladies and health disparities are attributed to biological differences in African Americans. Instead, we must look at the factors - those intersections in the built environment that contributes to a lower status of health and well-being. Again social exclusion and residential segregation greatly influences the day-to-day realities of the built environment. In this case, they greatly constrained the choices that people have the selection of healthy and nutritional foods. A 2002 study revealed that African Americans were actually five times less likely to live in census tracts with supermarkets than white Americans.16 Public health specialists have long been aware of the direct correlation between zip code, the availability of nutrient-rich products, and health.17 Even when the nutritional and subsequently more expensive food options are available, women of color may face a barrier of not having the needed purchasing power to afford to buy and consume the healthier options. This lack of access to nutritious food products has translated into the increased risk or manifestation of chronic diseases in communities of color.
Championing the access to healthy foods and safe spaces should be a topic of monumental and mutual concern for women, public health specialists, and those engaged in feminist discourse; in that the topics highlight an area where women have traditionally held agency and a degree of influence, with their traditional roles as care givers and custodians of health and well-being within families. In this role women meditate activities concerning dietary habits, personal hygiene, and childhood activities. The buildings and structures within the built environment also largely impact health, and housing concerns are prominent for women of color and single women, especially single mothers. The quality of housing is also likely to be poorer in racially segregated areas. 18 Housing concerns, particularly crowded and substandard housing, which impact health and wellbeing are numerous and include: elevated noise, inadequate or extreme heat depending on the season, as well as exposure to environmental hazards, such as carcinogens, toxic compounds, allergens and lead paint. A number of empirical studies, conducted over 40 years have determined that low-income communities and communities of color are more likely to be exposed to environmental hazards.19 Thus; women of color are burdened with the struggle to survive and thrive amidst environmental health risks.
Feminist organizing that addresses these issues would prove to be more attractive, inclusive, and beneficial to women of color. The final condition within the built environment that affects women's health and wellbeing is the level of crime and/or violence. Violence affects health by increasing the risk for injury and death, and of particular concern to women is domestic or intimate partner violence. Women of color experience high rates of domestic violence, and studies have found that African American women have the highest rates, followed by Latina women.20 Despite these alarming statistics, discussions on rape culture are not openly discussed in communities of color, and rape itself often goes unreported, particularly within the African American community.
Feminism must be rooted in liberation and self-agency, and agency should be looked upon as a mode of action and site of intervention. In other words, feminist ideology must identify, address, and help to mitigate or remove barriers and oppressive institutions that impede gender equity. Therefore, feminist organizing and analytics must include a focus on the role of the built environment in the lives of women, due to its ability to directly and often negatively impact women's health and wellbeing, and thus decrease the likelihood that they would become involved in women's and social movements. If feminism ideology is truly rooted in liberation, it must willingly address the various social issues - violence, poverty, poor education, unemployment and underemployment, and the lack of access to health care - which disproportionately impact women, particularly women of color.
In conclusion, collaborative efforts between public health specialists and feminists will provide a needed interdisciplinary approach that can critically examine the varying intersections and barriers to health, wellbeing and equity in the built environment. Those working in the field of public health have expertise in addressing the health effects of poverty, material disadvantage, and inequity, while feminists are quite familiar with addressing the less tangible aspects of inequity, which include lack of power, discrimination, and oppression.
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