“Weathering” HOPE VI: The Importance of Evaluating the Population Health Impact of Public Housing Demolition and Displacement

Abstract

HOPE VI has funded the demolition of public housing developments across the United States and created in their place mixed-income communities that are often inaccessible to the majority of former tenants. This recent uprooting of low-income, urban, and predominantly African American communities raises concern about the health impacts of the HOPE VI program for a population that already shoulders an enormous burden of excess morbidity and mortality. In this paper, we rely on existing literature about HOPE VI relocation to evaluate the program from the perspective of weathering-a biosocial process hypothesized by Geronimus to underlie early health deterioration and excess mortality observed among African Americans. Relying on the weathering framework, we consider the effects of HOPE VI relocation on the material context of urban poverty, autonomous institutions that are health protective, and on the broader discourse surrounding urban poverty. We conclude that relocated HOPE VI residents have experienced few improvements to the living conditions and economic realities that are likely sources of stress and illness among this population. Additionally, we find that relocated residents must contend with these material realities, without the health-protective, community-based social resources that they often rely on in public housing. Finally, we conclude that by disregarding the significance of health-protective autonomous institutions and by obscuring the structural context that gave rise to racially segregated public housing projects, the discourse surrounding HOPE VI is likely to reinforce health-demoting stereotypes of low-income urban African American communities. Given the potential for urban and housing policies to negatively affect the health of an already vulnerable population, we argue that a health-equity perspective is a critical component of future policy conversations.

Housing Relocation Policy and Violence

“…Chicago is the most frequently studied city (Keene & Geronimus, 2011;Kling et al, 2005;Lindberg et al, 2010;Popkin et al, 2009Popkin et al, , 2012Sharkey & Sampson, 2010), while MTO and HOPE VI are the most frequently studied housing policies (Table 2). Table 2 shows the terms we used to how each paper measured violence-related outcomes.…”

“…Literature assessing HOPE VI and its impact on specific violence-related outcomes in destination neighborhoods is much larger. Most of the literature regarding HOPE VI is based on two studies commissioned by Congress in 2001, and the HOPE VI Resident Tracking Study commissioned in a similar time frame by the U.S. Department of Housing and Urban Development (Keene & Geronimus, 2011;Lindberg et al, 2010;Popkin et al, 2009Popkin et al, , 2012. Among our chosen articles, there is a division of residents into two sets of comparison groups: (1) those who use their vouchers to move to private market housing versus those who move into other public housing and (2) traditional voucher holders versus voucher holders who are former public housing residents.…”

“…Despite notable constraints that restrict voucher users' choice of housing, perceived safety was greater among voucher users, with 80% reporting that their new neighborhood was safer than their old one (Keene & Geronimus, 2011). Conversely, certain interviews with Chicago public housing residents revealed that demolition of the public housing communities may have increased violence in and around the area as gangs were now in closer proximity (Keene & Geronimus, 2011). Furthermore, pervasive drug trafficking and gambling in the streets, as well as sporadic shooting, made people who moved to other housing projects feel less safe (Popkin et al, 2009).…”

“…Conversely, families lose social capital and intergenerational networks they count on for different levels of support. 11 Indeed, while people may feel their new neighborhoods are less violent in general, they feel more vulnerable to whatever violence exists because they have lost the ''protection of a familiar community where 'everyone had your back''' (Keene & Geronimus, 2011).…”

Public Health Implications of Medical Care Discontinuity for Imprisoned Black Men

“…6,7 As we noted, 5 given data limitations, the reductions we estimated in excess mortality among urban Black men between 1990 and 2000 might partly be an artifact of the explosion in the incarceration of urban Black men during this period. More broadly, given changing residential composition over the 1990s (owing not only to inequitable imprisonment, but also to gentrification, residential displacement in the wake of public housing demolition policies, and other factors that have disproportionately affected high-poverty Black urban populations), 8 the health outlook for these populations may be bleaker than we reported. The fact that most of the data available to monitor the health of poor populations in the United States are cross-sectional and do not allow researchers to track the geographic movement of individuals over time makes it difficult, if not impossible, to gauge the magnitude of these effects.…”