A research team led by CHIBE-affiliated faculty members and PIs Eugenia South, MD, MS, and Atheendar Venkataramani, MD, PhD, MPhil, has been awarded nearly $10 million from the NIH to conduct a randomized controlled trial of concentrated investment in Black neighborhoods in Philadelphia to address structural racism as a fundamental cause of poor health.
Previous research in Philadelphia has shown that life expectancy for people living in poor, predominantly Black neighborhoods, such as around Strawberry Mansion, is 20 years lower than for people living in the nearby affluent, predominantly White neighborhoods of Old City and Society Hill in the City.
Structural racism is the fundamental cause of this kind of drastic health disparity, the researchers note.
“Our Black neighborhoods have suffered from systematic disinvestment and discrimination at the hands of both the government and private industry, which has led to a lack of economic opportunity and deteriorating neighborhood conditions,” said Dr. South. “All of this is tied to poor health and undergirds the seemingly intractable racial health disparities we see between Black and White Americans.”
“I am excited to work with Dr. South on a project that has a chance to be truly transformative for population health,” Dr. Venkataramani said. “I hope that our experience in Philly can help inform the efforts of researchers and policymakers all over America in their quest to mitigate long-standing racial health disparities.”
This RCT is innovative in its approach, deploying multiple interventions simultaneously — a “big push” — to more definitively address the multiple mechanisms by which structural racism harms health. The timeframe for this project is 2021 to 2026 with the intervention slated to happen in the middle.
At the community level, the team will implement several place-based interventions proven to improve health, including vacant lot greening, abandoned house remediation, tree planting, and trash cleanup.
At the organizational level, the team will partner with community-based financial empowerment providers to build cross-organizational communications and data infrastructure to increase Black residents’ access to financial services and public benefits.
At the individual- and household- level, they will connect Black households to partners to apply for and receive key health-promoting public benefits (such as utilities assistance and food benefits), tax preparation and financial counseling services, and emergency microgrants.
“We anticipate this approach to have a significant impact on multiple measurable health outcomes, including overall health and wellbeing, psychosocial distress, food insecurity, social connectedness, and violence,” the researchers stated. “We hypothesize that, when implemented simultaneously in targeted geographic areas, the positive health impacts of these interventions will be multiplied and longer-lasting than has accrued by implementing any individual component.”
Dr. South is Assistant Professor of Emergency Medicine at the Perelman School of Medicine, University of Pennsylvania, as well as Vice Chair for Inclusion, Diversity, and Equity for the Department of Emergency Medicine and Faculty Director of Urban Health Lab. Dr. Venkataramani is an Assistant Professor of Health Policy and Medicine at the University of Pennsylvania and Director of the Opportunity for Health Lab.
They are joined in these efforts by Charles Branas, PhD, Professor and Chair of Epidemiology at Columbia University; Courtney Boen, PhD, MPH, Assistant Professor of Sociology at Penn; George Dalembert, MD, MSHP, Assistant Professor of Pediatrics at CHOP; Meghan Lane-Fall, MD, MSHP, FCCM, Associate Professor of Anesthesiology and Critical Care and Biostatistics, Epidemiology, and Informatics at Penn; Kristin Linn, PhD, Assistant Professor of Biostatistics at Penn (and CHIBE affiliate); John MacDonald, PhD, MA, Professor of Criminology and Sociology at Penn; and Christina Roberto, PhD, Associate Professor of Medical Ethics and Health Policy at Penn and CHIBE Associate Director.
This grant, 1-U01OD033246-01, is one of 11 NIH-supported grants for innovative health disparities research proposed by researchers across the country through the NIH Common Fund’s Transformative Research to Address Health Disparities and Advance Health Equity initiative.
“This initiative aims to move us closer to eliminating health disparities and paving the road to achieve health equity, where everyone has an equal opportunity to live the healthiest life possible,” stated the NIH Office of Strategic Coordination – which oversees the Common Fund.