San Francisco Chronicle, April 18, 2008: Study spotlights bleak effects of poverty

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Elizabeth Fernandez, Chronicle Staff Writer

Friday, April 18, 2008

(04-17) 21:37 PDT Oakland — A black child in West Oakland is much more likely to be born prematurely and into poverty than a white child in the Oakland hills. In school, he’s less likely to read at grade level and more likely to drop out.

As an adult, he’s more prone to diabetes, heart disease, cancer or stroke. And he can expect to die nearly 15 years earlier.

Illustrating the profound societal impact of chronic poverty, a new report released Thursday by the Alameda County Public Health Department documents health disparities by neighborhood, income and race. It highlights a widening social, economic and health gap in the county – as poverty goes up, life expectancy goes down.

“The data are overwhelming,” said Dr. Tony Iton, the county’s public health director. “It is shocking. It is not unique to West Oakland. You see it in Bayview-Hunters Point, in Richmond, in Cleveland and Detroit.”

A variety of factors, he said, affect whether a person thrives or doesn’t – education, income, transportation, housing, criminal justice, air quality, exercise, access to nutritious food or health care. Toxic stressors such as poverty, racism and discrimination cause a cumulative physical impact “that affects the body over time and leads to fewer years of life,” he said.

Joined by representatives from other agencies, including AC Transit, the Oakland Unified School District and the Association of Bay Area Governments, Iton called for sweeping “structural” policy changes to help reverse the tide of disparities and premature deaths.

“Typically, we in government work in silos,” Iton said. “Health people do health policy, education people do their thing, the transportation people do their thing. We can’t continue to do this. We have to come together to target the root causes of these disparities.”

Dramatic gaps in lifespan

The report, a summary of a larger analysis to be released next month, looked at life expectancies and ethnicity in different parts of Alameda County.

An African American living in the Oakland flatlands, for example, has a life expectancy of 70.5 years on average, compared with 77.4 years for an African American in the Oakland hills. A white person in the Oakland flats has a life expectancy of 76.6 years compared with a white person in the hills, who on average lives to be 82.3 years.

“People live longer in the hills,” said Sandra Witt, deputy director of public health. “People in the hills have higher incomes and education, better housing, they have health insurance, they live further from the freeway, they have more access to healthy food, to parks. It all adds up to greater opportunities and better health.”

The report correlates the poorest areas of the county – parts of North Oakland, West Oakland and East Oakland – with a striking pattern of disease and death.

“African Americans and Latinos are highly concentrated in these high-poverty areas, a result of racist institutional policies that led to physical separation of races in most of U.S. cities,” says the report. “While such policies are no longer sanctioned and the federal government has taken some affirmative steps to end residential segregation, inequalities associated with this shameful history persist. To help those who have been oppressed to rise out of poverty and gain access to a higher quality of life, sound economic and education policies are needed.”

Pinpointing the connection between income and health, the report showed a strong trend related to educational attainment: In areas with a higher high school graduation rate, life expectancy goes up. Those living in neighborhoods with a graduation rate under 70 percent live five years fewer on average than in neighborhoods where at least 90 percent of the residents have graduated from high school.

Rethinking public policy

The impact of homicide upon mortality rates was factored into the report.

“Homicides do influence the average life expectancy, but in West Oakland it is by only one year,” said Witt.

Bob Prentice, director of the Bay Area Regional Health Inequities Initiative, a collaboration of eight public health departments, said the report shows that “what really affects our health are the things that are tied to how we live our lives, the places where we live. This is a different way of thinking about community work, a rethinking of what a public health department means.”

The health issues of West Oakland have previously been documented. Last month, a study by the California Air Resources Board showed that diesel emissions from trucks, machinery and other sources cause an elevated risk of premature death, cancer, asthma and other chronic diseases.

To some residents of West Oakland, the dimensions of the problems facing the community seem overwhelming.

“It’s ugly,” said Shirley Burnell, who has lived in the neighborhood since 1961. “So many people here have asthma and other health issues. People on this corridor need decent jobs with health benefits. It would help a lot.”

Milton Lewis, 46, a Teamsters official, was born in West Oakland and spent his early years in the community – he was the third generation of his family to live there. His aunt died of cancer in her early 40s while living in a West Oakland housing project, he said.

“At one time it was a prosperous area,” said Lewis, who has moved to Manteca (San Joaquin County). “But now it’s as if everyone has forgotten about it. One of the reasons there’s such poverty is because there are few jobs. It is all connected. You can’t just put a Band-Aid over a wound that needs to be stitched – it will just keep bleeding. You have to fix the whole problem.”

Read the report

Summary: To see a summary of “Life and Death from Unnatural Causes – Health and Social Inequity in Alameda County,” go to www

Full report: It will be released next month.

E-mail Elizabeth Fernandez at

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