Structural Drivers of Inequitable Health in Urban Spaces

Catalog description

Efforts to improve life in urban spaces require making decisions regarding use of resources, targets for development, and priorities for financial and political investment. Each of these decisions is dynamic and builds off one another, but regardless of their intended target, these decisions all have consequences for health, a perspective embraced by the “Health in All Policies” framework. More specifically, each of these decisions (and their resulting policies) become structures that ultimately either serve to promote or prevent health equity in urban populations. The impacts of these structures extend beyond consequences for chronic disease (i.e., asthma, diabetes, cancer), as they lead to inequitable patterning of infectious disease risk as well, a phenomenon illustrated by the severe racial/ethnic disparities in disease and mortality risk that have been observed in New York City, throughout the COVID-19 Pandemic. This course is an introduction to structural thinking as it pertains to health in urban spaces. Throughout the course we will discuss items such as zoning, public transit, education, and policing, and think through their implications for health. Furthermore, we will discuss common practices regarding each of these domains and illustrate how these decisions have contributed towards health inequities across multiple axes, including race, ethnicity, gender, and social class. Lastly, we will walk through illustrative examples of policies that have positively influenced health outcomes for the overall population, but exacerbated inequity in doing so, and will discuss the ethics and utility of such trade-offs.