The Health Divide: Systemic racism haunts Black communities, and Asian Americans show high exposure to toxic chemicals

How neighborhood segregation affects children’s health

Policies that segregated neighborhoods by race officially ended decades ago, but the effects of this systemic racism persist and impact Black children growing up today.

In fact, one recent study found that neighborhood segregation is deepening in many parts of America.

Highlighting the wide-ranging effects on children’s health, articles last week looked at exposure to toxic lead, risk for repeated gun violence and the anxiety and trauma caused by losing a home.

Communities can address these health risks with strategies involving investment in neighborhoods, health education and long-term support, researchers suggest.

Lead levels in blood were higher in kids living in majority Black neighborhoods, according to a study of more than 300,000 North Carolina children through age 6, published in the journal Pediatrics. And the more segregated the neighborhood, the more likely Black children were to have high levels of lead in their blood.

The findings "highlight two issues that many Americans may think are relics of the past: childhood lead poisoning and neighborhood racial segregation," writes Amy Norton at HealthDay. 

The researchers calculated that residential racial segregation went up in 69% of U.S. neighborhoods from 1990 to 2010.

The older, rundown housing in low-income neighborhoods that once isolated Black Americans can contain lead, which is particularly toxic to young children as it accumulates in their developing brains.

While effects vary, children exposed to lead may score lower than others on academic tests, and they are more likely to later be incarcerated.

It’s up to communities, landlords and pediatricians to protect children, said study author Marie Lynn Miranda of the University of Illinois Chicago.

Another problem that plagues Black communities is eviction. One in 5 children of Black mothers experience evictions, compared with 11% of children of white mothers.

Evictions are correlated with developmental issues and mental illness among children who experience them, writes 2023 National Fellow Alexa Imani Spencer at Word in Black. 

“It creates a feeling of mourning that can morph into years of mental and emotional suffering if untreated,” Spencer writes. 

The symptoms of trauma can show up in a variety of ways, such as anger, depression, shame or disordered eating.

Eviction is also associated with infant mortality and pre-term and low-weight births.

This problem, too, can be traced to systemic racism, which “traps Black caregivers and their dependents in cycles of housing insecurity," Spencer writes.

Policies that trigger evictions can be biased against Black families. For example, some jurisdictions have ordinances that encourage landlords to evict victims of repeated domestic violence on "nuisance" grounds, said Leah Goodridge, managing attorney for housing policy at the New York poverty law center Mobilization for Justice. Such policies are more likely to affect Black mothers.

The ongoing effects of systemic racism also contribute to a high risk of gunshot injuries, often in repeated incidents, report Dierdre McPhillips and Jen Christensen at CNN.

About one out of 14 gunshot victims will be injured by a gun again within a year, according to a new study in the Annals of Internal Medicine. 

The study, which focused on more than 9,000 gunshot wound patients in St. Louis, Missouri, found that those most likely to suffer repeated firearm injuries were male, Black, young — the average age was 25 — and lacked health insurance.

"Most people see gun violence as a public safety issue. I see it as a public health issue that is basically driven by the sense of hopelessness," said Dr. Edward Barksdale, a pediatric trauma surgeon in Cleveland, who wasn’t involved with the study. “Primarily, these are young men who feel there is no future."

Victims of an initial firearm injury might be at increased risk because they start carrying their own weapon or are more likely to use one in a future conflict, write McPhillips and Christensen.

Repeated gunshot wounds often lead to major depression or suicide attempts, the pair add.

Gunshot wound survivors at high risk for additional firearm injury or death often come from areas deemed to have “high social vulnerability” — based on factors such as unemployment rates. These communities have decades-long histories of disinvestment, poverty and unemployment.

“Prioritizing community (re)investment approaches represents an important set of strategies to reduce community violence,” wrote the study authors, many from Washington University in St. Louis. A 2022 Brookings Institution report recommends policies that bolster safe community spaces, employment opportunities and youth programs. 

Barksdale and others have created hospital-based violence intervention programs that not only address the immediate injury, but also provide assistance such as mentoring, links to community services and long-term follow-up.

Research also suggests tougher gun laws, such as higher minimum ages for gun purchase and mandatory waiting periods, can curb firearm violence.

PFAS exposure highest in Asian Americans

“Forever chemicals” known as PFAS (“pee-fass”), found in products from firefighting foam to cosmetics, are at their highest levels among Asian Americans, reports Kimmy Yam at NBC News. 

The chemicals, which build up in the body with repeated exposure, can interfere with hormone systems, causing problems such as cancer, birth defects and death. 

A study in Environmental Science & Technology found PFAS levels were 88% higher in people of Asian descent in the U.S., compared to white people.

The reason for this high exposure isn’t clear. It may be linked to cultural dietary preferences, such as the consumption of freshwater fish, which are often contaminated, speculated Anna Reade, the lead PFAS scientist at the Natural Resources Defense Council, who wasn’t involved with the new study.

Or the higher levels could reflect the arrival of people from nations with different PFAS regulations, suggested study author Shelley Liu of the Icahn School of Medicine at Mount Sinai.

“Asian Americans, unfortunately, are not that well represented in medical research. There are definitely a lot of things we don’t know yet,” said Liu. “It would be really important to investigate how this higher PFAS burden [in] Asian Americans might be related to potential health impacts.”

Identifying racial disparities can also help target outreach and cleanup efforts, Reade said. 

Deaf children are unimpaired, say pediatricians

Deaf children are “equal, healthy and whole,” and shouldn’t be called “impaired,” according to the latest guidelines from the American Academy of Pediatrics.

“The terminology needs to change because kids who never had hearing from birth have not experienced a loss. It is their normal. They are not impaired,” Regina Zappi of the American Speech-Language-Hearing Association told Denise Mann at HealthDay.

The Academy report uses the terms “deaf” and “hard of hearing.”

However, deaf children who aren’t identified early may miss out on language acquisition during the key years before age 5. 

Infant screening doesn’t identify kids who only later become hard of hearing, so it’s important for hearing checks to continue throughout childhood.

What we’re reading:

• "Biden administration names 10 prescription drugs for price negotiations," by Amy Goldstein and Daniel Gilbert, The Washington Post
• "Fake ‘sober homes’ targeting Native Americans scam millions from taxpayers," by Alice Fordham, NPR’s Morning Edition
• "Black lung resurgence prompts new mining rules," by Kris Maher, The Wall Street Journal
• "Medicaid rebukes states for mistakenly disenrolling children," by Sarah Owermohle, STAT
• "Some older adults are being charged over $300 for the new R.S.V. vaccine," by Dana G. Smith, The New York Times
• "More cities address ‘shade deserts’ as extreme heat triggers health issues," by Lauren Peace and Jack Prator, KFF Health News
• "Playgrounds are too dang hot," by Willy Blackmore, Word in Black
• "Workers exposed to extreme heat have no consistent protection in the US," by Gabe Stern, AP News