Why Would Anyone Tolerate Poor Health And Early Death?

One of the most common criticisms I hear about our efforts to deconcentrate poverty by redeveloping public housing projects as mixed-income communities is that the revitalization process "destroys the existing community."

That refrain can be heard among well-intentioned elected and appointed officials as well as from so-called resident advocates (often self-appointed).

It is not, however, generally a mantra one hears from the majority of the residents who live in the public housing projects.

Surveys show that more than 97 percent of the families living in Atlanta's public housing projects wanted out, wanted a chance for a better life. What these survey respondents were saying – and what I'm saying – is that obsolete housing developments that foster social dysfunction are so awful, so toxic that the buildings should be razed and the public policies that prop them up should be abandoned.

Previously, I wrote about the corrosive influence concentrated poverty has on the education received by children living in the public housing projects. If there is one issue that goes even deeper than schools, it is health.

There is an easily observed link between poverty and poor health. The Encyclopedia of Public Health bluntly states: "People with low incomes, particularly those who live in poverty, face particular challenges in maintaining their health. They are more likely than those with higher incomes to become ill, and to die at younger ages. They are also more likely to live in poor environmental situations with limited health care resources—factors that can compromise health status and access to care."

Those of us who work in the affordable housing arena know those facts all too well. We know that all of the primary characteristics of concentrated poverty – low educational attainment, low employment rates, lack of access to quality medical care, frequent proximity to environmental hazards such as waste dumps, the prevalence of criminal activities such as the drug trade, violence and prostitution – make it inevitable that residents of public housing projects are more likely to become ill, more likely to suffer from chronic ailments and more likely to die young.

You can add to that dismal picture this economic reality: If public housing projects equals poverty, and poverty equals lack of disposable income, then low-income mothers and their children have limited access to quality food stores.

Why is this so? Simply put, all commercial services, amenities and private investments follow "disposable income."

University of Georgia Professor Angela Fertig in 2006 co-authored a study that found: "[E]vidence suggests that residents of poor neighborhoods lack access to grocery stores that stock fresh fruits, vegetables, and other perishable goods critical for maintaining positive nutritional status."

Fertig's study also quoted a report by the Chicago Department of Public Health on residents of public housing projects that concluded "more than a quarter of the residents [of public housing projects] live half a mile or more from the nearest food store with fresh produce – and nearly 40 percent don't have cars to get there.... Access to fresh produce was even more limited [near another project] where there was one large food store for every 19,000 people."

A study in San Francisco showed residents in affluent areas could reach three different grocery stores within 10 minutes roundtrip, while those in low-income communities spent about an hour roundtrip traveling to the nearest supermarket.

It is no coincidence that neighborhoods with high concentrations of poverty lack adequate grocery stores, restaurants and other commercial establishments. Businesses depend on the disposable income of their customer base to drive sales and, therefore, financial sustainability. No amount of government subsidy can overcome the lack of disposable income in an impoverished neighborhood.

Residents of the housing projects also tend to engage in less physical exercise (fear of crime is a major factor in deterring healthy outdoor activities). A Kansas City study found public housing developments to be severely lacking in physical activity resources.

There are plenty of fat-laden, fast-food joints in low-income neighborhoods. A 2006 Center for Disease Control (CDC) study indicates that obesity prevalence is higher among lower income individuals, minorities, women and persons with disabilities than among the general population. The American Journal of Public Health reported last year that in Boston more than 30 percent of residents of the public housing projects reported being diagnosed as obese as compared with 18 percent of the residents from the general population in the city.

Equally well documented are the impacts with regards to specific diseases. Consider:

1. "Poor adults, particularly those living in public housing, have higher asthma rates as a result of environmental factors as well as problems managing the disease once it has been diagnosed," according to the National Center for Health Care for Public Housing Residents. The center also reports that families living in public housing are about twice as likely to have a child with asthma as the general population.

2. A significantly higher percentage of residents of public housing are current smokers than non-residents of public housing, according to a study by Boston University, the Boston Housing Authority and other groups.

3. The Boston University / Boston Housing Authority study also found that residents of public housing are burdened with hypertension at levels that exceed those found among the general population.

4. According to the Boston University / Boston Housing Authority study, a significantly higher percentage of residents of public housing reported having been diagnosed with diabetes than non-public housing residents.

5. Mental health, too, is a factor. In an ongoing study since 1999, The Boston Public Health Commission reports approximately 1 in 5 residents of public housing experiences 15 or more days per month when their mental health is not good.

The facts are indisputable and I trust my point is obvious:

Why would a caring society want to condemn any family to so-called "communities" where the physical and mental health of the occupants is severely threatened and their lives are undoubtedly shortened?

In the final analysis, who would responsibly advocate raising a child in such unhealthy conditions?

We know from experience and from tomes of academic studies that a low-income child's chances of success improve dramatically when that child is enrolled in a middle-class school – it is not the funding or class size that makes a difference but the enrichments that almost always accompany a mix of income groups. We also know that when an unemployed/under employed person moves into a socially viable community and receives job training and education the chances are that person will enter the mainstream economy and become economically self-sufficient.

Most importantly, we know that one of the most urgent reasons to end the policies of concentrating low-income families in obsolete public housing projects is that the public housing projects are inherently unhealthy. That is something we cannot deny or tolerate.

Atlanta's low-income families are relocating from such housing projects to healthier communities. We are demolishing the obsolete, distressed housing projects and then redeveloping the vacant sites into healthy mixed-use, mixed-income communities. The families are living in substantially improved environments and are rewarded with the consequential health benefits.

No longer is "poor health and an early death" the only option for low-income people.

Children Face the Greatest Risk

Fifteen years ago, we knew that we must abandon the model of concentrating poverty in public housing projects and move in the direction of creating economically integrated, market rate quality, mixed-income communities. We knew that the concentrated poverty of traditional public housing projects was having an insidious and corrosive impact on the lives of the residents, the surrounding neighborhoods, and the entire Atlanta community. What we had not fully comprehended was the negative impact these concentrated poverty residential arrangements were having on the neighborhood public schools and the educational outcomes of the children who attended those schools.

As my dear friend Dr. Norman Johnson, a former professor at Georgia Tech, Carnegie Mellon and Florida A&M, and a former Atlanta public school board member, puts it, “If you concentrate poverty in the residential arrangement, you cannot help but concentrate poverty in the neighborhood school. And, if you concentrate poverty in the school, it doesn’t work.”

The nation for decades has been divided about education reform. Progressives are blamed for merely wanting to throw money at schools. Conservatives are accused of wanting to undermine public schools in favor of private education. What’s often missing in this debate is a clear strategy towards proven success. Those extremes aren’t the answer. A pragmatic approach that is based on proven, successful strategies is what is needed.

The educators, sociologists and economists who have extensively studied education issues have all concluded that concentrating low-income children as a sociological design in schools does not work. This is not a statement about the ability or capacity of low-income children to learn. It is, indeed, a statement about the sociological environment that is needed to facilitate learning and great educational outcomes for children. We all know that education is the language of life and civilization and education is the great equalizer.

While engaged in this debate, the world has changed and the educational challenges have become more urgent because we are now engaged in global competition. In order to sustain our globally competitive posture, we must resolve to better educate a larger percentage of our population.

David Rusk, the former mayor of Albuquerque and one of America’s foremost urban thinkers, has written a paper titled “Housing Policy Is Education Policy." This paper should be a primer for everyone engaged in national housing and education discussions. As the title implies, it makes little sense to talk about housing policy unless you factor in education or to talk about education policy unless you factor in housing policy.

Rusk’s central thesis is that if you deconcentrate poverty among school populations, the success rate goes up. However, deconcentrating poverty in neighborhood public schools has proved to be difficult and many large urban public school systems are broken and troubled. Policies that favor concentrating families in public housing projects only exacerbate the problem of poverty-dominated schools. Sadly, academic failure under these conditions has been almost a certainty.

By contrast, in schools with a mix of income groups, we know that average test scores go up as the percentage of middle-class students increases. Ah, you say, that’s only because if you put low-income children in a middle-class school the blended rate of success, such as test scores, is likely to be higher than the average test scores at a predominantly low-income school. Not the case!

Rusk found a stunning trend in his research:

o In an Albuquerque study of 1,108 students, the average pupil from a public housing household showed a 0.22 percent increase in a basic skills test for every one percent increase in middle-class classmates.

o In Baltimore, the average basic skills test scores for low-income students went up 0.18 percent for every one percent increase in the middle-class classmates.

o A study of 186 Texas school districts showed that for every one percent increase in the number of middle-class students in a school, low-income students improved their chances of passing state exams by 0.27 percent.

Rusk also cited two schools in Buffalo, NY, to illustrate his thesis. The school with the smallest class size and greatest per-pupil expenditures was not the school with the highest achievement rate. Why? As Rusk explained, the more successful school, with larger classes and lower funding, had a poverty rate of only 7 percent of its students. The less successful school, even with its class-size and monetary advantages, had a poverty rate of 81 percent.

Put another way, in those studies the average scores of poor children attending a predominantly middle-class school will show a double-digit percentage improvement over the average scores of a poor child relegated to a largely low-income school.

“When there are significant socio-economic disparities, the effects of poverty and low parental education just wipe out other factors,” Rusk reported.

That opinion is echoed throughout academic research. A 2004 Rand Corp. study found the “most critical factors associated with the educational achievement of children … appear to be socio-economic ones. These factors include parental education levels, neighborhood poverty, parental occupation status and family income.”

The impact of socio-economic background of schoolchildren’s families on academic outcomes was first documented in 1966 by renowned sociologist James S. Coleman in “Equality of Educational Opportunity.” He studied American schools in depth and here are several of his major findings:

· “The educational resources that a child’s classmates bring to school are more important than the educational resources that the school board provides. … [T]he social composition of the student body is more highly related to achievement, independent of the student’s own social background, than is any school factor.”

· “Poor children learn best when surrounded by middle-class classmates.”

In Atlanta, we have studies that mirror these findings. Poor children who move from schools embedded in, or captive to, public housing projects to mainstream schools do much better because of the improved socio-economic environment. Georgia Tech’s Dr. Thomas D. Boston, in a 2005 paper, “Environment Matters,” found that “children who live in high-poverty communities do not receive proper educational guidance, and miss out on important early childhood learning experiences, recreational and after school activities, and/or other enrichment programs which help their development and lay the ‘foundation for success or failure in school’ and in life.”

As administrators of housing programs, real estate developers or professionals in related fields, we know that concentrating poverty in public housing projects or other residential arrangements leads to terrible human failure. We must never forget that a huge percentage of the people living in public housing projects are children. Thus, the toxic impact of concentrated poverty has had a disproportionate impact on our children, setting the stage for generational devastation.

When we began reshaping Atlanta’s housing policies 15 years ago, we knew that if we overburdened schools with children of poor families, the failure would spread. So, the goal was blending children of all economic backgrounds in schools where the positive sociology would support every child.

The results of achieving that goal were clear. At Techwood Homes, one of Atlanta’s worst projects, Boston found that in 1995 just 10 percent of the students at the neighborhood elementary school passed a basic writing skills test. By 2002, there was a new mixed-income community, Centennial Place, with a new neighborhood school, Centennial Place Elementary. Boston found that 62 percent of the neighborhood children passed the basic writing skills test – a level that was about 50 percent higher than all elementary schools in the Atlanta system.

With the studies of Rusk, Coleman, Boston and many others, we realize what works best: schools with a healthy mix of income groups, which optimally means that low-income students account for no more than 20 percent of the pupils.

Achieving goals for schools is a matter of sensible policymaking. By adopting and implementing policies that result in the creation of economically integrated communities, we can embrace a strategy and a sociological design for the schools that has a proven track record. With this improved sociological design (coupled with progressive school reform), our nation’s public schools have a substantially improved prognosis.

As the studies have shown, deconcentrating poverty in housing and schools is a great idea and even better public policy.

The Toxic Impact of Concentrated Poverty

Where do we start our discussion about public housing? One of the underlying problems in any such discussion is that it always starts in the middle.

As a nation, we have never agreed on the source of the problem. That’s understandable – as a nation, we are uncomfortable about the issue of poverty. We are unsure about why people are poor, we vacillate about the following: Are people poor because they are incapable? Are people poor because they are “minorities, primarily black people”? Are poor people capable of moral behavior? Are the projects crime-ridden because the people are “bad” people?

We must address these issues. An obvious statement is: People are poor because they have fewer resources than they need to live a more affluent life. If you believe that objective assessment, as opposed to believing that poverty is a punishment or natural state for some people, then we can make a bold conclusion: Poverty does not have to be a permanent condition.

How we, as policymakers and administrators, approach issues of poverty makes all the difference. The fact of the matter is that in order to solve the issue of poverty, we must accept the “truth” of the “universal humanity of all human beings.

The second “truth” that we must accept is that “environment matters.”

To solve the issue of poverty and how best to address the need for housing that is affordable to people who are poor, we must diagnose objectively and with integrity the problem with “public housing.”

To attempt a solution, without understanding the root cause of the problem is to insure continued failure. That is exactly what we did in Atlanta. We took an honest look at the symptoms and found the following about each and every housing project in Atlanta:

• Deteriorated physical conditions;


• Dangerous, crime-ridden, drug-infested places;


• Hopeless, dispirited and stigmatized residents who were disconnected from, and afraid of, the mainstream, because they rightly felt they were labeled and marginalized;


• Children being poorly educated and socialized because they were taught in "captive elementary schools" located as part of each public housing project campus;


• And tragically low participation in the work force and high rates of illiteracy and/or
  under-education.

Rather than address the real issues, many would prefer to debate whether the projects are really communities and these "incapable" poor people would be better off in the projects because as bad and destructive as they are, these are their "communities." Therefore, the issues are intentionally debated around the margins: e.g. "where will the people go?" Will the people be capable of living in "mainstream" America? Will they destroy the communities into which they move? Will they choose to move to better communities? Will they move next to me? Are they moving to places that they have not earned or deserve? Will crime go up when they bring their low morals and incapacity to my neighborhood? What is the best "next" for public housing residents?

No doubt, these questions are important, and they must be answered. But as the starting point for decision-making, I think we can all agree that doing nothing or continuing to do things that have failed in the past makes no sense. There is simply too much at stake.

Affordable housing is not just a bricks-glass-and-steel consideration. The physical aspects of affordable housing are important, but these issues are dwarfed by the sociological design.

And that sociology can be summed up in two concepts: Concentrated poverty and low expectations. When we comprehend the full implications of those two phenomena, we then begin to understand the reasons we felt compelled to provide radical alternatives to old-style housing projects.

The importance of asking these first questions can’t be overemphasized. Often, those of us involved in providing affordable housing to the very poor are faced with concerns from Congress or the federal administration. Questions from many officials – well-meaning officials – assume that the best place for public housing residents is in conventional public housing. Thus, any solution or next step is wedded to the belief that anyone who requires assistance to pay their rent can’t function in mainstream society and cannot meet civil standards of law-abiding citizens and of a civil society and must be kept where they are. And, of course, as we have learned, "where they are" is the wrong solution! I find it incredible that so many people don’t comprehend the awful, corrosive impact of intensely concentrated poverty and de-humanizing low standards and expectations.

Let me state up front that the linkage of the grinding poverty in public housing projects with failed sociology of concentrating poverty and low expectations and standards is not a uniquely American experience. Nor is it, as some would have us believe, a matter of race. Elsewhere in the world, notably Europe, the findings are the same. Confine any group in a virtual prison of poverty, coupled with low expectations and standards, and social failure is the result. National Public Radio, for example, reported in 2005: "Analysts blame recent rioting in France on the discontent and alienation fostered by bleak housing projects on the poor outskirts of French cities. The location and architecture of public housing can contribute to a sense of isolation and hopelessness."

"Isolation and hopelessness" is one way to define "concentrated poverty". There are others. I wasn’t content to read reports and studies. I went to all of the housing projects AHA owned and managed. I vividly recall hundreds of conversations, one with a woman living at East Lake Meadows. She told me about the death threats she faced on a daily basis, about worrying day after day because her children were threatened by the violence and crime that preys on public housing residents. I realized that she had become exactly what society expected, someone whose life was doomed to failure. I recall the dismal epiphany when I learned that no child (black or white) living in Techwood Homes during its entire 70 year history had ever crossed the street to attend our state’s most prestigious university, Georgia Tech.

It struck me that there was something fundamentally wrong here. And it was wrong at many levels. For example, many in Congress believe that social design doesn’t matter. Well, it does matter.

In the mid-1990s, Atlanta was cited as one of the most crime-ridden and violent cities in the nation. That’s bad – but what’s unacceptably horrible is that in one of Atlanta’s housing projects violent crime was 35 times greater than the entire city. In another community, known in the 1990s as "Little Vietnam" there was a $38 million drug trade being operated from that site. Those horror stories are repeated over and over.

Other statistics were equally appalling. Just 10 percent of the children attending schools embedded in the housing projects passed basic reading comprehension tests. We found unemployment rates at a staggering 70 percent to 80 percent. And, about 80 percent of our residents were women and children, along with the men who illegally resided with them.

In short, families were broken or non-existent. Education was broken. Economic success was unattainable. The threat of crime was a daily, sometimes hourly, reality.

We know that the people are not inherently bad or defective. I personally believe that all people are children of God with unlimited human potential.

We know with 100 percent certainty that peoples’ lives will transform if their environment is transformed and we invest in the people. Environment matters. We not only believed that, over the last 15 years we have been innovative with our programs and we have believed, challenged and invested in the people, and we have measured their successes.

The good news is that the successes number in the thousands!

What we did will be detailed in this series of newsletters. In closing this first one, however, I want to say that while much of what I write in the future will be heavy with statistics and analysis, what we did in Atlanta began with matters of heart and spirit. I’ll never forget my promise that, as a community and nation, we can do better than allow the horrible conditions at housing projects to go unchallenged.

Why I'm Writing "Lessons Learned"

We have a crisis in housing, actually several crises, and as people as far apart on the political spectrum as Milton Friedman and Rahm Emanuel have noted, crisis can lead to opportunity and not, necessarily, to disaster.

It’s the opportunity I intend to focus on in this series of newsletters titled “Lessons Learned.” Why should you care? Because the crises I mentioned impact you. Many of you know me. Those who don’t – I’m Renee Lewis Glover, CEO of the Atlanta Housing Authority. To summarize my credentials, the ones that count in this discussion, Atlanta was the first city to build public housing in the United States, and within the next few months we’ll be the first city to eliminate our public housing campuses.

I presided over that transformation. There are many, many lessons contained in that historic arc, and many people refer to what we’ve learned as the “Atlanta model.” I’m not so arrogant as to think our model can be applied without modification to other cities – but with great humility, I believe our experience can help other cities confront their own housing issues.

Let me phrase it a different way. The current economic recession’s leading edge had a lot to do with housing – sub-prime and predatory lending, overbuilding, mortgage-backed securities, etc. At the same time, an unrelated turning point is being reached by many housing authorities in America. Housing projects – most dating back to the 1960s and 1970s, and many others built before World War II – are functionally obsolete. They are beyond the point where they can be repaired and repainted. More important, even if they could be repaired and repainted, that in my judgment would be a dire mistake.

The projects are sociologically and spiritually obsolete. They no longer serve the purpose for which they were intended – to give families a boost out of poverty. Instead, as laws and policies changed, the projects have become poverty traps that ensnare families into never-ending failure.
So we see this convergence of critical housing issues – at the same time that we have a new federal administration, one that is more inclined to listen to cities than its predecessor. That’s part of the opportunity I mentioned. The federal government can become an energetic ally in reinvigorating the nation’s urban areas. But we must sharpen our messages. Do we want to perpetuate systems that are demonstrably broken? Or, do we push, and push hard, for assistance to create better lives for citizens?

That’s why I’m dispatching these newsletters to friends and colleagues around the nation.

What I’m not doing is preaching. I hope that this newsletter develops into a vigorous roundtable of voices exploring solutions for our cities.