“It’s the Neighborhood, St***d”

“Life is like riding a bicycle. To keep your balance, you must keep moving.” Albert Einstein

A study just published in the September 20 issue of Science gives a whole new meaning to moving.  The study comes from the data of over 4,500 low income families who participated in a large-scale randomized social experiment called Moving to Opportunity.   The poor neighborhoods were in 5 cities, Baltimore, Boston, Chicago, Los Angeles and New York.     Moving to Opportunity used a random lottery to offer vouchers to around 2,000 extremely disadvantaged families who were living in distressed public housing projects .  These vouchers  allowed them to move to mixed income neighborhoods, that is, better neighborhoods.  The study was done to determine the impact of where one lives on one’s health.   The research published in Science is based on comparative data of those adults who moved and those that stayed in the neighborhood.  It is longitudinal data, data obtained 10 to 15 years after the move took place.

Most of the households in the study were headed by African-American or Hispanic women, most of whom had not completed high school.   According to participants, their motivation for moving was to find better schools, have better apartments and get away from gangs.

Findings from the study are interesting.  First, those who moved to better neighborhoods increased their physical and psychological health. They had lower rates of diabetes, obesity, anxiety, depression and stress than those who stayed.

In addition, movers in this study had gains in happiness and well-being compared to those who stayed.  In fact, although the movers did not see any income increases, they experienced the same gains in degree of happiness as would be found in people who have $13,000 family income gain.

Poverty and poor surrounding take a toll on people. Researchers have surmised that  in the the poor are severely impacted by decision fatigue.    Abhijit Banerjee and Esther Duflo note in their book Poor Economics, decision fatigues cost for the poor.

There are”…many things that…[those who are not poor]  take as given. We live in houses where clean water gets piped in — we do not need to remember to add Chlorine to the water supply every morning. The sewage goes away on its own — we do not actually know how. We can (mostly) trust our doctors to do the best they can and can trust the public health system to figure out what we should and should not do. … And perhaps most important, most of us do not have to worry where our next meal will come from. In other words, we rarely need to draw upon our limited endowment of self-control and decisiveness, while the poor are constantly being required to do so.”

In other words, making difficult decision after difficult decision takes a  toll on mental energy.   The more choices one has to make through the day, the harder each one decision becomes for the brain.  As decision fatigue sets in the brain looks for shortcuts: either becoming reckless,  impulsive, or making no decision at all and doing nothing.

Racial neighborhood segregation is decreasing in the US but economic segregation is increasing.  The findings in Science point to health improvements due to decent, safe housing.   When in stressful, difficult situations–like living in unsafe neighborhoods–much mental energy is used.  Important decisions based on health recommendations, like healthy eating or doing physical activity,  for personal or family health, are either neglected or ignored.  In other words, perhaps when the movers in the study didn’t have to decide the best time to go to the grocery store based on when gangs were roaming the neighborhood, they had more mental energy to make the “healthy” choices at grocery stores that are recommended.

No matter the mechanisms, one thing is certain from the research on Moving to Opportunity:  moving from extremely poor, violent neighborhoods to  better neighborhoods improves health.  Shouldn’t making neighborhoods safer and easier to live in be a national public health priority?

 

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