Frontiers of Health Services Management

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Winter 2022 - Volume 39 - Issue 2

  • Carla J. Sampson, PhD, FACHE
  • 0748-8157
  • 2475-2797
  • 4 issues per year

​​​​From the Winter 2022 Issue

In high school, I frustrated my history teacher with my repeated question: Why? Her approach of reciting what happened in the distant past was not nearly as interesting to me as understanding the mores and motives and tracing the consequences of what happened. Today, Google makes this information easy to find on my own.

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For example, while driving through Orlando as a new resident in 2013, I saw children playing in a yard near the busy Interstate 4 (I-4) and State Route 408 interchange. I was horrified. There they were, enveloped in the particulates discharged from the hundreds of thousands of vehicles that used those busy highways daily. I thought they must have asthma! Why are their families living amid such pollution? Quick research answered the question: Construction of I-4 through Orlando in the early 1970s isolated Black residents of the Parramore neighborhood into an unhealthful environment.

Orlando is not the only American city where this has happened. Last fall, the US Department of Transportation announced grants to remove these transportation divides, reuniting some cities. However, it is not just a question of why we put major roadways where we put them. A comparison of old redlined city maps to today's maps illustrates how development affects health determinants such as clean air, neighborhood safety, walkability, and access to green spaces, to name just a few. Those patterns of built segregation, along with socioeconomic inequality and practices that prohibit access to opportunity, become manifest today as health outcomes that have more to do with zip code than genetics.


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