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2.  Saying No to 
Racial, Economic, and Health Inequities
In California’s Transportation And Land Use System

Compared with a White child born in the Oakland Hills, an African American born in West Oakland is 1.5 times more likely to be born premature or low birth weight, seven times more likely to be born into poverty, twice as likely to live in a home that is rented, and four times more likely to have parents with only a high school education or less. As a toddler, this child is 2.5 times more likely to be behind in vaccinations. By fourth grade, this child is four times less likely to read at grade level and is likely to live in a neighbor- hood with twice the concentration of liquor stores and more fast food outlets. Ultimately, this adolescent is 5.6 times more likely to drop out of school and less likely to attend a four- year college than a White adolescent. As an adult, he will be five times more likely to be hospitalized for diabetes, twice as likely to be hospitalized for and to die of heart disease, three times more likely to die of stroke, and twice as likely to die of cancer. Born in West Oakland, this person can expect to die almost 15 years earlier than a White person born in the Oakland Hills.

Dr. Tony Iton
Life and Death from Unnatural Causes
Health and Social Inequity in Alameda County
Executive Summary


Before we look at the social justice opportunities and challenges of California’s Sustainable Communities & Climate Protection Act (SB 375), and the Health in All Policies Executive Order, we must briefly examine how transportation and land use developments in California in the past half-century have contributed to racial, economic, and health inequities in communities of color and low income communities throughout the state.  Civil rights, environmental justice and health equity advocacy groups have organized to address many of these issues for decades.

As we approach a new generation of public policies it is important to know how land use and transportation policies during the past fifty years, have contributed to massive gaps in opportunity between whites and communities of color. (Advocates of a new generation of climate policies seem reluctant to make these connections.) The goal of Part Two of the Toolkit is to help participants understand this background.


In 1956, with creation of the National Highway Defense act, the federal government began construction of a system of controlled-access highways designed and built specifically for high-speed vehicular traffic. The massive highway and tax subsidies in suburban development and corresponding disinvestment in the inner cities since the 1950s has contributed to social, economic, and environment, and health inequities between racial groups in California’s metropolitan regions.  The earlier pattern of metropolitan growth in the United States defined by walkable neighborhoods served by public transit has been replaced by a large scale, sweeping pattern of explosive suburbanization and central city decline.

The racially defined pattern of metropolitan development conferred multiple advantages on middle class white suburban home owners, positioned to capture health supporting benefits: good schools, low taxes, access to jobs, parks and open space, participation in local government.   These transportation and land use developments in California since then have contributed to racial, economic, and health inequities in low income communities of color throughout the state.

These benefits were unavailable to African Americans trapped by segregation in the housing market facing the social and economic consequences of inner city decline and growing concentration of poverty.
Freeways contribute to health inequities in at least four ways:

1.  Disproportionate impacts of highway pollution and locally unwanted land uses on communities of color.   Highway interchanges and bus depots, are often “locally undesirable land uses.” Poor people and people of color disproportionately live near these locations and suffer associated health consequences— the effects of diesel air pollution, noise pollution, injury risks, Stresses, and oppressively ugly surroundings.

2.  Highways divide communities, buttressing racial segregation and reinforcing health inequity.  Highways are free standing structures, surrounded by what Jane Jacobs called “border vacuums.” surrounded by what Jane Jacobs called “border vacuums.”  They are cut off from communities with no crossings with other roads, railways, or pedestrian paths. “ Racial residential segregation is a fundamental cause of racial disparities in health,” according to David R. Williams, and Chiquita Collins, “By determining geographic access to education and employment opportunities, segregation also creates conditions inimical to health in the social and physical environment”

3.  Highways shape metropolitan growth in ways that limit communities of color access to opportunity– to jobs, to schools, to parks, to healthy foods, to public services, thus undermining health equity.  Transportation systems that do not provide poor people with convenient, practical access to employment, medical care, and other necessities undermine their health in numerous ways. The spatial mismatch between where poor people live and where jobs are available, as well as the inability to get to good jobs, consigns people to ongoing poverty, a principal predictor of poor health.

4.  Lack of racial diversity in public decision-making excludes people of color from participating in shaping community environments.  For decades, transportation planning in California has been a closed, top down process dominated by the automobile industry, petroleum companies, the highway lobby, home builders and elite suburban governments, who made decisions about how our cities and regions should grow, placing the expansion of the market for automobiles above the best interest of the people.   Social movements are a major vehicle for ordinary people’s participation in public politics. Very often, such movements begin with protest against existing conditions, an act of resistance, saying no to policies and practice, which are unfair. An example is the civil rights movement, a struggle led by African Americans in the mid-1950s to late 1960s to achieve civil rights equal to those of whites.  The Civil rights movement included the quest for equal opportunity in employment, housing, and education, as well as the right to vote, the right of equal access to public facilities, and the right to be free of racial discrimination.


Framing Health Equity, Land Use and Transportation

A new movement for health equity is emerging in the United States and around the world.  This movement views health as a human right.  Health Equity is the absence of differences in health between groups with differential exposure to those social and economic policies and practices that create barriers to opportunity. (Source VA Dept of public Health)

An equitable pattern of human centered development, protecting our natural resources safeguarding the rights of the most vulnerable populations, sharing the burdens and benefits of climate change in ways that overcome racial, economic and health disparities caused by unfair social and economic policies.

People of color are now the majority population in California, yet they continue to face higher rates of morbidity and mortality, higher incidences of disease, across a broad spectrum of illnesses and injuries, than whites.

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