WELCOME to the second post of the Baltimore BLOG! The purpose of this Blog is to promote opportunity, equity, and good health for all of Baltimore’s citizens. To that end, we ask local social justice activists for insight and recommendations regarding urgent and neglected problems in the city.
Today’s discussion is Part 2 of an interview with Dr. Lindsay Beane about the root causes of Baltimore’s decades-long population decline. In Part 1 of this interview, Dr. Beane suggested that Baltimore’s decades-long population decline is no longer simply the result of middle class families moving to the suburbs in search of better schools and less crime. Instead, the high rates of premature mortality and mass incarceration in the impoverished African American communities of the city may have surpassed this longstanding exodus explanation as a primary contributor.
Dr. Beane is a public health expert who began researching health disparities in Baltimore City around 1995. Much of her work has focused on the southern Park Heights community in northwest Baltimore. She received her doctorate in public health from the School of Community Health and Policy at Morgan State University.
Baltimore BLOG: In addition to HIV, what are some other contributors to the high mortality rate in the low-income African American communities in Baltimore?
Dr. Beane: A harsh life in the ghetto not only compromises the longevity of young men or the average life expectancy of elders, it also compromises the survival of the babies. Researchers are now exploring what has been suspected for some time—that stress is a major culprit in the death of Black babies. There are many causes of the stress felt by African American adults living in the ghetto—unrelenting worries about money, homelessness, police harassment, protecting their children from drug dealers, the loss of loved ones and neighbors to violence, etc. Researchers are finding that the stress level of Black mothers during pregnancy that stems from the day-in and day-out experience of racism and discrimination leads to a high level of cortisol in a mother’s bloodstream, and that this high level of cortisol may be a contributing factor to infant mortality. What’s interesting is that this research controls for socioeconomic factors. In other words, the experience of racism and discrimination (and not poverty) is the common factor leading to stress, higher than normal cortisol levels, and infant mortality in these studies.
Keep in mind that “infant mortality” not only includes babies who are stillborn, it also includes babies that die at any time between birth and their first birthday. In other words, a mother’s stress level during pregnancy doesn’t just impact the fetus in utero leading to premature birth or low birthweight; it can impact a baby’s capacity to survive the first year of life outside the womb. These findings suggest that there is an association or possibly even a causal link between a Black mother’s stress level during pregnancy and SIDS (Sudden Infant Death Syndrome). It’s not surprising. In past years, the rate of infant mortality among African Americans in Baltimore has been reported to be as high as eight times the rate among whites.
Baltimore BLOG: Is there one statistic that reveals more than others?
Dr. Beane: Yes, life expectancy. According to findings published in 2007 by public health researchers at Harvard University, life expectancy in impoverished black communities throughout the country is significantly lower than the national average. Harvard used 20 years’ worth of life expectancy data which they analyzed at the county level. (Because Baltimore is an “independent city” that is not located in a county, it was treated as a separate county.) Life expectancy among men in the U.S. is around 76 years; life expectancy among Black men in Baltimore City is 58 years, nearly 20 years lower than the national average. In fact, Baltimore ranked 8th from the bottom for life expectancy out of all 3,147 counties across the country.
Baltimore BLOG: Did other cities rank as low as Baltimore?
Dr. Beane: Not even close. The seven counties that ranked below Baltimore in the Harvard study were all located inside of the Pine Ridge and Rosebud Lakota Sioux Indian Reservations in rural South Dakota. Most of the other counties among the lowest ranked 50 counties for life expectancy were rural counties in the Deep South.
Baltimore BLOG: Going back to one of your earlier points about population decline, what role does incarceration play?
Dr. Beane: The State does not make incarceration numbers public, so I can’t tell you precisely how many people in southern Park Heights have been incarcerated. What I suspect is that at least one quarter and possibly as much as one half of the population decline in this community is due to incarceration.
There was a reported decline of 5,000 residents in southern Park Heights between the last two Census tallies in 2000 and 2010. Approximately 300 deaths (from all causes) were reported each year between 2000 and 2010—that’s 3,000 deaths for the entire decade. That number is offset by the approximate 2,000 births (200 per year) during that same decade. So we are left with around 4,000 unexplained departures.
The math is fairly simple: a 5,000 person decline minus 3,000 reported deaths plus 2,000 reported births leaves 4,000 unexplained departures (i.e., 5,000 – 3,000 + 2,000 = 4,000). Bear in mind that young people going off to college or enlisting in the military would still be included in the overall population count. But any individual who is incarcerated during the time that a Census is conducted is shifted from the tally of their home zip code to the tally of the zip code area of the prison facility instead. I would guess that somewhere between 40% and 70% of southern Park Heights’ overall population decline over that 10-year period alone was due to incarceration. Without access to geocoded incarceration data, I can only conjecture. But the August 2016 report issued by the U.S. Department of Justice that documented massive arrests combined with the War on Drug’s longer sentences for drug convictions together suggest that incarceration is likely playing a disproportionate role in the overall decline in selected populations in Baltimore and all across the country.
Baltimore BLOG: Are you saying that as many as 300 to 400 people are being locked up every year just from southern Park Heights, and that they are staying locked up?
Dr. Beane: Undoubtedly, far more than 300 people from southern Park Heights are arrested and locked up every year for short periods of time (anywhere from a couple of days to 6 or 8 months). The DOJ’s investigation into unconstitutional police practices found that several hundred thousand individuals were unnecessarily stopped and arrested in selected neighborhoods in the past four years. In fact, the DOJ found that the police deliberately targeted poor Black neighborhoods for arrests. But in terms of population decline in southern Park Heights, I’m not referring to individuals who are simply arrested and then released a few days, weeks, or months later. What I’m suggesting is that something like 300 people from southern Park Heights are convicted of crimes and imprisoned, and are not returning to their community every year.
It would have been expected for Baltimore Police to target southern Park Heights, given the community’s notorious open-air drug markets, homicides, and gang activity. As a community of color, no doubt hundreds if not thousands of individuals were included in the city’s massive totals of arrests over time. And longer sentencing under the War on Drugs would have assured that even those individuals convicted of what used to be misdemeanors would be sent away for 5, 10, or even 20 years for what is now classified as a felony. Of course, as I said earlier, I am not in a position to give you accurate incarceration numbers. But I’m guessing that the net permanent loss is something like 300 individuals, mostly men, per year.
Baltimore BLOG: We don’t hear much about these population declines in the impoverished parts of our city. Why do you think that is?
Dr. Beane: What I am describing is not unknown to the Health Department or City Hall, but perhaps the general public is not aware of the full extent of the problem.
Everyone knows that hundreds of young men are killed in our city each year, that the HIV epidemic continues to take lives in Baltimore, and that drug addiction is widespread with a rising number of overdoses. But I don’t think that everyone understands the ripple effect that these problems have on the hardest hit communities—the volume of people who are traumatized by one homicide, for instance. When a young man is killed, the victim’s loved ones and extended family are of course traumatized; the victim’s friends and social network and classmates are also traumatized. Neighbors down the block, the church congregation where the victim’s family attends, the trauma surgeons and nurses at the hospital, the funeral home staff—many people are traumatized, obviously to differing degrees.
The young man’s killer and his family are also traumatized, both by the murder and, if the killer is caught, by his resultant conviction and incarceration. The ripple effect of 300+ homicides in one city over a 12-month period is massive.
When deaths from violence and drug addiction and disease in a community or entire city do not let up, the trauma becomes exponentially cumulative and compounds the effects of stress, depression, anxiety, anger, and grief. And the compound effect can make it harder to control chronic diseases, such as hypertension.
I don’t know why we don’t hear more about these trends. I can’t explain what enables people to look the other way when there is suffering all around us. No doubt there are some who feel that what is currently being done, in terms of targeted interventions or citywide initiatives, is the best that can be done.
Baltimore BLOG: Do you agree with that last thought—that we are doing the best that we can?
Dr. Beane: That would be a very sad state of affairs. No, I do not believe that we’re doing enough or even taking the right approach to turning the city around. The hundreds of interventions and initiatives that I am personally aware of have barely made a dent in the state of affairs in the ghetto. Homicides alone claimed the lives of 344 people in 2015 and another 318 people in 2016. The spike in 2015 constituted the highest per capita homicide rate in Baltimore’s 288-year-old history. Already in 2017, the volume of homicides makes it likely that we will surpass the horrifying spike in 2015.
Keep in mind that the drama of homicides get all the attention. There has also been no let-up in the volume of gunshot wound and stabbing victims who do not die (often more than triple the number of homicides). Many of these individuals sustain permanent physical injuries, not to mention emotional injuries. In addition, Baltimore’s HIV epidemic is far from being under control—an estimated 18% of people infected with the virus don’t know that they are infected. And the brisk business of illicit drug sales continues in plain sight on many of Baltimore’s street corners. So, despite the good intentions and efforts of many people, the allocation of government dollars, the generosity of a few wealthy families, criminal justice muscle, school reform, federal agency involvement, and so on, things continue to get worse in Baltimore—for a certain sector of Baltimore, that is.
And I have to add that the recent debacle of our outgoing Mayor—awarding a $660 million Tax Increment Financing (TIF) deal to local billionaire and Under Armour CEO Kevin Plank so that he can build an upscale residential complex for higher income (admittedly white) Millennials—is obviously not what is needed.
Baltimore BLOG: Dr. Beane, what do you think is the way forward?
Dr. Beane: The way forward could begin with the top leadership of the city taking a very firm and vocal stand against segregation, against police brutality, against the discrimination experienced by individuals branded with a (War On Drugs) felony conviction, against the blatant inequity in our city. Our new Mayor Catherine Pugh took office on December 6th of last year, but in her first six months, she has not proven herself to be a dramatic departure from her predecessor. That’s a missed opportunity, in my opinion, but she still has time to take a strong stance.
Second, the Mayor and City Council need to inform themselves about the efforts throughout the city that are effective. They (government officials) could provide meaningful infusions of funding and other resources for projects and initiatives whose survival is never assured. I’m not referring to the roster of organizations that always get the foundation funding and public accolades; I’m talking about grassroots projects, sometimes very small community projects that are having a profoundly positive impact on the hardest hit neighborhoods.
There are many inspired individuals and organizations—like Willie Flowers with the Park Heights Community Health Alliance and Eric Jackson with the Black Yield Institute who are planting organic gardens in low income neighborhoods, giving away fresh produce, and teaching residents how to feed their families a healthy diet. There is the “great debater” and spokesman Dayvon Love and Adam Jackson with the Leaders of a Beautiful Struggle, and Munir Bahar with his COR Institute and 300 Men March Movement that put up “We Must Stop Killing Each Other” posters on vacant buildings all over the city.
City leadership needs to sit down with Mama Rashida Forman-Bey and Mama Kay Lawal-Muhammad of WombWork Productions, whose dedication to the artistic expression of youth and young adults has literally averted suicides and homicides. They need to sit down with Fanon Hill and Navasha Daya of the Youth Resiliency Institute to learn about their effective Afrocentric strengths-based work with families in Cherry Hill. They need to sit down with Ademola Ekulona with Rites of Passage to learn about his decades-long success in getting young males to choose positive pathways over a violent past. They need to sit down with David Miller with the Urban Leadership Institute, one of the most informed and insightful experts I know, to hear his insight into the causes of police brutality, homicide, and disengaged youth as well as possible solutions that would inject our hopeless city with hope.
It’s hard for me not to get on a soapbox when so many extraordinary individuals and organizations are known and respected by those of us active on the community level, but are either unknown or unappreciated by the powers-that-be. In my opinion, the solution should start with the leadership of Baltimore. But because it hasn’t, all manner of organic solutions are beginning to blossom throughout the devastated communities themselves. Those grassroots efforts give me hope!Urban Health