This preview shows page 1. Sign up to view the full content.
Unformatted text preview: Journal of Social Issues, Vol. 59, No. 3, 2003, pp. 569--589 Poverty, Housing Niches, and Health
in the United States
City University of New York Graduate Center Gary W. Evans
Cornell University Drawing on psychological, health, and social science literature, a housing niche
model is developed that focuses on (a) housing markets and other societal processes
that constrain residential choice, (b) effects of residential environments on health
and access to human and social capital, and (c) family dynamic effects on health
and the intergenerational consequences of particular housing niches for future
health and housing choices. The model requires the examination of cumulative
risks, mediating and moderating processes, and the use of multilevel statistical
models. The health consequences of existing housing policies are explored and
future directions for research and policy suggested.
Even as the life expectancy of U.S. residents reaches new highs, death comes
much earlier to residents of some neighborhoods, for example, Harlem in New
York City (McCord & Freeman, 1990). Harlem’s residents are mostly poor and
largely African American. Numerous studies demonstrate that both lower
socioeconomic and minority status are strongly related to worse health and earlier death (Aday, 1994; Adler et al., 1994; Geronimus, Bound, & Waidmann,
∗ Correspondence concerning this article should be addressed to Susan Saegert, Environmental Psychology, CUNY Graduate Center, 365 Fifth Ave., New York, New York, 10016 [e-mail:
We appreciate Terry Hartig’s and Gary Winkel’s critical feedback on this article. Preparation of
this article was partially supported by a CUNY Collaborative Incentive Grant, the Edna McConnell
Clark Foundation Program for New York Neighborhoods, the John D. and Catherine T. MacArthur
Foundation Network on Socioeconomic Status and Health, the Bronfenbrenner Center for the Study of
the Life Course, Cornell University, and the National Institute for Child Health and Human Development
(1 F33 HD08473-01).
C 2003 The Society for the Psychological Study of Social Issues 570 Saegert and Evans 1999; Syme, 1994; Williams & Collins, 1995). Yet the higher mortality levels
reported in Harlem exceed those for poor African Americans in other environments. Researchers are just beginning to examine the extent to which
the concentration of poor and minority households in certain environments
contributes to the health consequences of socioeconomic and minority status
(Ellen, Mijanovich, & Dillman, 2001; Evans & Kantrowitz, 2002; Geronimus
et al., 1999). This topic is particularly important since the spatial concentration of poor, and especially poor minority, households has increased over the
last several decades (Jargowsky, 1997; Massey & Denton, 1993; Wilson,
In this article we develop a conceptual model of housing niches that relates health to housing and neighborhood conditions, social dynamics in the
family and community, and overarching societal structures and processes. The
purpose of this model is to shed light on the processes that underlie social inequalities in health and to understand their implications for policies designed to
reduce these inequalities. In developing the model, we observe that (a) housing markets, income distribution, and other societal processes constrain residential choice; (b) environmental threats and assets in particular locations directly
and indirectly affect health; and (c) opportunities and constraints in those locations also influence the residential choices and health of subsequent generations. This model emphasizes structural and policy determinants that establish
the context within which people perceive choices related to residence and evaluate the threats and opportunities in their residential environment. Once households occupy particular housing niches, exposure to environmental threats and
the psychosocial benefits of resources available in the housing niche have consequences for health. Within this model, psychological stress independently affects
health and well-being, beyond the health effects of specific threats and resources.
In addition, the consequences of individual stress for family dynamics can exacerbate stress experienced by other family members and so further undermine
In the following we first develop the housing niche model, describing the
social production of housing niches; the effects of housing niches on health;
cumulative, mediated, moderated, and multilevel risks in housing niches; and
the life trajectories of individuals and housing niches. We then discuss public
policy implications of the model. Although we emphasize the circumstances of
those living in poverty as we proceed in our discussion, much of the literature
we draw on reflects the fact that poverty is commonly confounded with race
and ethnicity. Numerous studies confirm the negative health consequences associated with poverty for all populations and with minority status, especially
African Americans, across the socioeconomic status (SES) spectrum (Adler et al.,
1994; Evans & English, in press; Geronimus et al., 1999; Williams & Collins,
1995). Poverty, Housing Niches, and Health 571 Housing Niches and Health
Two theoretical alternatives are usually posed to explain the differential spatial distribution of health (Ellen et al., 2001; Yen & Syme, 1999): Either people in
worse health drift into certain areas, or particular places tend to breed ill health. In
contrast, an ecological approach directs attention to the multilevel social processes
that channel people to particular locations and also affect health (Bronfenbrenner
& Morris, 1998). While personal choice and characteristics play a role in where
people live, housing markets and policies set the context in which choices can be
made. Subcultural and social network characteristics further affect the information
and resources available to individual households, and their perceived and actual
access to particular housing and neighborhoods (Pendall, 2000; Popkin, Buron,
Levy, & Cunningham, 2000; Turner, 1998; Varady & Walker, 2000). For example, in the United States, race and ethnicity powerfully affect access to housing
markets (Massey & Denton, 1993). Once a household is located in a resource-rich
or resource-poor environment, exposure to the particular place has its own consequences (O’Connor, Tilly, & Bobo, 2001). Health and other consequences of
living in a particular place in turn affect the assets that residents have for moving
to better places (Ellen et al., 2001; Leventhal & Brooks-Gunn, 2000). Thus, in
an ecological model, the correlation between residential environments and health
develops over time through processes of both selection and exposure to differentially health-promoting or -impairing conditions (Smith, Easterlow, Munro, &
Turner, this issue). Resources, physical environmental characteristics, and social
processes shape each other in a dynamic relationship.
Social Production of Housing Niches
An ecological approach implies the existence of what we refer to here as
“housing niches.” Housing niches are particular locations in the ecology of residential settings that can be occupied by specific groups. For example, buying an
apartment in the wealthiest section of Manhattan requires mobilizing high levels
of economic, social, and cultural resources. Adequate, moderately priced housing
in areas more distant from the central city can be found through intense mobilization of social networks even if other resources are limited. Those with few
financial and social resources are usually left to find homes in negligently managed, lower priced housing, in neighborhoods characterized by disinvestment, or
in worse cases, to become homeless. Population health varies enormously across
these different housing niches (Freudenberg, 2001).
The market-based provision of housing in the United States means that the
kind of housing obtained is most dependent on the household’s accumulated wealth
and disposable income. Poor households encounter problems related to both housing quality and affordability. In 1995, 4.8 million U.S. households lived in housing 572 Saegert and Evans that was structurally inadequate or overcrowded. Low-income urban renters encountered the highest number of deficits (Joint Center for Housing Studies, 1999).
Such households find it increasingly difficult to access better quality housing.
Housing costs for those in the bottom income quartile rose by 4.5% between
1995 and 1997 (Joint Center for Housing Studies, 1999). During the same period,
incomes of renters in the lowest income quartile dropped by 2.9%. Production and
availability of low-income units have also dropped. Compounding this problem,
existing housing subsidy programs are expiring and many landlords are opting
out (Dolbeare, 1999; Joint Center for Housing Studies, 1999; U.S. Department of
Housing and Urban Development, 1999). Accordingly, the number of poor renters
without housing assistance is at an all-time high; for some, housing costs exceed
minimum wage levels by a factor of two or more. Not all can manage the cost. In the
late 1990s, 5 to 10% of poor households experienced homelessness (Burt, 2002).
Racial segregation poses structural barriers to equal access to health-supporting
residential environments. Several studies show that African Americans are sorted
into housing niches characterized by both physical and social health hazards.
Greenberg and Schneider (1994) found that residence in urban areas with hazardous land uses mediated an apparent association of violent deaths with race.
LaViest (1989) documented higher Black infant mortality in more segregated communities that also had higher housing costs and lower wages for Blacks. Moreover,
the housing stock in Black areas was older, and those neighborhoods were less
well served by public services ranging from sanitation to health care. Disrespect
among groups, especially of Blacks by Whites, income inequality, and residential
segregation have all been found to undermine the health of low-income, minority
populations (James, Schulz, & van Olphen, 2001; Kawachi, Kennedy, Lochner, &
Prothrow-Stith, 1997; Subramanian, Kawachi, & Kennedy, 2001).
Wallace and Wallace (1998) trace the development of particularly disadvantaged housing niches in the South Bronx and Harlem. Economic declines and
out-migration of wealthier, Whiter populations in parts of New York City were
followed by institutional disinvestment leading to social fragmentation and housing insecurity for those who remained. As living circumstances got worse, the
remaining resource-poor inhabitants were also most susceptible to homelessness,
substance abuse, and violent crime. The fragmented social ties and deteriorated
physical conditions of these communities, combined with few public services,
were a favorable climate for AIDS and drug-resistant tuberculosis to take root.
In most of the research described thus far, weak social integration and low
levels of social capital are correlated with hazardous residential environments and
poor health. However, social capital itself is a factor that can affect access to particular housing niches, and which can be mobilized to improve environmental quality
in these niches. Social capital is defined as a property of groups that facilitates the
achievement of goals. It inheres in relationships characterized by trust, reciprocity,
communication, shared norms, and consequences for norm violation (Coleman,
1988; Putnam, 1995; Warren, Thompson, & Saegert, 2001). Poverty, Housing Niches, and Health 573 Finding a better place to live is a goal often achieved through the mobilization
of social capital. For poor, minority, and immigrant households, the social groups
within which they are embedded provide few resources of information, experience,
contacts, or available financial capital for achieving this goal (Ratner, 1996). Oliver
and Shapiro (1995) have argued that public policies and discriminatory institutional
practices have worked against African American home ownership. Thus African
Americans are often deprived of the major asset passed down across generations,
the family home. Linguistic and cultural isolation of Latinos and Asians has also
blocked access to home ownership (Listokin & Listokin, 2001; Ratner, 1996).
However, some immigrant groups have used the strong norms, trust, reciprocity,
and interdependence of their networks to accumulate financial capital to invest
in home ownership (Ratner, 1996). In other cases, ethnically defined community
advocacy groups help members of the community obtain information, advice, and
credit to achieve home ownership (Listokin & Listokin, 2001).
Social capital within poor, minority communities can also be organized to improve existing housing and neighborhood environments. For example, mobilization
of social capital among residents of very low-income, inner-city neighborhoods
contributes to perceived housing quality (Saegert & Winkel, 1998) and less crime
as measured by police records (Saegert, Winkel, & Swartz, 2002). Social capital
also has played a critical role in the decision of residents of polluted industrial
neighborhoods to take actions to improve air quality (Wakefield, Eliott, Cole, &
Eyles, 2001). The development of social capital that links residents to community
organizations, and these organizations to institutions and their resources, improves
housing in poor communities and increases the supply of high-quality residential
environments (Keyes, 2001).
Thus economic capital and social capital have many functions. Their unequal
distribution contributes to the sorting of those with fewer resources into worse
housing niches. Institutional practices are enmeshed in the distribution of these
forms of capital and are critical in either routinizing this cycle of inequality or in
finding ways out. Disadvantaged households, voluntary associations, and advocacy
groups often try to use each form of capital to leverage others to improve access
to and the quality of residential environments.
Housing Niches’ Effects on Health
Housing niches may contribute to health inequities through a variety of paths,
including exposure to environmental toxins and nuisances, accident risks, and
violence; the psychosocial dynamics of racism; access to environmental amenities;
and levels of perceived control over life. These paths may exist on different levels,
such as the physical housing unit and the neighborhood.
Despite relatively high housing standards, housing is receiving renewed attention in public health circles in the United States. Housing characteristics associated with health problems include dampness, pests, a lack of safe drinking 574 Saegert and Evans water, a lack of hot water for washing, and inadequate food storage (Matte &
Jacobs, 2000). Poorly built or poorly maintained housing contributes to accidents,
fires, respiratory disease, and lead poisoning (Matte & Jacobs, 2000; Sharfstein
& Sandel, 1998; Warner, Barnes, & Fingerhut, 2000), as well as poor mental
health (Evans, Wells, & Moch, this issue). Poor ventilation increases the risk of
asthma and bronchial infections (Institute of Medicine, 2000; Oie, Nafstad, Botten,
Magnus, & Jaakkola, 1999). The design and maintenance of windows, roofs, and
balconies contribute to falls (American Academy of Pediatrics, 2001). Noisier
housing can affect physiological stress (Evans, 2001) and has well-documented
adverse impacts on reading acquisition in children (Evans & Lepore, 1993).
Many residential neighborhood characteristics can influence health. Crime
and safety problems in neighborhoods contribute to injuries and death (Sampson,
Raudenbush, & Earls, 1997) and impede physical exercise, thus increasing risk
of poor health from many causes (Weinstein, Feigley, Pullen, Mann, & Redman,
1996). The siting of public parks, transportation policies, and other urban design decisions also influence access to opportunities for exercise (Brownson,
Baker, Housemann, Brennan, & Bacak, 2001) and opportunities for psychologically restorative experiences (Hartig, Evans, Jamner, Davis, & Garling, in press).
Although the epidemiological path is less clear, studies have also shown associations between residence in neighborhoods with deteriorated and abandoned
housing and gonorrhea (Cohen et al., 2000).
Disadvantaged populations occupy housing niches in which relatively high
levels of exposure to health risks and low levels of access to environmental amenities can be seen at both the housing and neighborhood scale. Twenty percent of
low-income American families have substandard housing according to U.S. Census criteria, as compared to 7% of those above the poverty line (Sherman, 1994).
Low-income families in the United States are significantly more likely to have
housing with inadequate plumbing systems, no central heating, and various structural defects (Mayer, 1997). Their homes are more crowded (Myers, Baer, & Choi,
1996) and they are exposed to greater levels of community noise (U.S. Environmental Protection Agency, 1977). American children in low-income homes have
greater exposure to allergens linked to asthma (Krieger, Song, Takaro, & Stout,
2000; Sarpong, Hamilton, Eggelston, & Adkinson, 1996). At the extreme, many
low-income children are homeless, with seriously negative consequences for their
health (Wood, Valdez, Hayashi, & Shen, 1990). Parallel results for socioeconomic
status and housing quality have been shown in the United Kingdom (Townsend,
1979) and several Third World nations (Bartlett, 1999; Garza, 1996; Stephens et al.,
Air quality in low-income and minority neighborhoods in the United States is
poorer (Brajer & Hall, 1992; Freeman, 1972), and disadvantaged families are significantly more likely to live near a hazardous waste source (Bullard, 1990; Mohai
& Bryant, 1992; White, 1998). African American children living in inner-city areas
carry a substantially higher body burden of lead (U.S. Environmental Protection Poverty, Housing Niches, and Health 575 Agency, 1992). Low-income, ethnic minority adults and their children are exposed
more often to dangerous pesticides from multiple sources (Moses et al., 1993).
Low-income neighborhoods are more hazardous for both children and adults. Disadvantaged children confront more dangerous street traffic (Macpherson, Roberts,
& Pless, 1998) and more hazardous playgrounds (Suecoff, Avner, Chou, & Drain,
1999) than their more affluent counterparts.
Low social capital, which is more common in poor, minority neighborhoods
and among renters, also contributes to poorer residential environments (Rohe &
Stewart, 1996). As noted above, socially fragmented low-income, minority neighborhoods have poorer municipal services (e.g., access to medical care, police and
fire protection, sanitation; Wallace & Wallace, 1998). Residents of low-income
neighborhoods also have poorer mass transit and are less likely to own a car
(Macintyre, Maciver, & Sooman, 1993). Their neighborhoods have fewer retail
stores and services (e.g., laundry and dry cleaning; Macintyre et al., 1993) and are
more apt to contain abandoned buildings and vacant lots (Joint Center for Housing
Studies, 1999; Wandersman & Nation, 1998).
Low-income areas may not only have less social capital, they may also have
poorer prospects for the development of social capital. Residential stability is
strongly tied to income, with low-income families five times more likely to move
involuntarily (Federman et al., 1996). Consequently, not only do low-income families themselves move more often, they live in neighborhoods with greater residential instability (Leventhal & Brooks-Gunn, 2000). It is not surprising then
that poorer children experience greater instability in their peer relationships during childhood in comparison to middle- and upper-class children (Dodge, Pettit, &
Bates, 1994). Also, they experience greater turnover in classmates at school (Rutter
et al., 1974). Residential stability is also related to neighborhood homicide rates
(Sampson et al., 1997). High crime rates and gang activity in urban low-income areas impede community life, further weakening the development and maintenance
of social capital (Sampson et al., 1997).
Cumulative, Mediated, Moderated, and Multilevel Risks in Housing Niches
One goal of the housing niche model is to better understand the ways that psychological, social, and physical environmental factors contribute to health within
a particular housing niche. Given adequate measurement, different conceptual and
methodological approaches can illuminate the confluence of these factors. These
include the use of cumulative risk models that combine risk factors from multiple
domains, mediation models that examine processes that link particular conditions
to outcomes, and moderation models that look at the interactions of individual
characteristics and housing or neighborhood conditions, as well as interactions
between housing and neighborhood factors.
An ecological model of housing and health emphasizes the covariation of
environmental and social forces impinging on families. Rather than focusing on 576 Saegert and Evans single risk factors associated with the geography of poverty and minority status,
an alternative strategy is to examine the accumulation of risk factors. Not only
do disadvantaged individuals face higher levels of pollution, crowding, inadequate housing, and neighborhoods with inadequate infrastructure, but also they
frequently experience these social and environmental demands in concert. For
example, low-income and minority children experience more severe and higher
numbers of stressful life events and hassles than their more advantaged counterparts (Attar, Guera, & Toaln, 1994; Brown, Cowen, Hightower, & Lotyszewski,
1986; Dubow, Tisak, Causey, Hryshko, & Reid, 1991). Low-income families both
in Britain (Rutter et al., 1974) and in the United States face a greater array of risk
factors in their homes and neighborhoods (Evans & English, in press; Liaw &
Brooks-Gunn, 1994; O’Campo, Gielen, Royalty, & Wilson, 2000; Repetti, Taylor,
& Seeman, in press). Chronic exposure to a high level of largely intractable demands is a major risk factor for both psychological and physical morbidity (Lepore,
Evidence increasingly shows that cumulative risk is more potent in accounting
for both psychological and physical morbidity than singular risk factors (Rutter,
1981; Sameroff, 1998; Taylor, Repetti, & Seeman, 1997; Werner & Smith, 1982).
Adults and children can often cope reasonably well with one or two adaptive challenges, even if severe. However, when the pressure of multiple demands begins to
accumulate, the system is more likely to be worn down (McEwen, 1998; McEwen
& Seeman, 1999).
Evidence suggests, also, that some of the well-known socioeconomic gradients in physical and mental health (Aber, Bennett, Conley, & Li, 1997; Adler
et al., 1994; Chen, Matthews, & Boyce, in press; Duncan & Brooks-Gunn, 1997;
Luthar, 1999; McLoyd, 1998) can be accounted for, at least in part, by income
and class differentials in cumulative risk exposure. Here we can see the value of
mediational models for elaborating the influences of housing niches on health. For
example, elevated physiological stress and psychological distress in low-income
rural elementary school children relative to middle-income children were largely
mediated by cumulative exposure to multiple physical (e.g., poor housing quality)
and psychosocial (e.g., family turmoil) stressors (Evans & English, in press). Lowincome children relative to middle-class children residing in rural areas experience
more crowding, noise, and inadequate housing in conjunction with elevated levels
of family turmoil, family separation, and exposure to violence. The greater the
accumulation of these multiple stressors, the stronger the adverse psychological
and physiological consequences. Rutter (1981) demonstrated that combined risks
at home and school substantially increased the likelihood of childhood pathology
relative to risk in only one domain. He showed also that combined risk occurred
more often among low SES families than in working-class families.
Thus, disadvantaged families living in inadequate housing situated in neighborhoods lacking social capital and basic infrastructure are situated in an ecology Poverty, Housing Niches, and Health 577 of cumulative risk. In addition, the cost of housing itself exposes poor households
to unhealthy living conditions such as poor nutrition. It depletes financial resources
for health care and other forms of preventing and coping with disease. Housing is
one of the largest expenditures in the budgets of low-income people (Edin & Lein,
1997; Stone, 1993). The poor pay so much of their incomes for housing that they
must scrimp on other household needs.
Since the housing niche concept presumes the interdependence of people and
environments, it suggests that characteristics of residents and of the residential
environment may moderate the relationships described above. Any genetic weaknesses among poor populations may be more likely to express themselves in either
poor health or health-endangering lifestyles because the residential environment
provides an eliciting context for damaging genetic predispositions (Rutter, 1997).
Deteriorated or polluted environments can lead to worse mental health for people
who have other strains and stressful events in their lives, even when less taxed residents remain unaffected by the environment (Caspi, Bolger, & Eckenrode, 1987;
Evans, Jacobs, Dooley, & Catalano, 1987).
Multilevel models are often the most appropriate way to examine interactions
between household, building, or neighborhood context and personal characteristics. The development of Hierarchical Linear Modeling (HLM) and other multilevel
statistical approaches has increased our ability to parse out the variance attributable
to lower levels of analysis, for example, the individual, versus that attributable to
higher levels such as neighborhoods. For example, a study of African American
women found that the interaction between aggregate-level community characteristics and individual psychological processes explained why some women prospered
or suffered more in particular community contexts (Cutrona, Russell, Hessling,
Brown, & Murry, 2000). By employing multilevel models, the authors were able to
overcome the bias created by the lack of independence of individual measures and
the larger units into which they are aggregated. They could demonstrate that while
aggregate-level ratings of neighborhood conditions were significantly related to
individual residents’ levels of distress, individual-level risk factors moderated the
Life Trajectories of Individuals and Housing Niches
Understanding housing niches and their effects on individuals and households
requires an examination of the mutual determination of housing niches, individual opportunities, and health. How does residing in resource-rich housing environments, or the opposite, position residents to improve their life circumstances,
including health and housing? How does good or poor health affect access to healthpromoting environments? This perspective has implications for understanding the
intergenerational transmission of both health and residential options. Households
who live in safe, friendly neighborhoods with good housing, schools, services, 578 Saegert and Evans and amenities would be expected over time to increase their access to resources
and choices by employing the human and social capital they accumulate in such
circumstances. Resource-poor residents located in places with poor housing, poor
schools and services, and socially fragmented neighborhoods would be likely to
experience ill health, lower levels of education and occupational attainment, and,
over time, less access to resources and choices (Braconi, Louch, & Morse, 2000;
Easterlow, Smith, & Mallinson, 2000).
Children growing up in these different environments are directly affected not
only by living conditions, but also by the obstacles or supports in the environment for effective parenting (Leventhal & Brooks-Gunn, 2000). Parents in these
conditions may be less able to promote healthy development for their children.
Coping processes that both parents and children develop may protect them from
threats, for example, limiting social relationships and exploration in dangerous
environments. But these forms of coping may also have negative consequences for
social ties and access to better housing environments and opportunities (BrooksGunn, Duncan, & Aber, 1997; Greenberg, Lengua, Coie, & Pinderhughes, 1999;
Klebanov, Brooks-Gunn, Chase-Landsdale, & Gordon, 1997).
The weathering hypothesis (Geronimus, 1992) addresses the intergenerational
implications of high levels of cumulative disadvantage among African American
women. While Geronimus focuses on birth outcomes, her argument has implications for housing niche mobility as well. She documents that African American
teen mothers have healthier babies than older African American women. She speculates that better birth outcomes may motivate teen pregnancies. She reasons that
first, African American women’s health deteriorates faster and further than the
health of White women; second, young mothers and their support networks are
better able to cope with teens’ babies; third, grandmothers of teens’ babies are
more physically capable of providing assistance; fourth, when daughters complete
childbearing earlier, they are freer to help their mothers with the problems of aging.
Support for the weathering hypothesis comes from an ethnographic study of the
lives of mothers in Harlem. Mullings and Wali (2001) trace how environmental deprivations and social burdens associated with poverty undermine the physical and
mental health of African American women from a wide range of socioeconomic
circumstances and across the life span. Even the admirable norm among African
Americans, to “give back” to their communities if their fortunes improve, exacts a
cost in this ecology of cumulative risk. Housing niche mobility across generations
is impeded by weathering itself, the interruption of education for childbearing, and
the strong intergenerational interdependence fostered by inadequate incomes and
nonfamilial sources of support.
The weathering hypothesis emphasizes not only the social structural context that constrains the choices of African American women, but also the critical
roles of stress and risk behaviors within this set of constraints. The burden of cumulative risk and accumulated health problems may translate into less adequate Poverty, Housing Niches, and Health 579 parenting, which may itself further undermine their children’s development. Studies of African American and Latino mothers and children in New York City public
housing revealed that children’s reactions to two socioenvironmental stressors depended on their relationships with parents, and family dynamics more generally.
Evans and Saegert (1999) demonstrated the critical role of parenting in determining children’s vulnerability to psychological distress in the face of residential
crowding. We found that children experienced more psychological distress and
more physiological stress under conditions of crowding and family turmoil. However, when parents were able to avoid harsh treatment of children in these stressful
conditions, children did better. Similarly, Krenichyn, Saegert, and Evans (2001)
found that while exposure to community violence took a very large toll on the mental health, physiological functioning, and social development of children in New
York City’s public housing, parenting moderated these effects. Children exposed
to both harsh parenting and community violence fared worse than those experiencing only one of those threats. Further, children exposed to violence in the context
of supportive parenting developed the highest level of self-reported competence
in the sample. These studies suggest that when parents’ behavioral adaptations
to stressful environments affect children’s experience of stress, the ground may
be laid for the intergenerational transmission of disadvantage by interfering with
healthy development, thus making it more difficult for the next generation to find
its way out of poor housing niches. Public Policy and Housing Niches
The housing niche concept builds on Link and Phelan’s (1995) argument that to
understand the relationship between poverty and health we need to contextualize
risk factors—that is, attempt to understand how people come to be exposed to
individually based risk factors such as poor diet, cholesterol, lack of exercise,
or high blood pressure, and to view the social conditions that contribute to risk
exposure as themselves fundamental causes of disease:
A fundamental cause involves access to resources. . . that help individuals avoid diseases and
their negative consequences through a variety of mechanisms. Thus even if one effectively
modifies intervening mechanisms or eradicates some diseases, an association between a
fundamental cause and disease will reemerge. As such, fundamental causes can defy efforts
to eliminate their effects when attempts to do so focus solely on the mechanisms that happen
to link them to disease in a particular situation. (Link & Phelan, 1995, p. 81) We argue that the economic and social processes that channel the poor into
inadequate housing niches are fundamental social causes of ill health because they
cascade into multiple specific mechanisms that undermine health and reinforce
differential access to healthy and unhealthy niches. One implication of this position
is that even public policies aimed at improving either housing or health are likely 580 Saegert and Evans to fail if they do not fundamentally change the underlying economic and social
Public housing in the United States provides a good example of how impoverished housing niches develop and become entrenched (Newman & Schnare, 1997;
Spence, 1993). From Lee Rainwater’s (1970) account of “life in a federal slum”
through Alex Kotlowitz’s (1991) aptly titled book, There Are No Children Here,
the dominant image of U.S. public housing is bleak. The National Commission on
Severely Distressed Public Housing (1992) concluded that the social isolation and
institutional abandonment of public housing residents was an even greater problem than the physical decay of public housing developments. Nationally, public
housing has been located in the most devastated neighborhoods and served the
most destitute populations (Goering, Kamely, & Richardson, 1997; Newman &
Schnare, 1997). Community violence has been a particularly dramatic problem
for public housing residents. In 1998, the U.S. Department of Housing and Urban
Development (HUD) reported that an average of one gunshot-related homicide a
day occurred in the 100 largest public housing authorities.
Recognition of the problems associated with public housing led to the creation
of HUD’s Moving to Opportunities (MTO) Program. Implemented in Baltimore,
Boston, Chicago, Los Angeles, and New York City, the MTO program relocated
public housing residents from areas of concentrated poverty into geographies of
greater opportunity. Early evaluations reveal positive effects on the quality of life
and the mental and physical health of public housing residents who were selected to
move and accepted this opportunity. Employing a randomized experimental design,
MTO assigned families who volunteered to one of three conditions: (a) suburban
movers, who were required to move to a suburban, low-poverty area and received
assistance in finding housing; (b) free choice movers, who used their subsidies to
find housing without assistance; and (c) a control group who remained in public
housing. All were expected to pay no more than 30% of their income in rent.
Although evaluation methods and findings differed across cities, early results
paint a fairly uniform picture of improvement in neighborhood quality for suburban
movers. About 90% of suburban movers relocated to census tracts with less than
10% poverty rates. About 75% of free choice movers went to tracts with poverty
rates ranging from 10% to 39%. Most of the control group remained in tracts of
concentrated poverty (over 40%). Evaluations from Boston, Chicago, and New
York all found that both mover groups described their new neighborhoods as
physically better and safer (Katz, Kling, & Liebman, 2001; Leventhal & BrooksGunn, in press; Rosenbaum & Harris, 2001, 2002). The Chicago evaluation also
assessed changes in housing conditions and found that while all movers reported
better housing conditions, those of suburban movers improved most. Housing
characteristics that showed most improvement all had potential health and safety
impacts: peeling paint, the presence of mice and rats, and problems with broken
locks (Rosenbaum & Harris, 2002). Poverty, Housing Niches, and Health 581 Comparisons of MTO baseline data with data gathered 2 to 3 years after moving indicated improvements in the physical and mental health of parents and children. In Boston, both groups of movers reported improved health for the head of the
household. Children in the suburban group also experienced reductions in injury,
asthma attacks, and victimization by crime (Katz et al., 2001). Chicago and New
York mover households were much less frequently the victims of crime, including
reduced incidents of shooting, stabbing, and beating (Leventhal & Brooks-Gunn,
in press; Rosenbaum & Harris, 2002). In New York, the physical and mental health
of both parents and children improved most for suburban movers and slightly for
free choice movers (Leventhal & Brooks-Gunn, in press). Parents in the New
York experimental group reported less reliance on harsh parenting tactics after
the move. Also in New York, both mover groups increased their levels of employment, and the suburban movers improved the household’s overall level of economic
Social capital is the one area in which findings are mixed regarding MTO.
In Chicago, suburban movers reported the weakest neighborhood ties and more
isolation as a result of an absence of public transportation (Rosenbaum & Harris,
2002). In New York, parental engagement with children’s school activities was
lowest for the suburban movers although they participated more than nonmovers
in school governance activities (Leventhal & Brooks-Gunn, in press). The importance of social ties to public housing residents may be one reason that the majority
of MTO participants who were assigned to the experimental conditions did not
actually move to wealthier, Whiter suburbs. These 52% had volunteered to participate in MTO but when they were chosen, they declined to move or failed to
complete the move successfully (Goering et al., 1999). Those who did not take the
treatment, as well as those who did not participate in the study, are likely to have
been embedded in stronger social networks.
When a program specifically attempts to overcome housing segregation by
race and class, the housing niches occupied by low-income and minority households who choose to participate can significantly improve. But it is important to
try to understand the social processes that helped the suburban movers gain access
to their new homes. The greater improvement of the suburban movers compared to
the free choice movers suggests that institutional assistance in overcoming housing segregation does convey health benefits. This finding accords with the view
that the cost of housing alone does not explain segregation by class and race into
less advantaged neighborhoods and worse housing. Discrimination and the limited
social capital of poor, minority households also figure in the problem.
The early results of the Moving to Opportunity Program suggest that it is possible to find ways to equalize access to housing with consequent benefits for health.
But deconcentration programs are expensive, do not reach many poor households,
and do not always work (Pendall, 2000; Popkin et al., 2000; Turner, 1998; Varady &
Walker, 2000). U.S. initiatives to increase home ownership among lower income, 582 Saegert and Evans minority, and female-headed households may also assist poor households in improving their housing niches. These changes in the provision and distribution of
housing would have to reverse U.S. trends in the past two decades toward growing
inequality in income and quality of life (Danziger & Gottschalk, 1994). Despite
the successes of federal programs to increase home ownership among minorities
and immigrants, these groups still lag, with minority home ownership rates less
than two thirds of those of Whites. Efforts to disperse recipients of housing assistance also have only partially succeeded, resulting in slightly better housing still in
primarily minority, low-income areas (Pendall, 2000; Popkin et al., 2000; Turner,
1998; Varady & Walker, 2000).
The general broadening of the housing affordability gap (Dolbeare, 1999;
Joint Center for Housing Studies, 1999; U.S. Department of Housing and Urban
Development, 1999) may swamp the gains made by specific demonstration projects
and programs, thus contributing to greater health disparities. However, as Link
and Phelan (1995) point out, careful program planning, evaluation, and research
can help us learn what puts people at risk for risk. If we truly seek to eliminate
health disparities, their recommendations continue to be good advice: Programs
should give priority to interventions that affect multiple causes of ill health, while
regarding with skepticism interventions that focus on intervening mechanisms
without situating these in broader social and physical contexts (p. 89). Taxation,
minimum wages, mortgage underwriting criteria, access to high-quality education,
and discrimination (or its prohibition) in housing, work, and education are among
the many policies and institutional practices that can increase or reduce inequality
in society. These policies and practices, perhaps as much as those directly related
to health, are likely to affect social disparities in health. One of the major ways in
which this occurs is through the sorting of the poor into disadvantageous housing
niches that directly and indirectly threaten health.
Other articles in this issue suggest that public policy commitments to improved
housing can benefit the health of populations. However, studies have shown that
lower SES is associated with poorer health even for those who are not at the
extreme end of deprivation (Adler et al., 1994). Using the housing niche concept,
it may be that even within SES groups, housing distribution systems translate small
differences in SES into significantly different residential ecologies.
Communities lower in social capital result in stronger gradients associating
lower status with poorer health (James et al., 2001), but social capital within poor
communities can only go so far. Strong social ties, norms of trust and cooperation, and intergenerational closure can support physical and mental health and
child development. However, social capital has limited utility in connecting these
communities with more resources. For that to occur, poor households and communities must develop leaders, institutions, and organizations that make claims
on the broader society (James et al., 2001; Saegert & Winkel, 1998; Warren et al.,
2001). In addition, governmental programs and actions by mainstream financial Poverty, Housing Niches, and Health 583 and social institutions must cease reinforcing, rather than reducing, the social and
economic marginalization of poor communities and households (Duncan, 2001;
Lopez & Stack, 2001). Public programs and institutional practices are needed that
support, rather than undermine, social and human capital and provide access to
better housing, education, jobs, and opportunities.
Our housing niche model and the policy-related arguments based upon it
suggest the need for research on the following questions:
1. To what extent do poverty and racism lead to residence in environments that
expose people to higher levels of environmental stressors and cumulative risks?
To what extent do those exposures mediate health outcomes?
2. What multilevel social processes offset or magnify the negative consequences
of exposure to environmental stressors and risks?
3. How is access to housing environments mediated by the social and human
capital of poor people and by public policies?
Only longitudinal studies can determine the individual and intergenerational
life trajectories of residents in particular housing niches who vary in health, economic, and social status. The strengths families and social networks bring to overcoming ecological disadvantages also require study. These should include not just
well-studied factors such as personal resiliency and social support but also family
dynamics and characteristics of social networks that not only resist damage but
move households and communities into more promising ecologies.
Aber, L., Bennett, N., Conley, D., & Li, J. (1997). The effects of poverty on child health and development. Annual Review of Public Health, 18, 463–483.
Aday, L. A. (1994). Health status of vulnerable populations. Annual Review of Public Health, 15,
Adler, N. E., Boyce, T., Chesney, M., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994).
Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49,
American Academy of Pediatrics. (2001). Falls from heights: Windows, roofs, and balconies. Pediatrics, 107, 1188–1191.
Attar, B., Guera, N., & Toaln, P. (1994). Neighborhood disadvantage, stressful life events, and adjustment in urban elementary school children. Journal of Clinical Child Psychology, 23, 391–400.
Bartlett, S. (1999). Children’s experience of the physical environment in poor urban settlements and
the implications for policy, planning, and practice. Environment and Urbanization, 11, 63–73.
Braconi, F., Louch, H., & Morse, K. (2000). Housing, health and work (Working paper). New York:
Citizens’ Housing and Planning Council of New York.
Brajer, V., & Hall, J. (1992). Recent evidence on the distribution of air pollution effects. Contemporary
Policy Issues, 10, 63–71.
Bronfenbrenner, U., & Morris, P. (1998). The ecology of developmental process. In W. Damon & R.
Lerner (Eds.), Handbook of child psychology (5th ed., pp. 992–1028). New York: Wiley.
Brooks-Gunn, J., Duncan, G. J., & Aber, L. (Eds.). (1997). Neighborhood poverty (Vols. 1 & 2). New
York: Russell Sage. 584 Saegert and Evans Brown, L., Cowen, E., Hightower, A., & Lotyszewski, S. (1986). Demographic differences among
children in judging and experience specific life events. Journal of Special Education, 20, 339–
Brownson, R. C., Baker, E. A., Housemann, R. A., Brennan, L. K., & Bacak, S. J. (2001). Environmental
and policy determinants of physical activity in the United States. American Journal of Public
Health, 91, 1995–2003.
Bullard, R. D. (1990). Dumping in Dixie. Boulder, CO: Westview Press.
Burt, M. R. (2002). Time for a common sense policy on homelessness. Shelterforce, 122, 27.
Caspi, A., Bolger, N., & Eckenrode, J. (1987). Linking person and context in the daily stress process.
Journal of Personality and Social Psychology, 52, 184–195.
Chen, E., Matthews, K., & Boyce, T. (in press). Socioeconomic status differences in health: What are
the implications for children? Psychological Bulletin.
Cohen, D., Spear, S., Scribner, R., Kissinger, P., Mason, K., & Wildgen, J. (2000). “Broken windows”
and the risk of gonorrhea. American Journal of Public Health, 90, 230–236.
Coleman, J. S. (1988). Social capital in the creation of human capital. American Journal of Sociology,
Cutrona, C. E., Russell, D. W., Hessling, R. M., Brown, P. A., & Murry, V. (2000). Direct and moderating
effects of community context on the psychological well being of African American women.
Journal of Personality and Social Psychology, 79, 1088–1101.
Danziger, S., & Gottschalk, P. (Eds.). (1994). Uneven tides: Rising inequality in America. New York:
Dodge, K., Pettit, G., & Bates, J. (1994). Socialization mediators of the relation between socioeconomic
status and child conduct problems. Child Development, 65, 649–665.
Dolbeare, C. N. (1999). Out of reach: The gap between housing costs and income of poor people in
the United States. Washington, DC: National Low Income Housing Coalition.
Dubow, E., Tisak, J., Causey, D., Hryshko, A., & Reid, G. (1991). A two year longitudinal study of
stressful life events, social support, and social problem solving skills: Contributions to children’s
behavioral and academic adjustment. Child Development, 62, 583–599.
Duncan, C. M. (2001). Social capital in America’s poor rural communities. In S. Saegert, J. P. Thompson,
& M. Warren (Eds.), Social capital and poor communities (pp. 60–88). New York: Russell Sage.
Duncan, G., & Brooks-Gunn, J. (1997). The consequences of growing up poor. New York: Russell
Easterlow, D., Smith, S. J., & Mallinson, S. (2000). Housing for health: The role of owner occupation.
Housing Studies, 15, 367–386.
Edin, K., & Lein, L. (1997). Making ends meet: How single mothers survive welfare and low-wage
work. New York: Russell Sage.
Ellen, I. G., Mijanovich, T., & Dillman, K. (2001). Neighborhood effects on health: Exploring the links
and assessing the evidence. Journal of Urban Affairs, 23, 391–408.
Evans, G. W. (2001). Environmental stress and health. In A. Baum, T. Revenson, & J. E. Singer (Eds.),
Handbook of health psychology (pp. 365–385). Mahwah, NJ: Lawrence Erlbaum Associates.
Evans, G. W., & English, K. (in press). The environment of poverty: Multiple stressor exposure,
psychological stress, and socioemotional development. Child Development.
Evans, G. W., Jacobs, S. V., Dooley, D., & Catalano, R. (1987). The interaction of stressful life events
and chronic strains on community mental health. American Journal of Community Psychology,
Evans, G. W., & Kantrowitz, E. (2002). Socioeconomic status and health: The potential role of environmental risk exposure. Annual Review of Public Health, 23, 303–331.
Evans, G. W., & Lepore, S. J. (1993). Nonauditory effects of noise on children. Children’s Environments,
Evans, G. W., & Saegert, S. (1999). Residential crowding in the context of inner city poverty. In S. Wapner, J. Demick, M. Minami, & T. Yamamoto (Eds.), Theoretical perspectives in environmentbehavior research: Underlying assumptions, research problems, and relationships (pp. 247–
268). New York: Plenum.
Federman, M., Garner, T., Short, K., Cutter, W., Levine, D., McGough, D., & McMillen, M. (1996,
May). What does it mean to be poor in America? Monthly Labor Review, 3–17. Poverty, Housing Niches, and Health 585 Freeman, A. M. (1972). The distribution of environmental quality. In A. V. Kness & B. Bower (Eds.),
Environmental quality analysis (pp. 243–280). Baltimore: Johns Hopkins Press.
Freudenberg, N. (2001, May 4). Geographic disparities in the health of New Yorkers. Paper presented
at the CUNY Urban Health Initiative Conference on Ethnic and Racial Disparities in Health,
Hunter College, New York.
Garza, G. (1996). Social and economic imbalances in the metropolitan area of Monterey. Environment
and Urbanization, 8, 31–42.
Geronimus, A. T. (1992). The weathering hypothesis and the health of African-American women and
infants: Evidence and speculation. Ethnicity & Disease, 2, 207–221.
Geronimus, A. T., Bound, J., & Waidmann, T. A. (1999). Poverty, time, and place: Variation in excess
mortality across selected US populations, 1980–1990. Journal of Epidemiology and Community
Health, 53, 325–334.
Goering, J., Kamely, A., & Richardson, T. (1997). Recent research on racial segregation and poverty
concentration in public housing in the United States. Urban Affairs Review, 32, 723–
Goering, J., Kraft, J., Feins, J., McInnis, D., Holin, M. J., & Elhassan, H. (1999). Moving to Opportunity
for Fair Housing Demonstration Program: Current status and initial findings. Washington, DC:
U.S. Department of Housing and Urban Development.
Greenberg, M. T., Lengua, L. J., Coie, J. D., & Pinderhughes, E. E. (1999). Predicting developmental
outcomes at school entry using a multiple-risk model: Four American communities. Developmental Psychology, 33, 403–417.
Greenberg, M, & Schneider, D. (1994). Violence in American cities: Young Black males is the answer
but what was the question? Social Science and Medicine, 39, 179–187.
Hartig, T., Evans, G. W., Jamner, L. D., Davis, D. S., & Garling, T. (in press). Tracking restoration in
natural and urban field settings. Journal of Environmental Psychology.
Institute of Medicine. (2000). Clearing the air: Asthma and indoor air exposures. Washington, DC:
National Academy Press.
James, S. A., Schulz, A. J., & van Olphen, J. (2001). Social capital, poverty, and community health:
An exploration of linkages. In S. Saegert, J. P. Thompson, & M. Warren (Eds.), Social capital
and poor communities (pp. 165–188). New York: Russell Sage.
Jargowsky, P. A. (1997). Poverty and place. New York: Russell Sage.
Joint Center for Housing Studies. (1999). The state of the nation’s housing. Cambridge, MA: Harvard
Katz, L., Kling, J., & Liebman, J. (2001). Moving to Opportunity in Boston: Early results of a randomized mobility experiment. The Quarterly Journal of Economics, 116, 607–654.
Kawachi, I., Kennedy, B. P., Lochner, K., & Prothrow-Stith, D. (1997). Social capital, income inequality,
and mortality. American Journal of Public Health, 87, 1491–1498.
Keyes, L. C. (2001). Housing, social capital, and poor communities. In S. Saegert, J. P. Thompson,
& M. Warren (Eds.), Social capital and poor communities (pp. 136–164). New York: Russell
Klebanov, P. K., Brooks-Gunn, J., Chase-Landsdale, L., & Gordon, R. (1997). Are neighborhood
effects on young children mediated by features of the home environment? In J. Brooks-Gunn,
G. Duncan, & J. L. Aber (Eds.), Neighborhood poverty: Context and consequences for children
(Vol. 1, pp. 119–145). New York: Russell Sage.
Kotlowitz, A. (1991). There are no children here. New York: Anchor Books.
Krenichyn, K., Saegert, S., & Evans, G. W. (2001). Parents as moderators of psychological and physiological correlates of inner-city children’s exposure to violence. Applied Developmental Psychology, 22, 581–602.
Krieger, J. W., Song, L., Takaro, T. K., & Stout, J. (2000). Asthma and the home environment of lowincome urban children: Preliminary findings from the Seattle-King County Healthy Homes
Project. Journal of Urban Health of the New York Academy of Medicine, 77, 50–67.
LaViest, T. (1989). Linking residential segregation to the infant-mortality race disparity in U.S. cities.
Sociology and Social Research, 73, 90–94.
Lepore, S. J. (1995). Measurement of chronic stressors. In S. Cohen, R. C. Kessler, & L. Gordon (Eds.),
Measuring stress (pp. 193–212). New York: Oxford Press. 586 Saegert and Evans Leventhal, T., & Brooks-Gunn, J. (2000). The neighborhoods they live in: Effects of neighborhood
residence on child and adolescent outcomes. Psychological Bulletin, 126, 309–337.
Leventhal, T., & Brooks-Gunn, J. (in press). Moving to Opportunity: What about the kids? In J.
Goering (Ed.), Choosing a better life? How public housing tenants selected a HUD experiment
to improve their lives and those of their children: The Moving to Opportunity Demonstration
Program. New York: Russell Sage.
Liaw, F., & Brooks-Gunn, J. (1994). Cumulative familial risks and low birth weight children’s cognitive
and behavioral development. Journal of Clinical Child Psychology, 23, 360–372.
Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health
and Social Behavior, 85, 80–94.
Listokin, D., & Listokin, B. (2001). Asian Americans for Equality: A case study of strategies for
expanding immigrant homeownership. Housing Policy Debate, 12, 47–76.
Lopez, M. L., & Stack, C. B. (2001). Social capital, inequity, and culture: Lessons from the field.
In S. Saegert, J. P. Thompson, & M. Warren (Eds.), Social capital and poor communities
(pp. 31–59). New York: Russell Sage.
Luthar, S. (1999). Poverty and children’s adjustment. Los Angeles: Sage Publications.
Macintyre, S., Maciver, S., & Sooman, A. (1993). Area, class, and health: Should we be focusing on
places or people? International Social Policy, 22, 213–234.
Macpherson, A., Roberts, I., & Pless, I. (1998). Children’s exposure to traffic and pedestrian injuries.
American Journal of Public Health, 88, 1840–1845.
Massey, D. E., & Denton, N. A. (1993). American apartheid: Segregation and the making of the
underclass. Cambridge, MA: Harvard University Press.
Matte, T. D., & Jacobs, D. E. (2000). Housing and health−Current issues and implications for research and programs. Journal of Urban Health of the New York Academy of Medicine, 77, 7–
Mayer, S. E. (1997). Trends in the economic well being and life chances of America’s children. In G.
Duncan & J. Brooks-Gunn (Eds.), Consequences of growing up poor (pp. 49–69). New York:
McCord, C., & Freeman, H. P. (1990). Excess mortality in Harlem. New England Journal of Medicine,
McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of
Medicine, 338, 171–179.
McEwen, B. S., & Seeman, T. (1999). Protective and damaging effects of mediators of stress.
In N. E. Adler, M. Marmot, B. S. McEwen, & J. Stewart (Eds.), Socioeconomic status
and health in industrial nations (pp. 30–47). New York: New York Academy of
McLoyd, V. C. (1998). Socioeconomic disadvantage and child development. American Psychologist,
Mohai, P., & Bryant B. (1992). Environmental racism: Reviewing the evidence. In B. Bryant & P.
Mohai (Eds.), Race and the incidence of environmental hazards (pp. 163–176). Boulder, CO:
Moses, M., Johnson, E., Anger, W., Burse, V., Horstman, S., Jackson, R., Lewis, R., Maddy, K.,
McConnell, R., Meggs, W., & Zahn, S. (1993). Environmental equity and pesticide exposure.
Toxicology and Industrial Health, 9, 913–959.
Mullings, L., & Wali, A. (2001). Stress and resilience: The social context of reproduction in central
Harlem. New York: Kluwer.
Myers, D., Baer, W., & Choi, S. (1996). The changing problem of overcrowding housing. Journal of
the American Planning Association, 62, 66–84.
National Commission on Severely Distressed Public Housing. (1992). Final report. Washington, DC:
U.S. Government Printing Office.
Newman, S. J., & Schnare, A. B. (1997). “. . . And a suitable living environment”: The failure to deliver
on neighborhood quality. Housing Policy Debate, 8, 703–742.
O’Campo, A., Gielen, C., Royalty, W., & Wilson, M. (2000). Injury-producing events among children
in low-income communities: The role of community characteristics. Journal of Urban Health
of the New York Academy of Medicine, 77, 34–49. Poverty, Housing Niches, and Health 587 O’Connor, A., Tilly, C., & Bobo, L. D. (2001). Urban inequality: Evidence from four cities. New York:
Oie, L., Nafstad, P., Botten, G., Magnus, P., & Jaakkola, J. K. (1999). Ventilation in homes and bronchial
obstruction in young children. Epidemiology, 10, 294–299.
Oliver, M. L., & Shapiro, T. M. (1995). Black wealth/White wealth: A new perspective on racial
inequality. New York: Routledge.
Pendall, R. (2000). Why voucher and certificate users live in distressed neighborhoods. Housing Policy
Debate, 11, 881–911.
Popkin, S. J., Buron, L. F., Levy, K. D., & Cunningham, M. K. (2000). The Gautreaux legacy: What
might mixed-income and dispersal strategies mean for the poorest public housing tenants.
Housing Policy Debate, 11, 911–943.
Putnam, R. D. (1995). Tuning in, tuning out: The strange disappearance of social capital in America.
PS: Political Science and Politics, 28, 664–683.
Rainwater, L. (1970). Behind ghetto walls: Black families in a federal slum. Chicago: Aldine.
Ratner, M. S. (1996). Many routes to homeownership: A four-site ethnographic study of minority and
immigrant experiences. Housing Policy Debate, 7, 103–145.
Repetti, R., Taylor, S. E., & Seeman, T. (in press). Risky families: Family social environments and the
mental and physical health of offspring. Psychological Bulletin.
Rohe, W. M., & Stewart, L. S. (1996). Home ownership and neighborhood stability. Housing Policy
Debate, 7, 37–82.
Rosenbaum, E., & Harris, L. (2001). Low-income families in their new neighborhoods: The shortterm effects of moving from Chicago’s public housing. Journal of Family Issues, 22, 183–
Rosenbaum, E., & Harris, L. (2002). Residential mobility and opportunities: Early impacts of the
Moving to Opportunity Demonstration Program in Chicago. Housing Policy Debate, 12, 321–
Rutter, M. L. (1981). Protective factors in children’s responses to stress and disadvantage. In M. Kent
& J. Rolf (Eds.), Prevention of psychopathology (Vol. 3, pp. 49–74). Hanover, NH: University
Rutter, M. L. (1997). Nature–nurture integration: The example of antisocial behavior. American Psychologist, 52, 390–398.
Rutter, M., Yule, B., Quinton, D., Rowland, O., Yule, W., & Berger, M. (1974). Attainment and
adjustment in two geographic areas: Some factors accounting for area differences. British
Journal of Psychiatry, 125, 520–533.
Saegert, S., & Winkel, G. H. (1998). Social capital and the revitalization of New York City’s distressed
inner city housing. Housing Policy Debate, 9, 17–60.
Saegert, S., Winkel, G. H., & Swartz, C. (2002). Social capital and crime in New York City’s low-income
housing. Housing Policy Debate, 13, 189–226.
Sameroff, A. (1998). Environmental risk factors in infancy. Pediatrics, 102, 1287–1292.
Sampson, R., Raudenbush, S. W., & Earls, F. (1997). Neighborhoods and violent crime: A multilevel
study of collective efficacy. Science, 277, 918–926.
Sarpong, S., Hamilton, R., Eggelston, P., & Adkinson, N. (1996). Socioeconomic status and race as
risk factors for cockroach allergen exposure and sensitization in children with asthma. Journal
of Allergy and Clinical Immunology, 97, 1393–1401.
Sharfstein, J., & Sandel, M. (Eds.). (1998). Not safe at home: How America’s housing crisis threatens
the health of its children. Boston: Boston University Medical Center Publication.
Sherman, A. (1994). Wasting America’s Future. Boston: Beacon Press.
Spence, L. H. (1993). Rethinking the social role of public housing. Housing Policy Debate, 4, 355–368.
Stephens, C., Akerman, M., Avle, S., Maia, P., Campanario, P., Doe, B., & Tetteh, D. (1997). Urban
equity and urban health: Using existing data to understand inequalities in health and environment
in Accra, Ghana and Sao Paulo, Brazil. Environment and Urbanization, 9, 181–202.
Stone, M. E. (1993). Shelter poverty: New ideas on housing affordability. Philadelphia: Temple University Press.
Subramanian, S. V., Kawachi, I., & Kennedy, B. P. (2001). Does the state you live in make a difference?
Multilevel analysis of self-rated health in the U.S. Social Science & Medicine, 53, 9–19. 588 Saegert and Evans Suecoff, S., Avner, J., Chou, K., & Drain, E. (1999). A comparison of New York City playground
hazards in high and low income areas. Archives of Pediatrics and Adolescent Medicine, 153,
Syme, S. L. (1994). The social environment and health. Daedalus, 123, 79–86.
Taylor, S. E., Repetti, R., & Seeman, T. E. (1997). Health psychology: What is an unhealthy environment
and how does it get under the skin? Annual Review of Psychology, 48, 411–447.
Townsend, P. (1979). Poverty in the United Kingdom. Berkeley, CA: University of California Press.
Turner, M. A. (1998). Moving out of poverty: Expanding mobility and choice through tenant-based
housing assistance. Housing Policy Debate, 9, 373–394.
U.S. Department of Housing and Urban Development. (1998). In the crossfire: The impact of gun
violence on public housing communities. Washington, DC: Author.
U.S. Department of Housing and Urban Development. (1999). Opting in: Renewing America’s commitment to affordable housing. Retrieved November 18, 2001, from www.hud.gov/pressrel/optingin.
U.S. Environmental Protection Agency. (1977). The urban noise survey (EPA 550/9-77-100).
Washington, DC: Author.
U.S. Environmental Protection Agency. (1992). Environmental equity: Reducing risk for all communities (EPA 230-R-92-008). Washington, DC: Author.
Varady, D. P., & Walker, C. C. (2000). Vouchering out distressed subsidized developments: Does moving
lead to improvements in housing and neighborhood conditions? Housing Policy Debate, 11,
Wakefield, S. E. L., Eliott, S. J., Cole, D. C., & Eyles, J. D. (2001). Environmental risk and (re)action:
Air quality, health, and civic involvement in an urban industrial neighborhood. Health & Place,
Wallace, D., & Wallace, R. (1998). A plague on your houses: How New York was burned down and
national public health crumbled. London: Verso.
Wandersman, A., & Nation, M. (1998). Urban neighborhoods and mental health. American Psychologist, 50, 647–656.
Warner, M., Barnes, P. M., & Fingerhut, L. A. (2000). Injury and poisoning episodes and conditions:
National Health Interview Survey, 1997. Vital Health Statistics, 10, 202.
Warren, M., Thompson, J. P., & Saegert, S. (2001). A framework for analysis: The role of social capital
in combating poverty. In S. Saegert, J. P. Thompson, & M. Warren (Eds.), Social capital and
poor communities (pp. 1–30). New York: Russell Sage.
Weinstein, A., Feigley, P., Pullen, M., Mann, L., & Redman, L. (1996). Neighborhood safety and the
prevalence of physical inactivity—Selected states. Washington, DC: Center for Disease Control,
Division of Nutrition and Physical Activity.
Werner, E., & Smith, R. (1982). Vulnerable but invincible. New York: McGraw-Hill.
White, H. L. (1998). Race, class, and environmental hazards. In D. E. Camacho (Ed.), Environmental
injustices, political struggles (pp. 61–81). Durham, NC: Duke University Press.
Williams, D. R., & Collins, C. (1995). U.S. socioeconomic and racial differences in health: Patterns
and explanations. Annual Review of Sociology, 21, 349–386.
Wilson, W. J. (1987). The truly disadvantaged: The inner city, the underclass, and public policy.
Chicago: University of Chicago Press.
Wood, D. L., Valdez, R. B., Hayashi, T., & Shen, A. (1990). Health of homeless children and housed,
poor children. Pediatrics, 86, 858–866.
Yen, I., & Syme, S. L. (1999). The social environment and health: A discussion of the epidemiologic
literature. Annual Review of Public Health, 20, 287–308. SUSAN SAEGERT is Professor of Environmental Psychology and Director of the
Center for Human Environments (CHE) at the City University of New York Graduate Center. Her current research examines the linkages between urban housing
and neighborhoods and health, and how community processes, especially those
related to social capital, contribute to better urban environments. Poverty, Housing Niches, and Health 589 GARY W. EVANS is Professor of Design and Environmental Analysis, College of
Human Ecology, Cornell University. He is an environmental and developmental
psychologist primarily interested in the role of the physical environment in socio
emotional development. Current research is focused on housing, noise, crowding,
and the environment of poverty. ...
View Full Document
This note was uploaded on 11/29/2010 for the course DEA 4010 at Cornell University (Engineering School).
- The Land