Changing the Black East Side: Pilot Initiative Will Tackle Social Determinants of Health

Driven by strong collaborations between community organizations, including the Buffalo Center for Health Equity, the UB Community Health Equity Research Institute, the School of Architecture and Planning, and the Jacobs School of Medicine and Biomedical Sciences at UB, the effort is aimed at tackling the root causes of the social determinants of health in order to improve the health of people who live on Buffalo’s East Side.

“Health outcomes will be the key metric of success,” says Henry-Louis Taylor Jr., PhD, director of UB’s Center for Urban Studies, professor of urban and regional planning in the School of Architecture and Planning, and lead author of the report guiding the effort: “How We Change the Black East Side: A Neighborhood Planning and Development Framework.”

“The goal of this neighborhood transformation is that people will live longer and better,” says Taylor, an associate director of UB’s Community Health Equity Research Institute. “We will see less infant mortality, fewer children born with birth weights that are too low, stresses will be reduced and so will a lot of illnesses that are catalyzed by high levels of stress. We will create these positive health outcomes by changing the physical, social and economic conditions found in the neighborhood.”

The Center for Urban Studies developed the report in response to the Buffalo Center for Health Equity’s request for a conceptual framework for a neighborhood demonstration project. That request followed the Center for Urban Studies’ 2021 report, “The Harder We Run: The State of Black Buffalo in 1990 and the Present,” which clearly demonstrated that Black Buffalo has not made progress during the past three-plus decades. It found that conditions in physical neighborhoods had deteriorated and that now there was a new, even more dangerous threat: gentrification.

Dozens of community activists, academics and policymakers have contributed their perspectives to “How We Change the Black East Side,” which underwent numerous revisions based on their input. It describes a demonstration project that transforms a selected East Side neighborhood into “a great place to live, work, play and raise a family for the actually existing population.” The project will then serve as a model for subsequent neighborhood transformations.

“This is the first time in the history of this city where we have outlined a clear and precise strategic approach to the development of a Black neighborhood,” says Taylor, who has devoted his career to studying neighborhood development. “We have to build a different type of neighborhood.”

Throughout the United States, and in Western New York, neighborhoods are based on the premise of the commodification of shelter. “Homeownership is seen as an instrument of wealth production,” says Taylor. “Exclusion on the basis of race and class is what keeps property values high.” This is the case even where African Americans are developing properties. While that can create some opportunity for middle-income families, he says, it does nothing for lower-income families.

“Is it morally correct to build neighborhoods based on keeping groups out simply because of their income and, in some instances, race?” Taylor asks. “Every book, every article we can get our hands on critiques this model. We thought, why don’t we try something new and different?”

Details of the report and discussion of which neighborhood will host the project will be shared in a public meeting to be scheduled early in 2024. The neighborhood that is chosen must rank high on the hardship index, a measure that Taylor created for all East Side neighborhoods, which takes into account factors such as levels of income, education and employment, poverty rate, and the percentage of residents paying 40% or more of their income on rent. It also includes how much a neighborhood is threatened by gentrification, a new and growing challenge.

“We’ve identified those geographies that we think are most threatened,” he says. “We want to do a demonstration project that will also create a firewall between those sections of the East side that are threatened by gentrification and those that aren’t in harm’s way at this point. We also wanted a neighborhood with a strong community base and organizations that have the capacity to house a neighborhood transformation team.”

Many organizations are already on board and their leaders are well aware of the pervasive impact of the social determinants of health. “Where schools are poor and there’s a lack of good jobs, lack of transportation, there’s this push-me-pull-you aspect where each social determinant of health is connected to another,” says Rita Hubbard-Robinson, JD, chief executive officer of NeuWater & Associates LLC, treasurer of the Buffalo Center for Health Equity and associate director of UB’s Community Health Equity Research Institute.

“You can’t just look at one thing,” agrees Rita Gay, president of the grassroots nonprofit Fillmore Forward. “You have to look at how folks are being treated at every level — crime, housing, education — so I like the holistic approach to community development.”

She adds that the strategies in the report, such as the fact that it must be led by the residents, are key. “I absolutely like that nobody is coming into the community to tell us what to do,” she says, noting that policymakers must also be at the table and participate.

The report emphasizes that the community itself will be making the improvements. “You miss the point if you bring in other people to do the jobs that need to get done,” says Taylor, “so you train the people that live there to do that work.”

Home ownership, he says, hasn’t worked in the Black community because of overcharging, high interest rates on mortgages, and foreclosures, the highest rates of which are on the East Side.

One solution is to promote collective forms of ownership. “The most successful enterprises we have in the Black community are churches, and that’s cooperative ownership,” says Taylor. “So what happens if we collectively pool resources to promote land ownership? You don’t have to focus on buying an individual house, build condominiums and other forms of collective ownership.” Sweat equity, where collective owners do their own repairs instead of hiring contractors, can help drive costs down, Taylor adds.

Many of these solutions are already happening in some fashion on the East Side. Hubbard-Robinson says many of the properties in the Hamlin Park neighborhood were purchased as doubles by intergenerational families who pooled their resources. “This concept of pooling resources and coming up with a way to address affordability is real important,” she says. “As Black people, we’ve had no background of accumulated wealth. We need ways to invest and build wealth, not even so much for this generation as for generations to come.”

But the report is clear that housing is only one aspect of transforming a neighborhood, and that all of the social determinants must be tackled holistically. The expertise of UB faculty will be a key ingredient.

For example, the Center for Urban Studies’ UB partner in the project is the Community Health Equity Research Institute, which recently launched its inaugural program soliciting research that attacks the root causes of health inequities on the East Side.

The effort also seeks to involve and inform UB students, including medical students in the Jacobs School.

“Our providers need to recognize that they provide health care in the context of people living in these social determinants of health,” says Timothy F. Murphy, MD, SUNY Distinguished Professor of medicine and director of UB’s Community Health Equity Research Institute. “We are teaching our students that when they see patients and see that they have social needs, they need to take the next step — for example, hook them up with a social worker to identify what could be done to mitigate those social determinants of health. It goes hand in hand with an awareness of the life of the person and what they need to get healthier.”

Taylor says the impetus for the neighborhood pilot project has been informed by the knowledge that funding for various projects is flowing into the East Side, especially since the racist shooting at the Tops market on Jefferson Avenue in May 2022. “There are new projects occurring all over the place, but they’re disjointed, they’re not connected to any type of plan or vision,” says Taylor. “And most employ white workers. So we said OK, we need to locate an area on the East Side, on a relatively small scale, to show how we can change the East Side.”

The goal is to establish an administrative structure with a key community group that can house the neighborhood transformation team and be responsible for raising funds from foundations, government and the private sector. Taylor expects to have that structure in place by the summer, but he notes that planning and implementation will be going at the same time.

“Is this a big, hugely complicated project?” he asks. “Yeah, that’s why we’re doing it. Four hundred years after the slave trade started, African Americans are still at the very bottom of the racial hierarchy of this country in every critical index. Creating a project that aims to transform a community for the actually existing population in a way that’s sustainable and generalizable clearly falls in the category of ‘Boldly Buffalo.’ And we can do it. I’ve been closely associated with activists on the ground in this city,” he adds. “Nobody sees us as the voice of the ivory tower.”

For more information on the project and to get involved, contact Taylor at 716-829-5910 or email htaylor@buffalo.edu.