Fight Against Buffalo’s Health Disparities Receives Boost

Published December 8, 2021

To more powerfully address and reverse Buffalo’s entrenched health disparities, a University at Buffalo center dedicated to regenerating underdeveloped neighborhoods is joining the Community Health Equity Research Institute at UB.

“The Center for Urban Studies focuses on neighborhoods, housing and the built environment where people live, work and play, which are key social determinants of health. And the focus of the Community Health Equity Research Institute is health disparities, a direct result of the social determinants of health. So it made a lot of sense to team up. ”
Director of the Community Health Equity Research Institute and SUNY Distinguished Professor of medicine
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The Center for Urban Studies in the UB School of Architecture and Planning has signed a memorandum of understanding with the institute that makes the center a vital component within the institute.

Strengthening Research on Health Disparities

Timothy F. Murphy, MD

“Making the Center for Urban Studies part of the Community Health Equity Research Institute represents a wonderful opportunity to marry our work on underdeveloped neighborhoods and issues with the built environment directly with the health disciplines on campus,” says Henry-Louis Taylor Jr., PhD, professor of urban and regional planning in the UB School of Architecture and Planning.

Timothy F. Murphy, MD, director of the institute and SUNY Distinguished Professor of medicine in the Jacobs School of Medicine and Biomedical Sciences, agrees, noting that this “marriage” between the two organizations will strengthen UB’s ability to conduct meaningful research aimed at addressing Buffalo’s health disparities. 

“This move of the center into the institute represents an important advance for both entities and makes them both bigger and better,” says Murphy, senior associate dean for clinical and translational research. “The Center for Urban Studies focuses on neighborhoods, housing and the built environment where people live, work and play, which are key social determinants of health. And the focus of the Community Health Equity Research Institute is health disparities, a direct result of the social determinants of health. So it made a lot of sense to team up.”

Engaging Disciplines Beyond the Health Sciences

Founded in 1987 by Taylor, the center conducts basic and action-based research on community and economic development, focusing on the needs and issues of traditionally marginalized groups, including Black, Latino, Asian American and Native American people; women and low-wage workers.

Established in 2019, the institute developed out of the work of UB faculty, staff and students working with the African American Health Equity Task Force, with which the Center for Urban Studies is also a close partner.

It engages the expertise of UB researchers working with communities of color to address through community participatory research decades of detrimental federal and local policies that have created racial, residential and educational segregation and disinvestment in Buffalo neighborhoods.

The partnership reflects the fact that health disparities are rooted in the social determinants of health, most of which are not directly related to the health care system.

“Most social determinants of health exist outside of the health care system,” Murphy notes. “They include poverty, neighborhoods, food access, the criminal justice system, educational opportunities and others. The success of our institute is going to depend on us being able to engage all the disciplines that are beyond the health sciences. Now we have the School of Architecture and Planning right in our institute. This move will help us attract other disciplines.”

Community-Based Participatory Research

Robert G. Shibley, professor and dean of the School of Architecture and Planning, says the alignment creates a critical bridge between the institute and the broader curricular and research enterprise of the school, where Taylor will continue to teach and the Center for Urban Studies remains physically housed.

“This alignment builds on a more than 30-year body of work by Henry and the Center for Urban Studies to address legacies of racism in the planning and development of our built environment. It also creates new openings for the school to link questions of health disparities to our research and teaching on food justice, climate action, affordable housing and inclusive design,” Shibley says. “We’re excited by the possibilities of this new partnership to build healthier, more equitable communities together.”

Indeed, that bridge is already building new connections across the university. The institute’s inaugural Research Day, held on Oct. 27, featured talks from prominent community members as well as descriptions of research projects addressing health disparities from faculty in UB’s School of Nursing, School of Pharmacy and Pharmaceutical Sciences, School of Law, College of Arts and Sciences and School of Architecture and Planning, as well as the Jacobs School. 

Ultimately, Murphy says, the goal is to inspire faculty members throughout all 12 of UB’s schools to conduct community-based participatory research on the social determinants of health.

Policy Decisions Result in Structural Racism

“The idea of the connection between health outcomes and the neighborhood you live in is not abstract,” Taylor says. “The very way that we build cities in the U.S. is racist. The policies and decisions that create the conditions that exist inside these neighborhoods and communities make it appear like it’s a natural process, rather than the decisions and choices of policymakers. It creates conditions that give rise to these undesirable outcomes.”

Jacobs School medical students have been exploring those conditions in-depth since 2018, when Taylor worked with Jacobs School faculty and community partners at Buffalo churches to develop a new elective called “Health in the Neighborhood.”

The course connects medical students with families in inner-city neighborhoods, helping students learn how structural racism results from policies that have created segregated, substandard living conditions.

Last summer, under a project overseen by the Department of Surgery, Michael Lamb, PhD, director of surgical education and a research assistant professor of surgery, led three Jacobs School medical students in participatory research, while Taylor worked with another medical student on housing and the neighborhood.

Training the Next Generation of Researchers

Taylor says the participatory research project gave the three students an opportunity to understand the significance of involving the community in research, while his project allowed the student to grasp the importance of housing and its effect on health. All of the medical students gained new skills in demographic data and spatial analysis.

“If median household income is around $11,000 a year and you’re paying more than half of it on rent, the stress of having to make ends meet and worrying that you might have to move unleashes these stressors, especially in single-parent families, and that links us back to the extraordinarily high infant mortality rate and low birth weight babies in these communities,” says Taylor, who has already engaged planning students in the work through the school’s practice-based studios and as research assistants in the Center for Urban Studies.

By conducting research on these issues, Taylor adds, students get to see how neighborhood conditions on the ground contribute to health outcomes, and grasp the importance of involving residents in the quest to forge strategies to improve their communities and take control of their health.

Murphy explains that training the next generation of researchers at the graduate and postdoctoral levels is a major focus of the $21.7 million Clinical and Translational Science Award that UB received from the National Institutes of Health (NIH) last year, a renewal of the NIH’s initial award in 2015.

A key goal of moving the center into the institute is to train the next generation of researchers in multiple fields who can look at housing and urban planning and understand how they affect health outcomes so they can work to improve them.

“If you do not transform the neighborhoods where people live, you will be very limited in being able to make any change,” Taylor says. 

Changing Environments a Sign of Hope

One project Taylor points to with obvious pride is what used to be an empty lot that he and his students from the Center for Urban Studies began transforming about 15 years ago. The lot was across from Futures Academy, also known as PS 37 Marva J. Daniel Futures Prep, an elementary/junior high school on Buffalo’s East Side.

“The idea with that project was to demonstrate that we have the capacity and the power to change the environment that we’re in,” Taylor says. “How could we tell the kids in that school that education will change their lives when you can’t even change their environment? So we found a way to completely transform it.”

Now, due to their efforts, that empty lot is a welcoming park with a whimsical entry sign, benches and a vegetable garden, and an abandoned building on the site has been demolished.

“That’s what we want to do,” Taylor concludes. “Our story is not one of doom and gloom, it’s one of hope and possibility.”

And, Taylor and Murphy note, it’s a story that’s happening because of UB’s strong support.

“If it wasn’t for the enthusiastic support of the president and the provost, we wouldn’t be having this conversation,” Taylor says. “It’s a demonstration of the commitment on the part of the university that says the health issues among African Americans are an urgent question. We are aligning our forces on this campus to play a significant role in partnership with the African American community to do something about it.”