Psychiatrist-Public Health Educator Mindy Thompson Fullilove Maps the Root Causes of America’s Inner City Decline and Paths to Restoration
America’s inner cities are sick. Have been for a long time. They’re long overdue for a sweeping public health approach that gets to some of the root causes of their decliine over the past 40-some years. North Omaha (really northeast Omaha) is a case in point. It’s long been in need of a transformation and one finally is underway after years of neglect, half-starts, spotty redevelopment, counterproductive urban renewal efforts, and rampant disinvestment. Psychiatrist and public health educator Mindy Thompson Fullilove has done much research, writing, and speaking about what’s happened to drag down inner cities and what’s needed to bring them back and I wrote the following piece on the eve of a presentation she gave in Omaha. I interviewed her in advance of her talk. I did attend her program, and though I didn’t do a followup story to report what she said I can tell you she covered many of the same points she made with me in our session.

Psychiatrist-Public Health Educator Mindy Thompson Fullilove Maps the Root Causes of America’s Inner City Decline and Paths to Restoration
©by Leo Adam Biga
Originally appeared iin The Reader (www.thereader.com)
The low standard of living found in segments of Omaha’s inner city mirrors adverse urban conditions across America. Poverty, low test scores, unemployment, gang violence, teen pregnancy, HIV/AIDS and STDs, distressed/devalued properties all occur at disproportionately high rates in these sectors.
Psychiatrist Dr. Mindy Thompson Fullilove, a public health educator at Columbia ((N.Y.) University, studies the causes and consequences of marginalized communities. A pair of talks she’s giving in Omaha next week, one for the public and one for health professionals, will echo local efforts addressing economic-educational-health disparities, infectious diseases and inner city redevelopment.
By training and disposition Fullilove looks for the connections in things. Much of her research focuses on linkages between the collapse of America’s urban core and the corollary decline in health — physical, psychological, emotional, environmental, economic — endemic there. She blames much of the blight on fallout from late ‘40s through mid-‘70s urban renewal projects.
Many longtime Omaha residents rue the North Freeway for driving a stake through the heart of a once cohesive, stable community. Hundreds of homes and dozens of businesses were razed to build it. Critics say this physical-symbolic barrier divided and damaged an area already reeling from late ‘60s riots that destroyed the North 24th St. business district, which only hastened white flight.
These interrelated phenomena, Thompson Fullilove believes, caused widespread carnage in cities like Omaha — displacing families, disrupting lives, rupturing communities, dragging down quality of life, property values, self-esteem and hope. In her view urban renewal was part of policies that “destroyed neighborhoods” — as many as 2,500 nationwide by her calculation — in the guise of progress.
“Many of the ways in which we built at that time involved demolishment of a neighborhood,” she said by phone. “There were these very large projects put in so that the old grid of the city was fused into sort of super blocks and huge things built on them like cultural centers or universities that made a fundamental change in the flow of the city. A lot of these projects were really not very thoughtful and didn’t work. So we’re living with the aftermath of very bad urban development, much of which is now coming down and being replaced.”The kind of severing of neighborhoods that occurred when freeway projects cut through the heart inner cities
Witness the sprawling Logan Fontenelle public housing project that came down a few years ago in northeast Omaha. In the early ‘70s, large tracts of land dotted with homes and businesses in far east Omaha were cleared for airport expansion. Anytime people are forced to move from their home it’s a major stress that can dislocate them from family, friends, jobs, neighborhood, community.
“Displacement is always accompanied by violence,” said Thompson Fullilove. “When people are displaced they need help to get back on their feet but if there’s never any help then things can get worse and worse. You get anger, hostility, and then people, instead of being able to solve problems, are just trying to survive.”
She said when people live outside social networks-support systems, epidemics like AIDS, STDs or gun violence emerge and grow entrenched. Often she said, people displaced from their homes also get displaced from blue-collar jobs. “People have no way to make a living and no social network to fall back on, so it’s really a double whammy,” she said. The results? “Terrible crime as people try to do work in the underground economy.” Thus, the drug trade thrives, gangs go unchecked. Some observers say Omaha’s African American community is still hurting from the packinghouse/manufacturing/railroad jobs lost in the ‘60s-‘70s.
She said today’s info service-high tech economy leaves many workers behind. “You have to get people to learn skills, you have to get people more education and you have to be inventing what they’re going to work at, and all these require a stable, engaged city as a center of exchange not a city of haves against have-nots,” she said. “Until cities are places of development, we’re in bad trouble as a nation.”
A term she uses to describe displacement’s trauma, “root shock,” is also the title of a book she authored examining how the ripple effects of urban renewal impact whole swaths of cities and persist long after the bulldozers leave.
“It has a ripple both in time and in space,” she said. “So tearing up a neighborhood has ripples for a whole metropolitan area and it also has ripples over time for generations of people who live in that area. Also, when you demolish a big area it creates a ripple of destruction on the other side of the area you demolish — you also decrease the value and the stability of the properties. And as those properties decline in value and really fall apart the properties next to them fall apart, and then the properties next to them fall apart. So you can actually take a drive in a place where there was urban renewal and find the leading edge of the destruction, typically a couple of neighborhoods over from where the urban renewal was done and, sometimes, even further.”

She said the decline extended to downtowns.
“Many neighborhoods demolished for urban renewal were near downtown or part of the downtown,” she said, “so demolishing a lively neighborhood which added to the strength of a downtown shopping center contributed to the collapse of many American downtowns, which are only slowly coming back.”
Like a disease introduced into a larger host, she said as urban decline spread it compromised the health of entire cities.
“It installed something that was dysfunctional in a critical part of the landscape of the city,” she said, “Although we think of all the terrible things that happened to the African Americans who actually lived in many affected neighborhoods, the worst consequence is that we made our cities weaker, so the whole nation lives with that grievous error. Cities are important for our nation because they really are the economic engine. So undermining the cities the way we did weakened our whole economic prosperity. You might say one of the seeds of this current economic crisis is in the destruction of our cities.”
From her perspective, America hasn’t corrected these problems — “what we’re doing instead is continuing to use versions of the same process.” She said even where a city center may enjoy a renaissance “it’s being rebuilt with the goal of attracting people from the suburbs to come back to the city.” That’s gentrification. “So the goal is not to make the city a welcoming place for all people that might like to live there. As opposed to figuring out how do you make a city which is a place of exchange, you’re making a city a place of exclusion,” she said, “and that’s just as destructive as urban renewal.”
She notes there‘s not yet widespread understanding among policymakers, developers and stakeholders of processes that diminish-threaten public health. She’s hopeful conferences like one she was at earlier this month in NYC, Housing, Health and Serial Displacement, “really open up this conversation, because I think if we’re going to have exciting cities in the United States it requires really a new approach to how you build cities, not just pushing people out.” She and her husband, community organizer and sociomedical sciences expert Robert Fullilove, work with urbanists on strategies for sustainable, inclusive, built environments.
Through the couple’s think tank, Community Research Group, they study and advocate holistic, public health approaches to urban living dynamics that view cities as ecosystems with interdependent neighborhoods-communities. What happens in one district, affects the rest. If one area suffers, the whole’s infected.
“You can’t undermine stable living conditions in a neighborhood or a community without bringing down the quality of life of everybody in the area, and it’s a very large area that then gets affected,” Thompson Fullilove said. “The foundation of health is good living conditions. Health is sort of our ability to enjoy our lives.”
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