About 16 percent of the women who moved had diabetes, compared with about 20 percent of women who stayed in public housing. And about 14 percent of those who left the projects were extremely obese, compared with nearly 18 percent of the other women.
The small-but-significant differences offered some of the strongest support yet for the idea that where you live can significantly affect your overall health, especially if your home is in a low-income area with few safe places to exercise, limited food options and meager medical services.
“This study proves that concentrated poverty is not only bad policy, it’s bad for your health,’’ Shaun Donovan, secretary of the Department of Housing and Urban Development.
But no one believes the deficit-plagued federal government is going to expand the program and start moving low-income women to better neighborhoods en masse.
“It’s not enough to simply move families into different neighborhoods,’’ Donovan said. Instead, new ways must be found to help families “break the cycle of poverty that can quite literally make them sick.’’ He did not mention specific proposals.
Public health experts have long thought that living in poor neighborhoods could ruin a person’s health, but this study put the idea to a rigorous test.
Here’s how it worked: Women believed to be about the same in most respects were randomly assigned to one group or another and then followed through time, in a model customarily seen in pharmaceutical studies. That makes it more scientifically rigorous than most research linking health problems to a social environment.
The study’s good design “provides a basis to infer cause and effect’’ between poverty and bad health, said Dr. Robert Califf, a noted Duke University cardiologist who is leading a massive study on neighborhoods and health outcomes.
The research was led by Jens Ludwig, a University of Chicago professor of public policy. It was published in Wednesday’s New England Journal of Medicine.
