Remember Samson and the Pillars?

One of the great films of my youth was the Cecil B. DeMille production of "Samson and Delilah."  The heart of the story is that strong man Samson reveals to seductress Delilah that the secret of his strength is in his long hair.  She cuts it off and delivers him to his enemies, who blind and torture him.  Over time, she regrets her betrayal and his hair grows back.  In the final scene, he tells her to lead him to the pillars of the building where his enemies are gathered.  He uses his great strength to push the pillars out of place and bring down the building.  To all of us raised on Bible stories, this was a very satisfying moment, and obviously it teaches us something about pillars.

I think the heads of NY Presbyterian Hospital -- despite the name -- did NOT go to Bible School and missed the pillar talk.

What's why they feel free to knock down a pillar of the Washington Heights neighborhood, Coogan's Restaurant, which has been holding the place up for decades.

For those of us who ate there, partied there, got support from there, this is an unconscionable act.  We understand the role of Coogan's in getting us through the crack era, with its street terror and violence.  We know that Coogan's always helped the neighborhood -- the 5K run, the book parties for local authors, the donations of water for our annual Hike the Heights.

Coogan's is not the place you imagine when you think of the train wreck of gentrification.  The photo in The Times shows the usual crowd, doctors, nurses, techs, administrators, business people from the hospital, enjoying lunch together.

But gentrification is not about a specific income target -- like getting poor people out of a neighborhood.  It's about maximizing profits -- the hospital wants $40,000 a month for the space, more than Coogan's can pay.  That Coogan's "pays" by caring for the neighborhood doesn't count in the math of "make more money."

And that is why we need to re-read the story of Samson.  Pillars are there for a very good reason.  This is a terrible Main Street story, because NYP got it all wrong.

The expulsion of poor people from our cities

I attended one day of the annual meeting of the National Association of City and County Health Officers (NACCHO). It had the bold theme of "creating a culture of health equity." It was interesting to listen to the presentations -- I'd say NYC, under the leadership of Dr. Mary Bassett, and with a new Center for Health Equity, is defining the cutting edge. Others are focused on righting obvious disparities in resources, but without an adequate analysis of the social processes driving inequity. Dr. Camara Jones asked the key question just at the closing bell: How we consider outcomes AND process as we create public health programs?

What are these processes?  Gentrification is an obvious one.  The New York Times had a sobering story about the "loneliness of black people in San Francisco."  Black people have been part of San Francisco since the Gold Rush days, but their numbers increased dramatically in World War II, when blacks from Texas and Louisiana moved there to work in the war industries.  They settled in the Fillmore, which had been left empty by "internal resettlement" of Japanese residents -- forced into concentration camps because they were presumed to be a threat to national security.   The newcomers quickly built a vibrant community, known as a center of American jazz.  Urban renewal, in the1950s, declared the Fillmore a "blight" on the city, the area was bulldozed and rebuilt.  This was a major blow to the black community.  Deindustrialization, which got started in the 1960s, undermined the economic foundation of the community.  Gentrification has really been the great force, driving working people out of the city.  The Mission District, a center of Hispanic life for many decades, is rapidly shifting the population there.  Rebecca Solnit's devastating article, "Death by Gentrification," told a story of a young man's death, triggered by the suspicions of newcomers who thought he was dangerous when in reality he was eating a taco.

The drama of expulsion -- going on in major cities across the US and the world -- has implications for everything from electoral politics to public health campaigns.  Take a simple example.  A public health program wants to enhance food options for a community that is considered a "food dessert."  they succeed, but so gentrification, which the public health program did not target for intervention.  The food options have improved but no poor people live in the neighborhood.  Did the public health program "work"?

One example of taking public health leaders taking on the process is found in the report, Development without Displacement: Resisting Gentrification in the Bay Area.  This report was written by Causa Justa::Just Cause, with policy and data analysis support from the Alameda County Public Health Department's Place Matters Team.  This is the kind work that is all too frequently missing from our public health agenda -- it is urgent that we understand and act on the massive displacement that is reshaping our urban regions and redefining massive communities.  We do not succeed if all we've done is create great food options for arriving hipsters.