Neighborhood Histories: White Flight Associated With Poor Health in Phoenix, Arizona

Neighborhoods and the built environment play a vital role in determining our health. But the majority of studies uncovering this relationship are cross-sectional, which can belie the fact that neighborhoods are shaped by historical processes over decades. In this study, we use white flight, the departure of white residents from an area, as our historical anchor to understand associations between current health outcomes and the histories of neighborhoods in Phoenix, Arizona. Given the link between white flight and investment trajectories and resources across a city, we posit it as a fundamental cause of past and present poor health and a detrimental health exposure. Using census data from 1980 to 2020, we assessed white flight's tie to economic and housing outcomes through Difference in Difference models and white flight's connection with a range of health outcomes through cluster regression models, grouped by spatial area. Census tracts that experienced white flight had significantly worse outcomes for median income, house value, and gross rent. Individuals living in areas with white flight had worse general wellbeing, less leisure-time physical activity, and higher chronic disease-related outcomes than those living in areas without white flight. Furthermore, individuals living in tracts that experienced white flight earlier had significantly higher rates of poor health. The compounding disadvantage of white flight has critical impacts on the health and wealth of neighborhoods; more studies need to focus on the historical and longitudinal histories of neighborhoods in order to understand the complicated associations between racial health disparities and place.