The New Urban Penalty
By: Source: AARP Bulletin Today Date Posted: 2004-05-28 14:55:00-04:00
For millions of older Americans, living in a big city isn't the vibrant, cosmopolitan experience that it is for others. For such people, the metropolis is a place of poverty, isolation and vulnerability.
Indeed, the archetypal downsides of city living—chiefly congestion, crime and pollution—are magnified in life-threatening proportions for many older people, especially those with few economic resources.
At the turn of the 20th century, before the advent of public health measures that Americans now take for granted, mortality rates in the nation's cities were significantly higher than they were in rural areas. Social scientists branded this phenomenon—fueled by poor sanitation and overcrowding—the "urban penalty."
Today there's a new urban penalty, at least for older city dwellers: dramatically higher mortality rates that seem to be brought on by environmental stresses and other factors. A recent study by the Detroit Area Agency on Aging and researchers from Wayne State University, for example, concluded that area residents in their 50s have been dying at more than twice the rate of people the same age elsewhere in the state.
"The last census showed that we had lost 23 percent of our elderly population," says Paul Bridgewater, the agency's executive director. "This study basically said to us that it wasn't out-migration."
What's more, mortality rates for older people in 10 other urban areas across Michigan were also higher than in the rest of the state.
"It's more the social milieu than anything else—not race," says Lee Kallenbach of Wayne State and the lead researcher on the study. "Your physical constitution can get beaten down in a city."
The new urban penalty isn't confined to Michigan. On hot summer days, temperatures in cities from coast to coast can hover 8 to 10 degrees above the temperatures in their suburban and rural surroundings, putting older residents at increased risk for heat exhaustion and heat stroke. Smog can make things even worse, especially for older people with respiratory problems.
Recent research points to other downsides, especially for low-income people:
In Boston, a recent study found that 15 percent of the city's older residents don't have anyone they can call in the event of an emergency and that 10 percent never leave their homes. "For a lot of older adults, it's a pretty grim picture," says Brian Souza, the executive director of the Boston Partnership for Older Adults, which commissioned the study. "People have a picture of an easier life in old age, but the reality, at least for the seniors here, is very, very different."
In San Francisco, the average rent for a modest one-bedroom apartment exceeds 200 percent of the monthly benefit under the federal Supplemental Security Income program, a safety net program for low-income people over age 65 or disabled; in 17 of the nation's housing market areas, rents are more than 150 percent of SSI.
Many studies have shown that prolonged stress can cause or intensify physical and mental afflictions. In Why Zebras Don't Get Ulcers, an exploration of the science of stress, Stanford University biologist Robert Sapolsky argues that humans get ulcers, diabetes, heart disease, memory loss and other chronic conditions because their bodies aren't designed to withstand the constant stresses of city life.
An interviewer once asked Sapolsky to compare living in urban America with living in remote Africa. "When I'm there," Sapolsky replied, "95 percent of the time I can relax in a way that I never can here."
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