By Kenneth J. Cooper

“Place matters for health.” That opening declaration in one of two new reports distills established wisdom that residential segregation is a big contributor to minority health disparities – because segregated neighborhoods tend to have less access to health care and fresh produce, fewer recreational facilities and more environmental hazards.

The report “Segregated Places, Risky Places”  (PDF) from the Joint Center for Political and Economic Studies takes that analysis a step further, examining the health effects of poverty in those neighborhoods. The study finds that concentrated poverty is more important than race or ethnicity, and it is the “most damaging” of all factors in minority residents’ health.

“Place matters for minority communities not because they are predominantly black or Hispanic but rather due to higher rates of poverty,” the report’s three coauthors conclude. “Even persons with middle and relatively higher incomes are at greater risk when more of their neighbors are poor.”

The second report, “A Lost Decade,” (PDF) shows that concentrated poverty has increased since 2000 as the nation’s overall poverty rate has risen from 11 percent to 14 percent.

By 2009 in the country’s large metropolitan areas, one in four African Americans, one in six Hispanics and one in eight Native Americans lived in neighborhoods with poverty rates of 30 percent or more, compared with one in 25 non-Hispanic whites. Such pockets of impoverishment had fallen during the 1990s, when the economy was growing rapidly.

Metro areas where concentrated poverty has increased include those in the Midwest andTexas, but it declined in New York and Los Angeles. By the end of the decade, the Chicago, Atlanta, Boston and Washington, D.C. had below average rates of residents living in the poorest areas.

The other report found that living in a high-poverty neighborhood that was also segregated has a significant negative impact on the general and mental health of black and Hispanic residents, and also on how often they develop diabetes.

“It is poverty concentration rather than racial composition of the zip code that increases the risk of negative health status,” the coauthors find. The occurrence of high blood pressure and stroke was not significantly affected by concentrated poverty.

Those findings do not mean race is not implicated in the disparities in health status and outcomes that African Americans and Hispanics experience. “Segregated Places, Risky Places” notes residential segregation abated between 2000 and 2010, but its effect on minority health has intensified, specifically when it comes to infant mortality.

The report estimates that full residential integration would save two black babies per 1,000 lives births, and the infant mortality rate for Hispanics would actually be lower than whites’.

“So, racial inequalities in health status and outcomes are predominantly the result of place. Race helps to determine place, and in turn, place influences health,” coauthors Thomas A. LaVeist, Darrell Gaskin and Antonio J. Trujillo explain. They are affiliated with the Johns Hopkins Bloomberg School of Public Health.

Recent, overlooked research by LaVeist and Gaskin gives white Americans who think are unaffected by minority health disparities and inequities are big financial reason to support government action to address them. The researchers estimate that during just four years in the last decade, health inequities caused $230 billion in medical expenditures, contributing to steep rises in insurance premiums. The overall economic impact, including lost wages and lower productivity, was put at $1.24 trillion.

Health officials and advocates have already begun to push place-based solutions to the inequities that play a role in them, instead of focusing solely on the medial treatment and exercise and dietary habits of African American and Hispanic individuals.

“Community conditions can overwhelm even the most persistent and determined efforts of individuals to take steps to improve their health,” says Brian Smedley, director of theJointCenter’s Health Policy Institute.

“Segregated Spaces, Risky Places” recommends policies to foster community-based collaboratives to “make poorer communities healthy communities.” The report cites existing efforts around the country to attract supermarkets, promote better diets and more exercise, and improve diabetes care in those communities.

In his foreword, Ralph B. Everett, president and CEO of the Joint Center, sets a tougher goal involving a stubborn social problem.

“It is highly unlikely that we will make significant strides toward eliminating health inequities without attending to their root cause—residential segregation,” he argues.

Everett also calls for “de-concentrating poverty from inner-cities and rural areas through smart housing and transportation policy.”

The authors of “A Lost Decade”—Rolf Pendall, Elizabeth Davies, Lesley Freiman[CQ] and Rob Pitingolo of the Urban Institute—see a demographic opportunity for the country to reduce both residential segregation and concentrated poverty.

“The aging and retirement of the baby boom generation will open unprecedented opportunities. If conditions are right, baby boomers’ neighborhoods can steadily integrate economically and racially as their housing is released to new generations of families,” the coauthors write. “Baby boomers’ jobs, too, can become available to young people who grow up in neighborhoods where investments in education have been steady and where public services have been maintained.”

That is an optimistic insight. With credit standards for home mortgages tightened, it will require positive action by the federal government and banking industry to make it more than that.

Kenneth J. Cooper, a Pulitzer-Prize winning journalist, is a freelancer based in Boston. He also edits the Trotter Review at the University of Massachusetts-Boston.