Keywords
Chronic Disease
Social Determinants of Health
Structural Determinants of Health
Built Environment
Black Community Engagement
Structural Racism
How to Cite
Abstract
The Live Well Allegheny-Lifting Wellness for African Americans (LWA2) Racial and Ethnic Approaches to Community Health (REACH) Initiative sought to address racial health disparities in chronic disease, as well as structural determinants and systems of oppression at their root, among the Black community in Allegheny County. LWA2-REACH implemented active transportation projects focused on predominantly Black neighborhoods. In doing so, LWA2-REACH enabled a first-of-its-kind connection between two county departments–economic development and the health department–and Black priority communities in the Monongahela River Valley and the Homewood neighborhood of Pittsburgh. During years four and five of the initiative, two miles of road for bicycle use and three miles of road for pedestrian use were improved through traffic calming, safety techniques, and sidewalk replacement. The evolution of the relationships between LWA2-REACH communities and the ACED generated an iterative, reciprocal awareness of community residents regarding the benefits of active transportation planning processes for their communities, and of municipalities regarding the interest of REACH community residents in engaging in active transportation planning processes. This work is a model for how to apply multi-sector, resident-engaged chronic disease prevention initiatives in predominantly Black communities as part of a comprehensive strategy to increase racial health equity by reducing racial health disparities.
References
Allegheny County. (2008). Allegheny Places: The Allegheny County Comprehensive Plan. http://www.alleghenyplaces.com/comprehensive_plan/comprehensive_plan.aspx
Allegheny County Economic Development. (2010). Active Allegheny: A Comprehensive Commuter Bicycle and Pedestrian Transportation Plan for Allegheny County. https://www.alleghenycounty.us/economic-development/communities/active-allegheny-grant-program.aspx
Allegheny County Health Department. (2017). Plan for a Healthier Allegheny-2015. http://onepgh.org/documents/library/PlanforaHealthierAllegheny.pdf
Alliance, B. R. (2023). Bronx River Alliance. Bronx River Alliance. Retrieved December 20 from Bronx River Alliance
Bors, P., & Moore, S. (2019, May 23, 2019). Active Transportation Equity. Healthy Places by Design. Retrieved December 20 from https://healthyplacesbydesign.org/active-transportation-equity/
Brown, C. T., Rose, J. L., & Kling, S. (2023). Arrested Mobility: Barriers to Walking, Biking, and E-Scooter Use in Black Communities in the United States. E. Cities. https://arrestedmobility.com/wp-content/uploads/2023/03/Arrested-Mobility-Report_web.pdf
CDC. (2019). Operationalized Intermediate Performance Measure Profile Physical Activity - Revised. In. Atlanta, GA: CDC.
CDC. (2022a, January 2022). Active People Healthy Nation. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. Retrieved August 20 from https://www.cdc.gov/physicalactivity/activepeoplehealthynation/index.html
CDC. (2022b, July 21, 2022). National Center for Chronic Disease Prevention and Health Promotion: About Chronic Diseases. Centers for Disease Control and Prevention. Retrieved August 11 from https://www.cdc.gov/chronicdisease/about/index.htm
CDC. (2022c, September 8, 2022). National Center for Chronic Disease Prevention and Health Promotion: REACH. CDC. Retrieved August 11 from https://www.cdc.gov/chronicdisease/resources/publications/factsheets/reach.htm
CDC. (2022d, July 25, 2022). Racial and Ethnic Approaches to Community Health. CDC, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. Retrieved August 11 from https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm
CDC. (2023a, May 8, 2023). National Center for Chronic Disease Prevention and Health Promotion. CDC. Retrieved August 11 from https://www.cdc.gov/chronicdisease/index.htm
CDC. (2023b, February 24, 2023). Selected Achievements and Milestones in CDC’s Efforts to “Bake In” Health Equity. CDC Office of Health Equity. Retrieved August 11 from https://www.cdc.gov/healthequity/timeline/index.htm
Corburn, J. (2017). Urban Place and Health Equity: Critical Issues and Practices. International journal of environmental research and public health, 14(2), 117. https://doi.org/10.3390/ijerph14020117
Courier Classifides. (2015). Is East End Renewal Really "Black Removal?". New Pittsburgh Courier. https://newpittsburghcourier.com/2015/07/30/is-east-end-renewal-really-black-removal/
Crittenden, L. D. (2019). The Pittsburgh problem: race, media and everyday life in the Steel City. Columbia Journalism Review. https://www.cjr.org/tow_center_reports/racism-black-burnout-in-pittsburgh-journalism.php
Cunningham, T. J., Croft, J. B., Liu, Y., Lu, H., Eke, P. I., & Giles, W. H. (2017). Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans — United States, 1999–2015. Morbidity and Mortality Weekly Report, 66, 444-456. https://doi.org/http://dx.doi.org/10.15585/mmwr.mm6617e1 (https://www.cdc.gov/mmwr/volumes/66/wr/mm6618a11.htm?s_cid=mm6618a11_w)
Dahlberg, L. (2009). The history of violence as a public health issue. Department of Health & Human Services, USA, Centers for Disease Control and Prevention.
Devaraj, S., Stewart, A., Baumann, S., Elias, T. I., Hershey, T. B., Barinas-Mitchell, E., & Gary-Webb, T. L. (2020). Changes Over Time in Disparities in Health Behaviors and Outcomes by Race in Allegheny County: 2009 to 2015. J Racial Ethn Health Disparities, 7(5), 838-843. https://doi.org/10.1007/s40615-020-00705-x
Doreen, M. (2004). Geographies of Responsibility [research-article]. Geografiska Annaler. Series B, Human Geography, 86(1), 5. http://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=edsjsr&AN=edsjsr.3554456&site=eds-live&scope=site&custid=s7614884
Elliott, J. P., Christian, S. N., Doong, K., Hardy, H. E., Mendez, D. D., & Gary-Webb, T. L. (2021). Pharmacist Involvement in Addressing Public Health Priorities and Community Needs: The Allegheny County Racial and Ethnic Approaches to Community Health (REACH) Project. Prev Chronic Dis, 18, E07. https://doi.org/10.5888/pcd18.200490
Fullilove, M. T. (2013). Urban Alchemy: Restoring joy in America's Sorted-Out Cities. New Village Press.
Gary-Webb, T. L., N., C. S., Casas, A. D., Hardy, H. E., Feldmiller, J., Scott, S., Harris, R., & Mendez, D. D. (2022). A Comprehensive, Community-Based Coalition to Address Racial Disparities in Chronic Disease: REACH (Racial and Ethnic Approaches to Community Health) in Allegheny County, PA. Progress in Community Health Partnerships: Research, Education, and Action. https://preprint.press.jhu.edu/pchp/preprints/comprehensive-community-based-coalition-address-racial-disparities-chronic-disease-reach
Go Crenshaw. (2023, 2023). Go Crenshaw. Go Creshaw. Retrieved December 20 from https://www.gocrenshaw.com/
Heckler, M. M., et al.,. (1985). Report of the Secretary’s Task Force on Black and Minority Health. https://minorityhealth.hhs.gov/assets/pdf/checked/1/ANDERSON.pdf
HELP Initiative-Pittsburgh. (2023, c2023). About Homewood. Retrieved August 17 from https://helppgh.org/help-communities/about-homewood/
Hill, L., Ndugga, N., & Artiga, S. (2023, March 29, 2023). Key Data on Health and Health Care by Race and Ethnicity. KFF. Retrieved August 11 from https://www.kff.org/racial-equity-and-health-policy/report/key-data-on-health-and-health-care-by-race-and-ethnicity/
Homewood Mobility Plan. (2022). C. o. P. D. o. M. a. Infrastructure. https://apps.pittsburghpa.gov/redtail/images/17844_Homewood_Mobility_Plan.pdf
Howell, J., Goodkind, S., Jacobs, L. A., Branson, D., & Miller, L. (2019). Pittsburgh's Inequality Across Gender and Race (Gender Analysis White Papers, Issue. https://apps.pittsburghpa.gov/redtail/images/7109_Pittsburgh's_Inequality_Across_Gender_and_Race_09_18_19.pdf
Lease, S. R. (c1992). McKeesport and Glassport: The Changes Through The Years: An Ethnographic Research Project For The Steel Industry Heritage Corporation. https://riversofsteel.com/_uploads/files/mckeesport-and-glassport-final-report.pdf
Massey, D. (1995). Spatial Divisions of Labour: Social Structures and the Geography of Production. Palgrave Macmillan.
Mendez, D. D., Christian, S. N., Casas, A. D., Scott, S., Hardy, H., Harris, R., Wilkerson, A., & Gary-Webb, T. L. (2022). Instituting Racial Equity: The Allegheny County Racial and Ethnic Approaches to Community Health Initiative. Community Health Equity Research & Policy, 0(0), 2752535X221135301. https://doi.org/10.1177/2752535x221135301
Minkler, M., Breckwich Vasquez, M., Tajik, M., & Peterson, D. (2008). Promoting Environmental Justice Through Community-Based Participatory Research: The Role of Community and Partnership Capacity. Health Education Behavior, 35, 119. https://doi.org/10.1177/1090198106287692
Mon Valley Initiative. (2020, 2020). Black Lives Matter to Us. Mon Valley Initiative. Retrieved August 17 from https://monvalleyinitiative.com/black-lives-matter-to-us/
National Caucus of Environmental Legislators. (2022, c2022). Issue Area: Active Transportation. Retrieved August 18 from http://www.ncelenviro.org/issue/active-transportation/
Ogourec, A. (2023). Personal Communication. In Email (Ed.). Pittsburgh, PA.
Pastor, M., & Morello-Frosch, R. (2014). Integrating public health and community development to tackle neighborhood distress and promote well-being. Health Affairs, 33(11), 1890-1896.
Patterson, R. F. (2020). New Routes to Equity: The Future of Transportation in the Black Community. https://www.cbcfinc.org/wp-content/uploads/2020/10/NewRoutestoEquity-Final5.pdf
Petras, M. (2019, October 1, 2019). In the Mon Valley, public transit limitations are felt by residents who’ve left Pittsburgh’s core Public Source. https://www.publicsource.org/in-the-mon-valley-public-transit-limitations-are-felt-by-residents-whove-left-pittsburghs-core/
Proulx, M. J., Todorov, O. S., Aiken, A. T., & de Sousa, A. A. (2016). 'Where am I? Who am I? The relation between spatial cognition, social cognition, and individual differences in the built environment': Corrigendum. Frontiers in Psychology, 7. http://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=psyh&AN=2016-30280-001&site=eds-live&scope=site&custid=s7614884
a.desousa@bathspa.ac.uk
Red Bike & Green. (2023). Red Bike & Green. Retrieved December 20 from http://www.rbgoakland.com/contact.html
Southwestern Pennsylvania Commission. (2019). Pre-Built Tables: 1930-2020 Total Population. In. Pittsburgh, PA.
The Major Taylor Cycling Club. (2019, 2019). The Major Taylor Cycling Club. The Major Taylor Cycling Club. Retrieved December 20 from https://pmtcc.org/history/
Thomas, C. (2008, October 8, 2008 Wednesday). The Mon Valley's Promise: Bright Spots Aside, Its Redevelopment Has a Long Way to Go. Pittsburgh Post-Gazette (Pennsylvania), B-7. https://advance-lexis-com.pitt.idm.oclc.org/api/document?collection=news&id=urn:contentItem:4TMK-HXF0-TX33-C13R-00000-00&context=1516831.
Trigg, D. (2012). The Memory of Place : A Phenomenology of the Uncanny [Book]. Ohio University Press. http://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=nlebk&AN=836354&site=eds-live&scope=site&custid=s7614884
Turtle Creek Connector Trail Feasibility Study. (2022). http://alleghenycounty.us/TurtleCreekTrailStudy
Walk, Bike, Ride McKeesport: Mobility Plan. (2022). H. F. L. C. Environmental Planning and Design. https://mckeesport-pa.gov/DocumentCenter/View/493/MCK_11322-Multimodal-Planning-Study_Digital-Version
Weber, M., Bodnar, J., & Simon, R. (1981). Seven Neighborhoods: Stability and Change in Pittsburgh's Ethnic Community, 1930-1960. Western Pennsylvania History: 1918-2020(April 1, 1981), 121-150. https://journals.psu.edu/wph/article/view/3705
Wideman, J. E. (1985). The Homewood trilogy. Avon.
Wilkinson, R., Marmot, M., & World Health Organization. Regional Office for, E. (2003). Social determinants of health: the solid facts (2nd (en) ed.). World Health Organization. Regional Office for Europe. https://apps.who.int/iris/handle/10665/326568
WPRDC. (2021). City of Pittsburgh Neighborhood Population 2020. https://data.wprdc.org/dataset/95af9f2c-61c8-446b-ae72-852e195684f3/resource/a8414ed5-c50f-417e-bb67-82b734660da6/download/preliminarycitypittsburghneighborhood_pl94171summary-2.csv
Yearby, R. (2020). Structural Racism and Health Disparities: Reconfiguring the Social Determinants of Health Framework to Include the Root Cause. J Law Med Ethics, 48(3), 518-526. https://doi.org/10.1177/1073110520958876
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Copyright (c) 2025 Andrea Casas, Hannah E. Hardy, Sheila C. Cunningham, Ann Ogoreuc, Dara D. Méndez, Tiffany L. Gary-Webb