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Another dimension of the neighborhood poverty issue, the research highlights, is that most people who are poor now also tend to live in a poor neighborhood. The two were once less tightly linked: In the 1980s, people could be poor and live in low-poverty neighborhoods. This has become a rarity, making it harder to escape poverty as a whole — from deteriorated public services to the lack of educational opportunities.

Those factors also make low-income areas in the U.S. an easy target for epidemics. “People are often living in more crowded spaces, so you’re having more opportunity for transmission of infectious diseases,” said Grace Noppert, postdoctoral scholar at the Carolina Population Center at the University of North Carolina, Chapel Hill. “You also have more people mixing and mingling in crowded spaces in those communities.” The stress of the environment also makes residents more vulnerable to diseases. Noppert has studied the impact of tuberculosis on poor communities and Covid-19, just like TB, is not sparing these communities, either.

And this comes with demographics attached: A low-income African American is three times more likely to live in a poor neighborhood than a low-income white person, even though the demographics of poor neighborhoods has changed in the past decades, and an increasing number of Hispanics are now in these underserved communities, the study highlights. “The zip code you’re born in determines your health,” Noppert said, “but the zip code you’re born in is determined by your race and ethnicity.”

Reversing the trend isn’t easy — and Fikri and Benzow don’t spend much time on this in their report. To Mallach, instead of trying to economically “turn around” poor neighborhoods, local officials should focus on improving existing living conditions. “If you are poor, that doesn’t mean that you shouldn’t have the opportunity to live in a decent neighborhood,” he said.