Over 60 years ago, the Brown v. Board of Education decision found that segregation is a denial of the equal protection of the laws. At that time, many clinics and hospitals were segregated by race, while others had separate rooms, wings, floors, and staff for black people. As a result of educational segregation, the number of black medical professionals was low. Due to a long history of structural disadvantages and racism, the health of this population suffered greatly. The Civil Rights movement did not provide a significant or rapid change in health outcomes and the newly desegregated hospitals remained understaffed and under-resourced. Today, the effects of de facto neighborhood segregation still impact the black population, as many neighborhoods resemble those of 60 years ago. Two-thirds of young African Americans live in poor neighborhoods compared to 6 percent of whites. As we have discussed prior, social mobility is difficult and two-thirds of African American families that lived in the poorest neighborhoods a generation ago continue to live in such neighborhoods. In comparison, only 40 percent of white families still do so. This neighborhood segregation impacts the healthcare of black families as well.

• Neighborhood segregation is correlated with the likelihood of hospital closings.
• Neighborhood segregation is linked to poor health outcomes.
• Neighborhood segregation is linked to less extensive treatment options from physicians.

Although segregation was outlawed, the effects of racial isolation remain in fact (de facto) today in families, schools, healthcare, and the larger society rather than by law (de jure).