July 18, 2025 • 43 mins
Guest: Dr. John Joe Schlichtman, Urban Sociologist & Community Ethnographer
In this thought-provoking kickoff episode of What About Rural Health?™, host Chinasa Imo sits down with urban sociologist Dr. John Joe Schlichtman to explore a surprising and powerful question: What can resistance in urban spaces teach us about rural health? Drawing on his acclaimed works Gentrifier, Showroom City, and his upcoming book on Community Fabric, Dr. Schlichtman breaks down how place, power, and policy shape community well-being, whether in the city or the marginal spaces. Together, they dive into what “just development” means across geographies, how communities assert power through resistance, and why asset-based, people-centered frameworks matter for rural health equity.
Expect deep analysis, respectful disagreements, powerful storytelling, and a fresh, justice-centered lens on rural health. Whether you're an urban or rural planner, health practitioner, student, or advocate, this episode will challenge assumptions and offer new ways of thinking about community and care.
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Episode Transcript
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Speaker 1 (00:02):
Welcome to the What About Rural Health podcast, a
place where research, policy,and real life stories come
together to ask the criticalquestion. What about the
communities too often leftbehind? I am Chinasa, a
development and global healthpolicy strategist. And for me,
(00:25):
this work is personal. From thevillage health workers
struggling with limited suppliesto the mothers working miles for
care, their stories shape thepolicies we need.
Join me as we uncoverchallenges, spotlight
innovations, and amplify thevoices of those at the heart of
(00:46):
rural health systems. Becauseevery community matters, and it
is time the world listens.Hello, and welcome. You are
listening to the podcast thatasks the question many forget.
What about rural health?
I'm your host, Chinasa Imo, andtogether, we are uncovering the
(01:09):
stories, challenges, andinnovations shaping health care
in overlooked communities. Weare still in our introductory
series breaking down ruralhealth issues, advocacies,
policies, and systems reforms.And today's episode is titled
beyond the city, what urbanresistance can tell us about
(01:31):
rural health realities. Beforeme here, we have doctor John
Slickman. Doctor Slichman is anurban sociologist and a
community owned ethnographer, athought leader on justice
centered development.
He's a professor of sociology atDePaul University, and his work
(01:53):
examines how community resist,adapt to, or shape forces like
gentrification, globalization,and structural changes, and what
it means to build just peoplecentered policy. Doctor John is
and I think at some point, I'lljust call him John, which is
(02:14):
what I know him and refer to himas always. He is the author of
Gentrifier and Showroom City,and he has a new book coming,
which we would discuss later.We'll discuss now after I'm done
introducing him, and I thinkit's such a privilege to have
him talk about his unpublishedbook in our episode today. So
(02:37):
his work brings, you know, anaccessible reflective lens to
the question of equity,resistance, and transformation.
So you may wonder, how does anurban sociologist who spends
majority of his career focusedon the workings of urban spaces
(02:57):
relates to rural health? Well,you are here to find out. The
topic of today says that all,but his insights are very
relevant to rural health as theyare also for urban planning.
John's work has been featured inmajor outlets and journals, such
as New York Times, Bloomberg,CityLab, NPR, Next City, The
(03:22):
Economist, and ArchitecturalDigest. John has led one of the
largest virtual network of urbanthinkers.
It's called Urbanist onLinkedIn. You can go check that
out. It has over 90,000 membersof urbanists that are part of
that group worldwide. And hebrings a justice centered
(03:44):
approach to development thatchallenges how we think about
power, place, and policy, makinghim an important voice in
today's conversation on ruralhealth. So, John.
Welcome to today's episode.Thank you. So tell me, I I know
(04:07):
that we've discussed a lot aboutyour work, your academic life,
and sometimes I think, you know,your you know, because
professionals always talk aboutwhat they do, but sometimes you
like to shift away from what youdo and talk about who you are.
So can you tell me a little bitabout why you are writing your
(04:32):
next book and what that nextbook is about?
Speaker 2 (04:37):
That's an interesting question. So first of all, I'm a
sociologist, not just bytraining or not even first by
training, but just in the waythat I look at the world, which
means that, you know, you haveany one given person, any one
(05:00):
given individual with their ownpersonal agency and ability to
act. And then around that personis structures, Social
structures, or sometimes we justsay structures, which are the
fixed patterns of the world,seen and unseen, that shape that
(05:23):
person's action and shape thatperson's perception. So, you
know, there is a place forholding individuals accountable.
There is a place for personalagency.
In our friendships, you know, wehold our friends accountable. We
(05:45):
never say we never talk to ourfriends in terms of the
structures that they're locatedwithin. We we we help to
motivate them, but at the sametime, we recognize what they're
going through. So that's myapproach towards communities.
Right?
And so my new book, wasmotivated out of my previous two
books, looking at the argumentsthat people have over what just
(06:12):
development looks like. And allof the vague statements that are
made, all of the errors that aremade, the way that people talk
past each other. And sothroughout my career, I have
worked on equipping people tohave better arguments, better
(06:37):
debates. And so my goal is toreach broader audiences than
just academia with each book tohelp people understand, and this
is getting to the current book,where people where communities
have come from and wherecommunities are going. So
(06:58):
communities that have beendevalued, symbolically but also
economically, there are plans inplace to revalue those
communities.
And everyone has a differentmotive in the revaluation, and
(07:20):
every community has a differentstory in the devaluation. So my
third book is a handbook,basically, of what I call the
threads of community history,which is what are the all of the
things, and I've identified 11things that a community can go
(07:45):
through that would cause it tobe devalued, and what are the 11
things that a community can gothrough that would cause it to
be revalued. And so this bringsa lot of clarity because the
minute we talk about a communitybeing devalued, the
conversation's not over, it'sjust beginning. Because you have
(08:08):
all of these various threadsthat create a fabric of how this
particular community got to thisparticular place. Now when you
come with a plan to revalue it,now you those those threads of
revaluation, they're fittinginto an old fabric of
devaluation.
(08:29):
And so my my main breakthroughin this book, my main epiphany
in this book is that everycommunity is completely
distinct, But the threads thatmake it distinct, those 22
threads of 11 devaluation, 11revaluation, are very common
(08:51):
throughout the world. So if youexamine those threads, you begin
to compare places that peoplewouldn't think of comparing, and
you get clarity that peopledon't normally get in these
conversations when they justsay, well, you know, this area
was devalued because it wasredlined, and then that's the
end of And So then what doeswhat does that mean? You know?
(09:14):
What's the answer? And and so mybook helps to push those
conversations forward.
It doesn't provide the answers.It provides clarity in the
discussion.
Speaker 1 (09:24):
I yeah. Thank you for that explanation. And I'm I'm
curious, and I just need to do afull disclosure that I've seen
those frameworks. So and I'mgoing to ask you questions that
bug my mind. Like, when you talkabout eleven and eleven of the
re devaluation and revaluationframeworks, and what usually
(09:46):
struck me when I'm when, youknow, when I think about this in
relation to places and effortsin the way they are, whether
from government or, you know,individuals themselves within
the community making meaning ofhow their environment is
becoming devalued and what theythink would make an improvement
(10:09):
if, you know, certain changesare done.
And sometimes I try myself topair these things together
between, okay, if there is, if adevalued factor is here, should
we apply an alternate force? Andsometimes that's not the way
(10:29):
because there are underlyingthings that is that could be
making what we are seeing lookthe way they are, but, you know,
the frauds that need to repay itare not directly matched. Would
you, you know, say a little bitabout that?
Speaker 2 (10:43):
Yes. So I think this is the number one way that
communities are exploited, is inthe marketing and the promotion
of what seems to be common senseplans, that if this community
(11:09):
was defunded, then we need torefund it. Conversation over. If
this community was detached, weneed to reconnect it.
Conversation over.
If this community, wasdeteriorated in its housing
(11:35):
stock, then we need to renovateit. And when you look at
communities from a fabricapproach, you can't undo the
fabric that's already created.You can't go back in history.
So, you know, there is a crazearound the world right now in
(12:02):
wealthier nations of removingroads that were unjustly placed.
But, you know, I think this isthe kind of the most obvious
example.
Like, removing a road sixtyyears after the community didn't
want it there might not be thenumber one way to address that,
(12:27):
that issue. So another analogythat I use, and I have there's
two analogies in the books. Oneis a fabric, and one is the
making of a loaf of bread. Youknow, you put in all these
ingredients to the loaf ofbread, and it becomes something
new. You can't go back threedays later and take out the
eggs.
(12:48):
You can't go back later and addthe chocolate chips that you
wish you added. You know? Andwith the fabric, you know, you
can't go back later and take thered threads out that you don't
like. So I think it's it itprovides a framework like this,
shows us the messiness and thenuance of community building,
(13:12):
which I think are the two thingsthat are most lost in
conversation because everyonewants an easy side to be on and
an easy side to articulate, Andeveryone wants to have an
obvious quick answer that youcan put in a one page document.
Speaker 1 (13:30):
Wow. I know some of our listeners will be wondering,
why am I asking an urbansociologist to talk about, you
know, spaces and stuff when weare asking the questions around,
you know, rural health care? Andthat brings me to a follow-up
(13:52):
question. I looked at theframeworks, and I teased us
specifically four of thosedevalued frames that you put
together. And I want us to talka little bit about it because
they jump to me as veryrelatable when I'm thinking
about place based policies andhow they affect, you know,
(14:17):
health care accessibility.
And these four frameworks aredefunding, and you've mentioned
you mentioned it when you werespeaking the other time. The
second one is detaching. And byyour definition, like, when you
detach people or by myunderstanding, when you detach
things from the services thatthey used to receive before. And
(14:38):
then the third one isdestabilization, and then the
last one is deterioration. Ibring these four questions
specifically because when welook at rural communities,
there's always that inherentchallenge of health facilities,
(14:59):
you know, being left todeteriorate because of other
things that I could still tieback to defunding and other kind
of things.
And, you know, that struck meas, yes, this is something that
I want us to spend a little bitof time to talk about. And I
know you might disagree. Oh, Idon't see the direct relations
between rural health careaccessibility and all of these
(15:23):
frameworks.
Speaker 2 (15:23):
Well, you know that that's my perspective. So you
you know you know I was askingyou why why why you want me
here. So yes.
Speaker 1 (15:30):
So and, I mean, I know you can disagree, but, you
know, when I look at it fromthat place based issues Sure. I
want you to just, like, tell meabout these four frameworks, you
know, how you see them play outin communities. And looking at
the examples that I have givento you, what was running through
(15:54):
your mind when you structuredthem?
Speaker 2 (15:58):
Well, I mean, these are very these are very, very
common threads that communitiesface. So you said defunding,
deterioration.
Speaker 1 (16:13):
Detaching.
Speaker 2 (16:13):
Detaching and Destabilization.
Destabilization. And you did saydeterioration.
Speaker 1 (16:21):
Yes, I So
Speaker 2 (16:25):
deterioration is so in in my definitions,
deterioration is the physicaldecline of the place, which
becomes very, very costly, youknow, when a place is when a
when a place is builtenvironment, and built
environment is just all of thethings that were made by people.
(16:47):
Mhmm. So when a place's builtenvironment or all the things
that have been made by peoplebegin to deteriorate because of
a lack of, maintenance, then thewhole conversation changes. I
mean, so, you know, well knownexample in The United States is
Congress allowed US publichousing to deteriorate by by not
(17:09):
funding regular maintenance. Andso the conversation's able to
change into something like,well, we need to demolish it,
which is another thread.
But deterioration is alsoimportant because deterioration
helps to create health hazardsin terms of lead, other things
(17:35):
that asbestos, other things thatdecaying buildings might have.
Community destabilizationrelates to the social weakening
of of the community. So if youhave a community that's
weakening in its social fabricand also weakening weakening in
its physical buildings, you havea momentum that's very hard to
(17:58):
overcome. And so these are justtwo reasons why a neighborhood
would become detached. And whenI say that a neighborhood is
detached, I mean something veryspecific.
It's a real or perceivedreduction in a neighborhood's
resources, its functions, itspurposes, its assets, its safety
(18:22):
in the minds of outsiders. Sopeople from outside that
neighborhood. And so what thismeans in urban planning talk is
that this neighborhooddisappears from the cognitive or
mental map that people have ofthe city. So they have a map of
(18:45):
the city in their minds, andthere there are are murky
places, blurry places, what oneleader famously and and horribly
called holes on the map. And sothat begins to have its own
momentum.
Once a place begins todisappear, that that becomes its
(19:08):
own driver for housing to becomedevalued because people aren't
looking at that housing orwanting to live in those
apartments. It retail becomesdevalued because the only
clientele is a local clientele.So that would detaching. And
then defunding is a decrease ingovernment support for
(19:30):
buildings, for infrastructure,for businesses, for spaces, for
programs. And, you know,governments oftentimes try to
especially in a in aconservative leaning, right
leaning government, wherecommunity is looked at through a
(19:52):
business lens.
Speaker 1 (19:53):
Mhmm.
Speaker 2 (19:54):
The idea is this community is a bad investment,
so we're going to take away ourfunding from it and put our
funding in some place where thatdeserves it. And this results in
what is known and what I call inthe book a containment strategy,
where it's like, okay, this thisarea is going to have problems
(20:17):
because of all of these issues.We're going to have to, the
government says, create aboundary around this
neighborhood and make sure thatall of those issues are
contained within this area so itdoesn't blight, pollute the rest
of the city. And that becomes anentire strategy around urban
planning and policing, etcetera.Wow.
(20:39):
And so in many countries, thedecanting or relocation of
people from prime urban areas tothe rural periphery is a
strategy to remove many of theseissues out of sight.
Speaker 1 (20:55):
Wow. That's very insightful. And when you were
talking, I my mind just go wentthrough a time that I was doing
a documentary on hospitalfunctionality, specifically
primary health care. And most ofthe about 75% of the hospitals
(21:16):
that I went to were sodeteriorated that you would
think you are coming there topick diseases. And not getting,
you know
Speaker 2 (21:27):
Not not
Speaker 1 (21:28):
not not getting care. So and when I look around, like,
when you were mentioning aboutthe duration of building and I
think you called them, you know,Biowest, like, in relation to
the hospital setting, that willbe medical waste. Now imagine
when because of deterioration,the pipes, the sewages are not
(21:51):
working, and the hospital, thedoctors still need to work. They
need to function. Women stillcome there to give birth, And
all those wastes are notproperly managed because, you
know, they have a whole lot ofstructural problems within the
health facility to grapple with.
(22:11):
And, you know, that becomes agood pro a huge problem. Well,
you are still listening to whatabout rural health. We are going
for a short break. When we comeback, our guests would dive into
the deeper conversations that,you know, coming out from his
other book, showroom city.Welcome back.
(22:36):
You are still listening to whatabout rural health with
Chennacer. So, John, let's diveinto showroom city.
Speaker 2 (22:46):
You If you insist.
Speaker 1 (22:47):
I do insist because see, the thing is when I read
that book, and I took awaybecause I'm not a new one, an
urban sociologist. I am not. I'man administrator. I look at
things from public perspectiveand how does that inform public
(23:09):
policy? How does communityaction inform change?
That is what I'm looking outfor. And that is a whole lot of
things that the book was tellingme when I read them and I when I
read it. So I still want tobring it in, and we'll talk
about it, and then we'll comeback to these frameworks. So
(23:34):
your work in showroom city, itties directly it ties real
estate to urban changes thatshows broader social impact. And
you've discussed a whole lotabout this from the re the
framework.
But when you think about thesespaces, how how do you think it
(23:57):
shapes people's health andwell-being?
Speaker 2 (24:08):
So the question is how do spaces shape health and
well-being? Yes. I mean, Ithink, you know, one of the one
of the benefits of this momentis is that we are thinking
about, health in regards to thesocial determinants of health.
(24:34):
Yes. You know, so if you thinkabout that individual and you
think about all of the thingsthat surround that individual,
You know, you think around aboutthe air, around the individual.
How polluted is that air? Whatis polluting that air? How noisy
(24:57):
is that place? Can the personsleep? How stressful is is the
noise?
Is the noise itself threatening?Is it bombing? You know? So you
think about the air aroundsomeone, you think about the
soil, that's available, the leadin the soil, the the pollutants
(25:18):
in the soil, and the weatheraround that individual, you
know? Places that are heavilypaved and the heat island that
envelops those places becausethere's not the natural
ecosystem to be able to handleheat.
You think about how easy it isfor that person to walk around
(25:38):
and get to other places, notjust walk around within the
neighborhood, that's one piece,but to get around to other
places. The food that'savailable to that person. The
housing that that person'sliving in. Is there mold in the
housing? Is there lead in thehousing?
The health care that's in thearea. And then you begin to look
(26:01):
at the social cohesion, thesocial capital, the what what we
would call the glue betweenpeople. And so, I think that's
one of the things that,devalued, marginalized
neighborhoods have, oftentimesin abundance, is social
(26:27):
cohesion. And I think that iswhere, plans that are successful
in addressing all of these otherthings about the environment,
air, soil, noise, pedestrianaccess, housing, food, health.
Oftentimes, successful planswill leverage the cohesion, the
(26:55):
social glue, the social capitalthat's already in place.
And I think, you know, majorinstitutions, you know, you're
you're from more familiar thanI, but major institutions like
the United Nations and andothers are are leaning on this
type of perspective now as adefault, even if it's only in
(27:17):
rhetoric, in a way that's neveroccurred before. So it's almost
the new common sense that thelocal has expertise. The you
know, that that that communitycohesion, that those community
relationships, that there'sexpertise and know how in it.
(27:39):
Now whether that actually isacted upon, whether that know
how is actually respected,whether community input is just
a symbolic stage, that's a wholeanother thing. But I think, you
know, these are the socialdeterminants of health, which
I've basically overviewed here.
(27:59):
Like, this is a great way tounderstand where a community
sits and then how it can canmove forward. So I think, you
know, in the in the High Pointcase, this was the case of a
city that lost it. This is thethe subject of So Room City is
(28:19):
High Point, North Carolina,which is a city that, lost its
downtown because its downtownbecame the setting for a global
exposition of furniture fashionthat occurred twice a year so
that the whole world, everycontinent would come, 85,000
(28:43):
visitors from a 110 countrieswould come to this downtown, and
the place lost their communitycenter and therefore lost a lot
of the mechanisms they had forcohesion Wow. And glue and
social capital. And so this bookis largely about that.
(29:05):
It's a very, very unique andstrange, one reviews called it
weird case that helps tohighlight very common threads.
And again, this is one of thethings that led me to this
thread approach that as strangeas High Point is, the threads
that make it into what itsstrangeness are very common.
Speaker 1 (29:29):
Yeah. Yeah. And thank you for that response, thank you
for drawing social determinantsof health to this conversation
because, you know, when we talkabout health care and I think I
I usually make this point somuch that we are remove we are
not just focusing on themedicalization of the health
(29:54):
care system where you becomesick and you go get help, but
the constitution of everythingthat makes you a healthy being,
and spaces are part of that. AndI when you mention social
cohesion, I just smile. I'mlike, it is only an ethnographer
(30:14):
who would, you know, take timeto study humans, people, and how
they function within society,how they build this social
cohesion.
And and I would add that in somecases, even how they
disintegrate, It is stillwithin, like, human to, you
(30:36):
know, move from being discomfortto taking action. And you being
an ethnographer.
Speaker 2 (30:45):
If I could just say, like Yes. We're we're at a
moment in history Mhmm. Wheredoctors and sociologists are
discovering each other. Mhmm.And public health has not
bridged that gap.
Like, public health has notbridged the gap between the
people who look at individualsand structures, which are
(31:09):
sociologists, and the people whowho provide medicine, which are
doctors. And we are in a momentright now where, like, this is
everyone's learning from eachother. So I'm hoping that twenty
years from now, you'd never havesomeone like me on this podcast
Mhmm. Because we would havemoved past a place where I would
(31:29):
have something useful to sayeven though I don't do rural
health.
Speaker 1 (31:32):
Right? I agree with you. I I agree with you. I went
to a global health conference inDC two years ago, and that is
that became the frame of theconversation. Like, we're
talking about public health, andthings were still being typified
around, you know, healthcommunication and promotion, one
(31:54):
bucket.
Right? Surveillance in onebucket. Right? And laboratory
services in one bucket.
Speaker 2 (32:04):
Mhmm.
Speaker 1 (32:04):
And then medical practice in one bucket.
Everything, even when we talkabout public health, things are
still bucketed. For instance,when we talk about rural health,
people think, oh, okay. It'sjust it's rural spaces. Yet, we
have seen the migration ofdiseases from, you know, water,
(32:24):
contaminated water, to theglobal space where everybody
grapple with both in the urbanand rural spaces.
So all these things areinterconnected. And sociologists
do this by studying why arethese things happening within
social spaces. Right? Doctors dowhat they do, but if they open
(32:47):
up spaces to think that what ispresenting before them in the
hospital are a combination ofall of these other things put
together. And if we just open upthat space to understand this,
you know, and begin to see thatthe decisions that you make, you
know, begin does not just beginand end with you.
(33:09):
There is someone else makingconscious decision that may
facilitate or destabilize yourwork. And if we look at it from
that interconnected spaces, theworld will be better. I think
so.
Speaker 2 (33:22):
Yes. And so, you know, I think that people are
specialists. Yes. And they wantto bring the thing that they
specialize into the group thatthey think needs it. And I think
that's where a lot of damage isdone.
You know, a famous insight or awell known insight from policy,
(33:45):
and I can't remember, you know,who was the first to state it,
but that the the policies oftoday fix the problems caused by
the policies of yesterday. Youknow, the the things that we
consider social problems todaywere are caused by are the
answers from yesterday. That'strue. And so and so to have the
(34:06):
humility of saying that there'sso much more going on than this
one area that I specialize in.So, like, to give an example,
like, the person who wants tobring transit cannot understand
why someone would not want atransit stop.
(34:29):
Mhmm. They think that they mustthey think that they must be
naive. Mhmm. When in fact, itcould be the transit stop
proponent who's naive becausethey're not looking at all the
all the various factors.
Speaker 1 (34:41):
Yeah.
Speaker 2 (34:43):
Someone who says, you know, I wanna bring a bike lane.
That's my life's work. Andsomeone says, no. I don't want a
bike lane. And the response is,that's naive.
No. The person bringing the bikelane is probably the one who is
naive. You know, solving a fooddesert with a Whole Foods, you
know, that seems like an obviousthing for the person who wants
(35:07):
to bring the best, you know.Well, we don't just want any
grocery store. We want a WholeFoods.
But that's not looking at at thewhole picture. And so I think
this holistic approach is verycomplicated. It's also very
difficult to politicize. Youknow, you see mayors in Chicago
and and now in New York, in inthat election trying to talk
(35:33):
about a totality of issues thatresult in individual well-being.
And it's very difficult topursue that today.
You know? That's the question.Yeah. You know, other nations
have had a more holistic view ofof the individual.
Speaker 1 (35:52):
That's right.
Speaker 2 (35:52):
A more societal view of the individual. The US in
particular has beenindividualistic to a fault, had
so much to learn from othernations. Many of those nations,
its communities, you know, TheUS has ruined with this
individualism. But I think it'svery difficult to say, well, how
(36:14):
do you help this individualwho's sick? Well, you do it
through transportation.
You do it through grocerystores. You do it through
sidewalks. You do it throughgreen space. You do I mean,
that's a very difficult thing torun for, you know, to to to to
have a platform as as a mayor.
Speaker 1 (36:30):
That's true. Thank you for for that response. And
we we are still on on showroomcity and, you know, having
conversation around that. But II want to ask you a question. In
by your profile, yourself, youalways describe yourself as both
(36:53):
a teacher and a student, andthat's now, like, you know, puts
you in a place of both teachingand learning of community
sociology and how you use thatto approach your work.
I you know, while puttingtogether this, I'm like, what do
(37:13):
I hit him with? What question doI hit him with that would allow
him to talk about his academicwork? Right? It was the comeback
to showroom city. And I gotfascinated in your use of asset
based community led developmentAnd, you know, in within this
(37:37):
context, how can we use that tounderstand health equity
generally?
Speaker 2 (37:45):
I think asset based community development is used
quite often for health outcomes.I could because I think health
outcomes are kind of the mostsocial of our outcomes. You
(38:07):
know, we could also put maybeeducation in that, you know,
that it takes all of thesedeterminants to create an
educated child. But really,health is is something when you
think about mental, physical,spiritual health, it's really
something that brings togetherall aspects of of society. And
(38:32):
so asset based communitydevelopment is very, very
straightforward.
It looks at places from the lensof their strengths rather than
their their deficiencies. And itsays, what are the strengths of
(38:52):
individual talents in a place?Mhmm. What do these residents do
better than anyone? Or what whatwhat can they do that others
can't do?
What are the physical assets ofthis place? Like, what are the
what are the buildings? What arethe plazas? What are the trees?
(39:16):
Because, you know, somecommunities a 200 year old tree
might be one of the mostimportant meeting spaces in that
community.
You know? So what are thephysical assets of that
community? And theninstitutions, you know, what are
the organizations that maybesome of them inhabit those
(39:37):
important buildings. What arethe organizations that that, are
the strengths of that community?And the association.
So things that are less formal,you know, residents that get
together, around savings clubsor things like that, which may
actually become more formalizedin the future. And then
culturally, what are the thingsthat this community wants to
(40:02):
retain and develop? So lookingat a community through the lens
of its strengths and movingforward from from there. That's
the only type of developmentthat can possibly be
sustainable.
Speaker 1 (40:21):
That's true.
Speaker 2 (40:22):
Because that's the only type of development that
respects what the current fabricis and weaves into that current
fabric. Most other plans are tocreate a new fabric, and that's
how development has operatedaround the world from the
removal of informal settlementsto the demolishing of public
(40:43):
housing is the the declarationof we need a new fabric and you
know, by elected officials andand appointed officials. And
while that can seem like a veryneat and clean answer and even a
very profitable answer, if youare turning that land into
(41:05):
something that makes more moneyand has higher rent, The
societal costs of that, and Idon't just mean the social costs
of that, I mean the economiccosts of that. Okay. So the
costs of people who had socialcohesion now no longer having
(41:26):
social cohesion.
Speaker 1 (41:28):
Mhmm.
Speaker 2 (41:29):
The the cost of places that had networks of kids
that knew each other and weregrowing up together, now not no
longer having thoserelationships for kids. The
those the businesses thatcatered to local people that
(41:51):
allowed them to get discountsuntil they got paid or maybe not
pay for something until payday,that being lost. Like, all of
those things being lostincreases issues like health
problems, increases issues likecrime that all have economic not
(42:16):
to mention the lostproductivity. The lost
productivity of that localbusiness being gone, of, people
who were living close topotential livelihood, their
their proximity to jobs beinggone. So it's it's really comes
down to the issue of short termeconomic costs and profits and
(42:43):
long term economic costs andbenefits.
All of these things that we aredoing for short term profits
have long term economic costs.
Speaker 1 (42:54):
That's true. Thank you, doctor John, for coming to
our show today. And for ourlisteners, I would invite you to
stay with us, listen to thepodcast. And if there's
something that you learn out ofit, please share to your
(43:16):
audience as well and leave us areview. You are still listening
to what about rural healthbecause health isn't just about
systems, it's about the peoplethose systems are made to serve,
how they make meaning of theplaces they call home, which
sometimes are left behind.
(43:37):
That is why we continue to askthis question, what about rural
health? Let's create thistogether. Until next time, I'm
still your host Chinasa Imo.Thank you. Bye.
Welcome to the What About Rural Health podcast, a
place where research, policy,and real life stories come
together to ask the criticalquestion. What about the
communities too often leftbehind? I am Chinasa, a
development and global healthpolicy strategist. And for me,
(00:25):
this work is personal. From thevillage health workers
struggling with limited suppliesto the mothers working miles for
care, their stories shape thepolicies we need.
Join me as we uncoverchallenges, spotlight
innovations, and amplify thevoices of those at the heart of
(00:46):
rural health systems. Becauseevery community matters, and it
is time the world listens.Hello, and welcome. You are
listening to the podcast thatasks the question many forget.
What about rural health?
I'm your host, Chinasa Imo, andtogether, we are uncovering the
(01:09):
stories, challenges, andinnovations shaping health care
in overlooked communities. Weare still in our introductory
series breaking down ruralhealth issues, advocacies,
policies, and systems reforms.And today's episode is titled
beyond the city, what urbanresistance can tell us about
(01:31):
rural health realities. Beforeme here, we have doctor John
Slickman. Doctor Slichman is anurban sociologist and a
community owned ethnographer, athought leader on justice
centered development.
He's a professor of sociology atDePaul University, and his work
(01:53):
examines how community resist,adapt to, or shape forces like
gentrification, globalization,and structural changes, and what
it means to build just peoplecentered policy. Doctor John is
and I think at some point, I'lljust call him John, which is
(02:14):
what I know him and refer to himas always. He is the author of
Gentrifier and Showroom City,and he has a new book coming,
which we would discuss later.We'll discuss now after I'm done
introducing him, and I thinkit's such a privilege to have
him talk about his unpublishedbook in our episode today. So
(02:37):
his work brings, you know, anaccessible reflective lens to
the question of equity,resistance, and transformation.
So you may wonder, how does anurban sociologist who spends
majority of his career focusedon the workings of urban spaces
(02:57):
relates to rural health? Well,you are here to find out. The
topic of today says that all,but his insights are very
relevant to rural health as theyare also for urban planning.
John's work has been featured inmajor outlets and journals, such
as New York Times, Bloomberg,CityLab, NPR, Next City, The
(03:22):
Economist, and ArchitecturalDigest. John has led one of the
largest virtual network of urbanthinkers.
It's called Urbanist onLinkedIn. You can go check that
out. It has over 90,000 membersof urbanists that are part of
that group worldwide. And hebrings a justice centered
(03:44):
approach to development thatchallenges how we think about
power, place, and policy, makinghim an important voice in
today's conversation on ruralhealth. So, John.
Welcome to today's episode.Thank you. So tell me, I I know
(04:07):
that we've discussed a lot aboutyour work, your academic life,
and sometimes I think, you know,your you know, because
professionals always talk aboutwhat they do, but sometimes you
like to shift away from what youdo and talk about who you are.
So can you tell me a little bitabout why you are writing your
(04:32):
next book and what that nextbook is about?
Speaker 2 (04:37):
That's an interesting question. So first of all, I'm a
sociologist, not just bytraining or not even first by
training, but just in the waythat I look at the world, which
means that, you know, you haveany one given person, any one
(05:00):
given individual with their ownpersonal agency and ability to
act. And then around that personis structures, Social
structures, or sometimes we justsay structures, which are the
fixed patterns of the world,seen and unseen, that shape that
(05:23):
person's action and shape thatperson's perception. So, you
know, there is a place forholding individuals accountable.
There is a place for personalagency.
In our friendships, you know, wehold our friends accountable. We
(05:45):
never say we never talk to ourfriends in terms of the
structures that they're locatedwithin. We we we help to
motivate them, but at the sametime, we recognize what they're
going through. So that's myapproach towards communities.
Right?
And so my new book, wasmotivated out of my previous two
books, looking at the argumentsthat people have over what just
(06:12):
development looks like. And allof the vague statements that are
made, all of the errors that aremade, the way that people talk
past each other. And sothroughout my career, I have
worked on equipping people tohave better arguments, better
(06:37):
debates. And so my goal is toreach broader audiences than
just academia with each book tohelp people understand, and this
is getting to the current book,where people where communities
have come from and wherecommunities are going. So
(06:58):
communities that have beendevalued, symbolically but also
economically, there are plans inplace to revalue those
communities.
And everyone has a differentmotive in the revaluation, and
(07:20):
every community has a differentstory in the devaluation. So my
third book is a handbook,basically, of what I call the
threads of community history,which is what are the all of the
things, and I've identified 11things that a community can go
(07:45):
through that would cause it tobe devalued, and what are the 11
things that a community can gothrough that would cause it to
be revalued. And so this bringsa lot of clarity because the
minute we talk about a communitybeing devalued, the
conversation's not over, it'sjust beginning. Because you have
(08:08):
all of these various threadsthat create a fabric of how this
particular community got to thisparticular place. Now when you
come with a plan to revalue it,now you those those threads of
revaluation, they're fittinginto an old fabric of
devaluation.
(08:29):
And so my my main breakthroughin this book, my main epiphany
in this book is that everycommunity is completely
distinct, But the threads thatmake it distinct, those 22
threads of 11 devaluation, 11revaluation, are very common
(08:51):
throughout the world. So if youexamine those threads, you begin
to compare places that peoplewouldn't think of comparing, and
you get clarity that peopledon't normally get in these
conversations when they justsay, well, you know, this area
was devalued because it wasredlined, and then that's the
end of And So then what doeswhat does that mean? You know?
(09:14):
What's the answer? And and so mybook helps to push those
conversations forward.
It doesn't provide the answers.It provides clarity in the
discussion.
Speaker 1 (09:24):
I yeah. Thank you for that explanation. And I'm I'm
curious, and I just need to do afull disclosure that I've seen
those frameworks. So and I'mgoing to ask you questions that
bug my mind. Like, when you talkabout eleven and eleven of the
re devaluation and revaluationframeworks, and what usually
(09:46):
struck me when I'm when, youknow, when I think about this in
relation to places and effortsin the way they are, whether
from government or, you know,individuals themselves within
the community making meaning ofhow their environment is
becoming devalued and what theythink would make an improvement
(10:09):
if, you know, certain changesare done.
And sometimes I try myself topair these things together
between, okay, if there is, if adevalued factor is here, should
we apply an alternate force? Andsometimes that's not the way
(10:29):
because there are underlyingthings that is that could be
making what we are seeing lookthe way they are, but, you know,
the frauds that need to repay itare not directly matched. Would
you, you know, say a little bitabout that?
Speaker 2 (10:43):
Yes. So I think this is the number one way that
communities are exploited, is inthe marketing and the promotion
of what seems to be common senseplans, that if this community
(11:09):
was defunded, then we need torefund it. Conversation over. If
this community was detached, weneed to reconnect it.
Conversation over.
If this community, wasdeteriorated in its housing
(11:35):
stock, then we need to renovateit. And when you look at
communities from a fabricapproach, you can't undo the
fabric that's already created.You can't go back in history.
So, you know, there is a crazearound the world right now in
(12:02):
wealthier nations of removingroads that were unjustly placed.
But, you know, I think this isthe kind of the most obvious
example.
Like, removing a road sixtyyears after the community didn't
want it there might not be thenumber one way to address that,
(12:27):
that issue. So another analogythat I use, and I have there's
two analogies in the books. Oneis a fabric, and one is the
making of a loaf of bread. Youknow, you put in all these
ingredients to the loaf ofbread, and it becomes something
new. You can't go back threedays later and take out the
eggs.
(12:48):
You can't go back later and addthe chocolate chips that you
wish you added. You know? Andwith the fabric, you know, you
can't go back later and take thered threads out that you don't
like. So I think it's it itprovides a framework like this,
shows us the messiness and thenuance of community building,
(13:12):
which I think are the two thingsthat are most lost in
conversation because everyonewants an easy side to be on and
an easy side to articulate, Andeveryone wants to have an
obvious quick answer that youcan put in a one page document.
Speaker 1 (13:30):
Wow. I know some of our listeners will be wondering,
why am I asking an urbansociologist to talk about, you
know, spaces and stuff when weare asking the questions around,
you know, rural health care? Andthat brings me to a follow-up
(13:52):
question. I looked at theframeworks, and I teased us
specifically four of thosedevalued frames that you put
together. And I want us to talka little bit about it because
they jump to me as veryrelatable when I'm thinking
about place based policies andhow they affect, you know,
(14:17):
health care accessibility.
And these four frameworks aredefunding, and you've mentioned
you mentioned it when you werespeaking the other time. The
second one is detaching. And byyour definition, like, when you
detach people or by myunderstanding, when you detach
things from the services thatthey used to receive before. And
(14:38):
then the third one isdestabilization, and then the
last one is deterioration. Ibring these four questions
specifically because when welook at rural communities,
there's always that inherentchallenge of health facilities,
(14:59):
you know, being left todeteriorate because of other
things that I could still tieback to defunding and other kind
of things.
And, you know, that struck meas, yes, this is something that
I want us to spend a little bitof time to talk about. And I
know you might disagree. Oh, Idon't see the direct relations
between rural health careaccessibility and all of these
(15:23):
frameworks.
Speaker 2 (15:23):
Well, you know that that's my perspective. So you
you know you know I was askingyou why why why you want me
here. So yes.
Speaker 1 (15:30):
So and, I mean, I know you can disagree, but, you
know, when I look at it fromthat place based issues Sure. I
want you to just, like, tell meabout these four frameworks, you
know, how you see them play outin communities. And looking at
the examples that I have givento you, what was running through
(15:54):
your mind when you structuredthem?
Speaker 2 (15:58):
Well, I mean, these are very these are very, very
common threads that communitiesface. So you said defunding,
deterioration.
Speaker 1 (16:13):
Detaching.
Speaker 2 (16:13):
Detaching and Destabilization.
Destabilization. And you did saydeterioration.
Speaker 1 (16:21):
Yes, I So
Speaker 2 (16:25):
deterioration is so in in my definitions,
deterioration is the physicaldecline of the place, which
becomes very, very costly, youknow, when a place is when a
when a place is builtenvironment, and built
environment is just all of thethings that were made by people.
(16:47):
Mhmm. So when a place's builtenvironment or all the things
that have been made by peoplebegin to deteriorate because of
a lack of, maintenance, then thewhole conversation changes. I
mean, so, you know, well knownexample in The United States is
Congress allowed US publichousing to deteriorate by by not
(17:09):
funding regular maintenance. Andso the conversation's able to
change into something like,well, we need to demolish it,
which is another thread.
But deterioration is alsoimportant because deterioration
helps to create health hazardsin terms of lead, other things
(17:35):
that asbestos, other things thatdecaying buildings might have.
Community destabilizationrelates to the social weakening
of of the community. So if youhave a community that's
weakening in its social fabricand also weakening weakening in
its physical buildings, you havea momentum that's very hard to
(17:58):
overcome. And so these are justtwo reasons why a neighborhood
would become detached. And whenI say that a neighborhood is
detached, I mean something veryspecific.
It's a real or perceivedreduction in a neighborhood's
resources, its functions, itspurposes, its assets, its safety
(18:22):
in the minds of outsiders. Sopeople from outside that
neighborhood. And so what thismeans in urban planning talk is
that this neighborhooddisappears from the cognitive or
mental map that people have ofthe city. So they have a map of
(18:45):
the city in their minds, andthere there are are murky
places, blurry places, what oneleader famously and and horribly
called holes on the map. And sothat begins to have its own
momentum.
Once a place begins todisappear, that that becomes its
(19:08):
own driver for housing to becomedevalued because people aren't
looking at that housing orwanting to live in those
apartments. It retail becomesdevalued because the only
clientele is a local clientele.So that would detaching. And
then defunding is a decrease ingovernment support for
(19:30):
buildings, for infrastructure,for businesses, for spaces, for
programs. And, you know,governments oftentimes try to
especially in a in aconservative leaning, right
leaning government, wherecommunity is looked at through a
(19:52):
business lens.
Speaker 1 (19:53):
Mhmm.
Speaker 2 (19:54):
The idea is this community is a bad investment,
so we're going to take away ourfunding from it and put our
funding in some place where thatdeserves it. And this results in
what is known and what I call inthe book a containment strategy,
where it's like, okay, this thisarea is going to have problems
(20:17):
because of all of these issues.We're going to have to, the
government says, create aboundary around this
neighborhood and make sure thatall of those issues are
contained within this area so itdoesn't blight, pollute the rest
of the city. And that becomes anentire strategy around urban
planning and policing, etcetera.Wow.
(20:39):
And so in many countries, thedecanting or relocation of
people from prime urban areas tothe rural periphery is a
strategy to remove many of theseissues out of sight.
Speaker 1 (20:55):
Wow. That's very insightful. And when you were
talking, I my mind just go wentthrough a time that I was doing
a documentary on hospitalfunctionality, specifically
primary health care. And most ofthe about 75% of the hospitals
(21:16):
that I went to were sodeteriorated that you would
think you are coming there topick diseases. And not getting,
you know
Speaker 2 (21:27):
Not not
Speaker 1 (21:28):
not not getting care. So and when I look around, like,
when you were mentioning aboutthe duration of building and I
think you called them, you know,Biowest, like, in relation to
the hospital setting, that willbe medical waste. Now imagine
when because of deterioration,the pipes, the sewages are not
(21:51):
working, and the hospital, thedoctors still need to work. They
need to function. Women stillcome there to give birth, And
all those wastes are notproperly managed because, you
know, they have a whole lot ofstructural problems within the
health facility to grapple with.
(22:11):
And, you know, that becomes agood pro a huge problem. Well,
you are still listening to whatabout rural health. We are going
for a short break. When we comeback, our guests would dive into
the deeper conversations that,you know, coming out from his
other book, showroom city.Welcome back.
(22:36):
You are still listening to whatabout rural health with
Chennacer. So, John, let's diveinto showroom city.
Speaker 2 (22:46):
You If you insist.
Speaker 1 (22:47):
I do insist because see, the thing is when I read
that book, and I took awaybecause I'm not a new one, an
urban sociologist. I am not. I'man administrator. I look at
things from public perspectiveand how does that inform public
(23:09):
policy? How does communityaction inform change?
That is what I'm looking outfor. And that is a whole lot of
things that the book was tellingme when I read them and I when I
read it. So I still want tobring it in, and we'll talk
about it, and then we'll comeback to these frameworks. So
(23:34):
your work in showroom city, itties directly it ties real
estate to urban changes thatshows broader social impact. And
you've discussed a whole lotabout this from the re the
framework.
But when you think about thesespaces, how how do you think it
(23:57):
shapes people's health andwell-being?
Speaker 2 (24:08):
So the question is how do spaces shape health and
well-being? Yes. I mean, Ithink, you know, one of the one
of the benefits of this momentis is that we are thinking
about, health in regards to thesocial determinants of health.
(24:34):
Yes. You know, so if you thinkabout that individual and you
think about all of the thingsthat surround that individual,
You know, you think around aboutthe air, around the individual.
How polluted is that air? Whatis polluting that air? How noisy
(24:57):
is that place? Can the personsleep? How stressful is is the
noise?
Is the noise itself threatening?Is it bombing? You know? So you
think about the air aroundsomeone, you think about the
soil, that's available, the leadin the soil, the the pollutants
(25:18):
in the soil, and the weatheraround that individual, you
know? Places that are heavilypaved and the heat island that
envelops those places becausethere's not the natural
ecosystem to be able to handleheat.
You think about how easy it isfor that person to walk around
(25:38):
and get to other places, notjust walk around within the
neighborhood, that's one piece,but to get around to other
places. The food that'savailable to that person. The
housing that that person'sliving in. Is there mold in the
housing? Is there lead in thehousing?
The health care that's in thearea. And then you begin to look
(26:01):
at the social cohesion, thesocial capital, the what what we
would call the glue betweenpeople. And so, I think that's
one of the things that,devalued, marginalized
neighborhoods have, oftentimesin abundance, is social
(26:27):
cohesion. And I think that iswhere, plans that are successful
in addressing all of these otherthings about the environment,
air, soil, noise, pedestrianaccess, housing, food, health.
Oftentimes, successful planswill leverage the cohesion, the
(26:55):
social glue, the social capitalthat's already in place.
And I think, you know, majorinstitutions, you know, you're
you're from more familiar thanI, but major institutions like
the United Nations and andothers are are leaning on this
type of perspective now as adefault, even if it's only in
(27:17):
rhetoric, in a way that's neveroccurred before. So it's almost
the new common sense that thelocal has expertise. The you
know, that that that communitycohesion, that those community
relationships, that there'sexpertise and know how in it.
(27:39):
Now whether that actually isacted upon, whether that know
how is actually respected,whether community input is just
a symbolic stage, that's a wholeanother thing. But I think, you
know, these are the socialdeterminants of health, which
I've basically overviewed here.
(27:59):
Like, this is a great way tounderstand where a community
sits and then how it can canmove forward. So I think, you
know, in the in the High Pointcase, this was the case of a
city that lost it. This is thethe subject of So Room City is
(28:19):
High Point, North Carolina,which is a city that, lost its
downtown because its downtownbecame the setting for a global
exposition of furniture fashionthat occurred twice a year so
that the whole world, everycontinent would come, 85,000
(28:43):
visitors from a 110 countrieswould come to this downtown, and
the place lost their communitycenter and therefore lost a lot
of the mechanisms they had forcohesion Wow. And glue and
social capital. And so this bookis largely about that.
(29:05):
It's a very, very unique andstrange, one reviews called it
weird case that helps tohighlight very common threads.
And again, this is one of thethings that led me to this
thread approach that as strangeas High Point is, the threads
that make it into what itsstrangeness are very common.
Speaker 1 (29:29):
Yeah. Yeah. And thank you for that response, thank you
for drawing social determinantsof health to this conversation
because, you know, when we talkabout health care and I think I
I usually make this point somuch that we are remove we are
not just focusing on themedicalization of the health
(29:54):
care system where you becomesick and you go get help, but
the constitution of everythingthat makes you a healthy being,
and spaces are part of that. AndI when you mention social
cohesion, I just smile. I'mlike, it is only an ethnographer
(30:14):
who would, you know, take timeto study humans, people, and how
they function within society,how they build this social
cohesion.
And and I would add that in somecases, even how they
disintegrate, It is stillwithin, like, human to, you
(30:36):
know, move from being discomfortto taking action. And you being
an ethnographer.
Speaker 2 (30:45):
If I could just say, like Yes. We're we're at a
moment in history Mhmm. Wheredoctors and sociologists are
discovering each other. Mhmm.And public health has not
bridged that gap.
Like, public health has notbridged the gap between the
people who look at individualsand structures, which are
(31:09):
sociologists, and the people whowho provide medicine, which are
doctors. And we are in a momentright now where, like, this is
everyone's learning from eachother. So I'm hoping that twenty
years from now, you'd never havesomeone like me on this podcast
Mhmm. Because we would havemoved past a place where I would
(31:29):
have something useful to sayeven though I don't do rural
health.
Speaker 1 (31:32):
Right? I agree with you. I I agree with you. I went
to a global health conference inDC two years ago, and that is
that became the frame of theconversation. Like, we're
talking about public health, andthings were still being typified
around, you know, healthcommunication and promotion, one
(31:54):
bucket.
Right? Surveillance in onebucket. Right? And laboratory
services in one bucket.
Speaker 2 (32:04):
Mhmm.
Speaker 1 (32:04):
And then medical practice in one bucket.
Everything, even when we talkabout public health, things are
still bucketed. For instance,when we talk about rural health,
people think, oh, okay. It'sjust it's rural spaces. Yet, we
have seen the migration ofdiseases from, you know, water,
(32:24):
contaminated water, to theglobal space where everybody
grapple with both in the urbanand rural spaces.
So all these things areinterconnected. And sociologists
do this by studying why arethese things happening within
social spaces. Right? Doctors dowhat they do, but if they open
(32:47):
up spaces to think that what ispresenting before them in the
hospital are a combination ofall of these other things put
together. And if we just open upthat space to understand this,
you know, and begin to see thatthe decisions that you make, you
know, begin does not just beginand end with you.
(33:09):
There is someone else makingconscious decision that may
facilitate or destabilize yourwork. And if we look at it from
that interconnected spaces, theworld will be better. I think
so.
Speaker 2 (33:22):
Yes. And so, you know, I think that people are
specialists. Yes. And they wantto bring the thing that they
specialize into the group thatthey think needs it. And I think
that's where a lot of damage isdone.
You know, a famous insight or awell known insight from policy,
(33:45):
and I can't remember, you know,who was the first to state it,
but that the the policies oftoday fix the problems caused by
the policies of yesterday. Youknow, the the things that we
consider social problems todaywere are caused by are the
answers from yesterday. That'strue. And so and so to have the
(34:06):
humility of saying that there'sso much more going on than this
one area that I specialize in.So, like, to give an example,
like, the person who wants tobring transit cannot understand
why someone would not want atransit stop.
(34:29):
Mhmm. They think that they mustthey think that they must be
naive. Mhmm. When in fact, itcould be the transit stop
proponent who's naive becausethey're not looking at all the
all the various factors.
Speaker 1 (34:41):
Yeah.
Speaker 2 (34:43):
Someone who says, you know, I wanna bring a bike lane.
That's my life's work. Andsomeone says, no. I don't want a
bike lane. And the response is,that's naive.
No. The person bringing the bikelane is probably the one who is
naive. You know, solving a fooddesert with a Whole Foods, you
know, that seems like an obviousthing for the person who wants
(35:07):
to bring the best, you know.Well, we don't just want any
grocery store. We want a WholeFoods.
But that's not looking at at thewhole picture. And so I think
this holistic approach is verycomplicated. It's also very
difficult to politicize. Youknow, you see mayors in Chicago
and and now in New York, in inthat election trying to talk
(35:33):
about a totality of issues thatresult in individual well-being.
And it's very difficult topursue that today.
You know? That's the question.Yeah. You know, other nations
have had a more holistic view ofof the individual.
Speaker 1 (35:52):
That's right.
Speaker 2 (35:52):
A more societal view of the individual. The US in
particular has beenindividualistic to a fault, had
so much to learn from othernations. Many of those nations,
its communities, you know, TheUS has ruined with this
individualism. But I think it'svery difficult to say, well, how
(36:14):
do you help this individualwho's sick? Well, you do it
through transportation.
You do it through grocerystores. You do it through
sidewalks. You do it throughgreen space. You do I mean,
that's a very difficult thing torun for, you know, to to to to
have a platform as as a mayor.
Speaker 1 (36:30):
That's true. Thank you for for that response. And
we we are still on on showroomcity and, you know, having
conversation around that. But II want to ask you a question. In
by your profile, yourself, youalways describe yourself as both
(36:53):
a teacher and a student, andthat's now, like, you know, puts
you in a place of both teachingand learning of community
sociology and how you use thatto approach your work.
I you know, while puttingtogether this, I'm like, what do
(37:13):
I hit him with? What question doI hit him with that would allow
him to talk about his academicwork? Right? It was the comeback
to showroom city. And I gotfascinated in your use of asset
based community led developmentAnd, you know, in within this
(37:37):
context, how can we use that tounderstand health equity
generally?
Speaker 2 (37:45):
I think asset based community development is used
quite often for health outcomes.I could because I think health
outcomes are kind of the mostsocial of our outcomes. You
(38:07):
know, we could also put maybeeducation in that, you know,
that it takes all of thesedeterminants to create an
educated child. But really,health is is something when you
think about mental, physical,spiritual health, it's really
something that brings togetherall aspects of of society. And
(38:32):
so asset based communitydevelopment is very, very
straightforward.
It looks at places from the lensof their strengths rather than
their their deficiencies. And itsays, what are the strengths of
(38:52):
individual talents in a place?Mhmm. What do these residents do
better than anyone? Or what whatwhat can they do that others
can't do?
What are the physical assets ofthis place? Like, what are the
what are the buildings? What arethe plazas? What are the trees?
(39:16):
Because, you know, somecommunities a 200 year old tree
might be one of the mostimportant meeting spaces in that
community.
You know? So what are thephysical assets of that
community? And theninstitutions, you know, what are
the organizations that maybesome of them inhabit those
(39:37):
important buildings. What arethe organizations that that, are
the strengths of that community?And the association.
So things that are less formal,you know, residents that get
together, around savings clubsor things like that, which may
actually become more formalizedin the future. And then
culturally, what are the thingsthat this community wants to
(40:02):
retain and develop? So lookingat a community through the lens
of its strengths and movingforward from from there. That's
the only type of developmentthat can possibly be
sustainable.
Speaker 1 (40:21):
That's true.
Speaker 2 (40:22):
Because that's the only type of development that
respects what the current fabricis and weaves into that current
fabric. Most other plans are tocreate a new fabric, and that's
how development has operatedaround the world from the
removal of informal settlementsto the demolishing of public
(40:43):
housing is the the declarationof we need a new fabric and you
know, by elected officials andand appointed officials. And
while that can seem like a veryneat and clean answer and even a
very profitable answer, if youare turning that land into
(41:05):
something that makes more moneyand has higher rent, The
societal costs of that, and Idon't just mean the social costs
of that, I mean the economiccosts of that. Okay. So the
costs of people who had socialcohesion now no longer having
(41:26):
social cohesion.
Speaker 1 (41:28):
Mhmm.
Speaker 2 (41:29):
The the cost of places that had networks of kids
that knew each other and weregrowing up together, now not no
longer having thoserelationships for kids. The
those the businesses thatcatered to local people that
(41:51):
allowed them to get discountsuntil they got paid or maybe not
pay for something until payday,that being lost. Like, all of
those things being lostincreases issues like health
problems, increases issues likecrime that all have economic not
(42:16):
to mention the lostproductivity. The lost
productivity of that localbusiness being gone, of, people
who were living close topotential livelihood, their
their proximity to jobs beinggone. So it's it's really comes
down to the issue of short termeconomic costs and profits and
(42:43):
long term economic costs andbenefits.
All of these things that we aredoing for short term profits
have long term economic costs.
Speaker 1 (42:54):
That's true. Thank you, doctor John, for coming to
our show today. And for ourlisteners, I would invite you to
stay with us, listen to thepodcast. And if there's
something that you learn out ofit, please share to your
(43:16):
audience as well and leave us areview. You are still listening
to what about rural healthbecause health isn't just about
systems, it's about the peoplethose systems are made to serve,
how they make meaning of theplaces they call home, which
sometimes are left behind.
(43:37):
That is why we continue to askthis question, what about rural
health? Let's create thistogether. Until next time, I'm
still your host Chinasa Imo.Thank you. Bye.
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