Reflection Questions

1. Consider the community you grew up in. How would you define it? Describe an unwritten division in the community that people who live in the community know about but a visitor would not.
2. Take a walk in your community from one end to the other end on a main street. How would you describe how the neighborhood changes?
3. Imagine taking a walk in your community in the year you were born compared to now. How would you describe the neighborhood. What has changed? What has stayed the same?

Discussion Questions

1. How could neighborhood conditions from decades ago influence the health of residents today? Does history really matter?
2. Harris (1927) quotes a Chicago Whip editorial which stated: “If it is not the duty of the city to make all parts of the city a healthy place in which to live, it is certainly the duty of a community to see that it gets all that the city has to give for the protection of health”. Consider the first part of sentence, “If it is not the duty of the city…”. Should this be the duty of the city?
3. Contrast figures 1.5 and 1.6 (detailing Black and White mortality rates from tuberculosis over time) with figures 10.1 later in the book (detailing Black and White mortality rates for breast cancer). How are these patterns similar, how are different?
4. Harris (1927) doesn’t use the term “social determinants of health” (which came into our lexicon only recently). Yet clearly he is describing social factors that adversely affect the health of Black people in Chicago. What are the factors that he describes? Are they fundamentally different than the factors you might associate with poor health today?
5. Faris and Dunham’s chapter builds on an important model from the “Chicago School” of sociology – the concentric zone theory of the city (see figure 2.1). Does this model reflect the city as you know it today?
6. Faris and Dunham grapple with the question of causality – describing the “drift hypothesis”. What does this hypothesis imply? Is it relevant to our understanding of health inequities today?
7. Drake and Cayton add the first substantial piece of qualitative data to our story. What do their interview excerpts reveal? Why might qualitative data be particularly useful in health equity advocacy?
8. Abraham’s Mama Might Be Better Off Dead focuses on the plight of one family, living in poverty amidst the scientific marvels of the Illinois Medical District. What does the experience of the Banes family teach us?
9. Does this section of the book reflect your experiences of Chicago? If you follow Sampson’s footsteps along Michigan Avenue, do you observe similar things, or do you come to different conclusions about the city’s divisions? Or do you have a different perspective?

Solution Finding

1. Imagine that you were the Health Commissioner of the City of Chicago in 1925 and you just read Harris’ article calling out health inequities. How would you have found a solution? Would you follow Harris’ suggestions or would you do something different?​

Further Readings

Bonner, T. (1957). Medicine in Chicago. Madison: American History Research Center.

Klinenberg, E. (2003). Heatwave: A Social Autopsy of Disaster in Chicago. Chicago: University of Chicago Press.

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