Under the shadow of downtown Dallas’ skyscrapers and a few feet away from the Trinity River and Interstate 35E are the 10th Street Historic District and The Bottom neighborhoods, the census tract with the lowest life expectancy in Dallas County.
A resident here can expect to live just 64.2 years on average, according to the Parkland Center for Clinical Innovation’s analysis based on census data.
Of the inhabitants in this census tract, 50.9% are Hispanic, 44.7% are Black and 14.2% are white.
About 20 miles away, in a census tract of the city of Richardson that is part of The Reservation and JJ Pearce neighborhoods, residents live, on average, 86.5 years, the highest life expectancy in Dallas County.
In this area of Richardson, 77.4% of inhabitants are white, 10.6% are Asian and 6.2% are Hispanic.
The factors behind this disparity are multifaceted and complex, and access to health care is only a small part of the equation, says Gül Seçkin, a specialist in medical sociology from the University of North Texas.
Seçkin said health outcomes in a population depend not only on individual choices, but also on socioeconomic factors that explain the difference in life expectancy of more than two decades between two communities in the same county.
Three of the most important factors are income disparities, access to health care and the type of work they do, she said. But there are other not-too-evident factors.
“Even simple things like being able to afford a vacation, taking time off from work, having to work multiple jobs, living in neighborhoods that are not safe, the quality of the air or the soil, or your housing condition,” Seçkin said. “The accumulation of all these factors over a long period of time leads to these differentials in life expectancy.”
None of this comes as a surprise to residents in areas where health outcomes are worse.
“The community here has been broken for so many years and we are neglected,” said Patricia Cox, president of the 10th Street Historic District Residents Association.
“Here, you don’t have nearby stores, no clinics, no hospitals, crime is rampant and we’re facing gentrification. We are highly stressed,” she said.
The 10th Street Historic District is part of Oak Cliff. It was originally an African American community, where some slaves who came with the white settlers of the Dallas area first settled in the 1840s.
Years after the abolition of slavery, the first freedmen’s town in North Texas was established there.
After years of changes in the area, including construction of highways and the demolition of dozens of homes, Cox said the 10th Street Historic District went from being a thriving community with stores, churches, workshops and clean streets to a forsaken area with high crime, littered streets, unmowed yards and crumbling homes. Developers are now looking to buy it for its proximity to downtown, only 3 miles north.
“This inequality is something we have lived with for centuries,” said Cox, who was born in this neighborhood in 1943 and, after living for a few years in California, returned in 2006 to take care of her mother.
“Here lived those who were abused and exploited. It seems nothing has changed,” she said.
Cox has lived past the average life expectancy in this neighborhood. She’s 77, and her mother died at 93 not from an illness, but as a result of a fall that injured her head.
Even though Cox is diabetic and has heart issues, she thinks the diet she has had all her life —meat- and animal fat-free— has protected her from worse outcomes.
However, in the past few years, as she took on a larger role advocating for her community, diabetes has taken a toll. She lost 40 pounds in the past year because of the disease.
During the day, the streets in the 10th Street Historic District look empty, with very few people walking on them or spending time on their porches or in their front yards.
The only time neighbors see each other is when they leave for work or when they’re back home to rest. In 2018, the area’s median household income was $25,385 a year, less than half the Dallas County median, according to data from the Census Bureau.
There are no grocery stores nearby to speak of. The same goes for dollar stores or even bus or DART rail stations.
Those without a car have to walk up to at least one mile to the nearest public transit line.
If they need something from the grocery store, they have to walk 2.5 miles, or about 40 minutes, to reach Supermercado Monterrey, the nearest in the area, on the other side of I-35E.
There are no emergency clinics close to the area either. The closest health care provider they can go to is Methodist Dallas Medical Center, about 2 miles away.
Dallas Police Department data shows that this is an area where crime is high. So far this year, there have been reports of 11 retail shop and commercial building thefts, 10 stolen vehicles, five armed assaults, three armed robberies and two burned vehicles in the area.
Cox is retired and uses Medicare. She makes her copayments comfortably and receives her diabetes control drugs on time.
Living in the same neighborhood, Abel González, 59, has had a more difficult time affording health care.
González has had a stomach hernia for the past few years, but it wasn’t until last summer that it kept him from working in construction, a job he’s been doing since he arrived in Dallas from Durango, Mexico, in 1979.
“I knew I had it, but I never searched for care because it was either that or taking food from my children’s mouths,” González said.
“I had to choose between getting screenings and visiting the doctor or feeding my kids.”
A father of six between 9 and 18, González has been out of work since July and has been helping pay his household expenses with his federal child tax credit money.
Now he’s getting unemployment benefits, but he makes only half as much as he used to when he had a job.
Upon losing his job, González lost his health insurance, too. So he went to Parkland Hospital, where he is scheduled for surgery in mid-December.
“I think we live less long here because we’re neglected,” González said.
“We are poorer and face a lot of obstacles to access care. To be fine here in our neighborhood ... we cannot do it alone.”
Seçkin said residents of poor neighborhoods experience stressors from all sides — and when you add their financial strains to the mix, that can lead to poorer health.
“It’s like being in a constant survivor mode. It puts your body in a fight, because you don’t have any opportunity to relax; you are always struggling,” she said.
To the north, only 17 miles away, the area of the Reservation and JJ Pearce neighborhoods where life expectancies are the longest in Dallas County is one with few of these stressors. It has a thriving upper middle class with spacious homes and well-kept lawns.
Front yards are dotted with lawn chairs and playgrounds, and it is common to see people of every age walking their dogs or working out.
Kathy and Russell Scott, 68 and 64, have been living in the area for 28 years. Russell owns a music school. Kathy works as a secretary at Waterview Christian Church in the same Richardson community.
They have never had serious health problems nor have they had trouble getting treatment for the illnesses they have faced.
“We have always had health insurance through our jobs. And each year we get routine checkups, try to eat healthy and everything is fine,” Kathy Scott said.
The Scotts also believe part of their well-being derives from the environment they live in.
“There are places where crime is higher, people don’t know each other, and you can see more stress in those people’s eyes,” Russell Scott said.
Richardson police data shows that this is an area with no record of high-impact crime. So far this year, just three assaults and five business thefts have been reported.
In addition to having access to quality health care, the Scotts have the support of a network of friends and acquaintances helping them get better care and make good decisions.
“Both of us already had cataract surgery, and two of our congregation leaders are physicians, so they told us where to go,” said Russell Scott.
Greg Parks and Lenin Munguía, community outreach ministers at Waterview, said the jobs and lifestyles of people living in the area allow them to have a higher life expectancy than the rest of the county.
“This neighborhood is very stable. People come in, they settle here and they stay, sometimes for many decades,” said Parks. “The neighborhood itself is very communal, with lots of neighbor interaction and many people with a religious affiliation.”
“Access to health care is tied to employment, so a community where people have good jobs, they necessarily have access to better health care,” said Munguía, in charge of the church’s outreach with the Latino community.
However, it’s not the area with the highest income in the county.
The area’s median household income was $114,306 in 2018, according to census data. That’s roughly twice the Dallas County median, but five census tracts in northern parts of Dallas have median household incomes that topped $250,000, according to data compiled by PCCI.
Around this Richardson neighborhood, there’s a wide variety of businesses and services available.
Real estate agents often talk of the “Starbucks effect,” where the coffee shops’ locations indicate an area of rising prosperity. Unlike in the 10th Street Historic District, where the closest Starbucks is 3 miles away in a downtown building, the area where the Scotts live has at least 10 Starbucks locations in a 2-mile radius.
The area also has several grocery stores, including some offering organic food like Sprouts Farmers Market and Whole Foods Market.
The closest emergency clinic is just across a street, and the nearest large hospital, Medical City Dallas, is 4 miles away.
Seçkin said that although individuals may have better overall health in communities with more economic resources, no one is exempt from the chance of facing a chronic illness or health crisis.
The difference, she said, is in having a way to deal with it.
“Let’s say if I’m making six figures, $200,000, $300,000 or if I’m a millionaire, making more money is not going to substantially increase my health,” Seçkin said. “But if I’m making $30,000 or $40,000, increasing my income level does make a difference. That’s why our leaders need to work on this, so that there’s less inequality.”
Seçkin said placing the sole responsibility for health on each individual — by simply recommending dieting, exercise or better sleep, for example — misses the point. Communities that address inequities, she said, can help individuals make the healthier choices they may want to make and improve health outcomes for all.
Mitchell Schnurman, Business Columnist at The Dallas Morning News, contributed to this report.
