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How Declining Underserved Communities Can Cause Health Issues

The health of individuals is deeply intertwined with the conditions of their communities. When communities decline, particularly underserved ones, a myriad of health issues can arise. Understanding the connection between community decline and health is crucial for policymakers, healthcare providers, and community advocates aiming to improve public health outcomes. This post explores the ways in which declining underserved communities can contribute to health problems and highlights the importance of addressing these issues holistically.

Economic Decline and Health

1. Unemployment and Income Instability

Economic decline often leads to high unemployment rates and income instability. This can have direct and indirect effects on health:

  • Stress and Mental Health: Financial instability increases stress levels, contributing to mental health issues such as anxiety and depression.

  • Access to Healthcare: Without stable income, individuals may forgo necessary medical care, including preventive services and treatments for chronic conditions.

  • Nutrition: Economic hardship can lead to food insecurity, resulting in poor nutrition and related health problems such as obesity, diabetes, and malnutrition.

2. Housing Instability

Economic decline can also lead to housing instability, with more people experiencing homelessness or living in substandard housing conditions:

  • Exposure to Environmental Hazards: Substandard housing often has issues like mold, lead paint, and poor ventilation, which can cause respiratory problems, lead poisoning, and other health issues.

  • Lack of Safe Spaces: Homelessness or unstable housing situations can expose individuals to violence and injury, further exacerbating health problems.

Social and Environmental Decline

1. Reduced Social Cohesion

Declining communities often experience a breakdown in social cohesion, which can negatively impact health:

  • Isolation and Loneliness: Social isolation is linked to various health issues, including cardiovascular disease, depression, and cognitive decline.

  • Support Networks: A lack of strong social networks can make it harder for individuals to manage health conditions and access resources for support.

2. Environmental Degradation

Environmental conditions in declining communities often worsen, contributing to health issues:

  • Pollution: Industrial decline can leave behind environmental pollution, affecting air and water quality and leading to respiratory and cardiovascular diseases.

  • Limited Green Spaces: A lack of green spaces reduces opportunities for physical activity and relaxation, impacting both physical and mental health.

Healthcare Access

1. Decline in Healthcare Facilities

As communities decline, healthcare facilities often follow suit, leading to reduced access to medical care:

  • Closure of Hospitals and Clinics: The closure of local hospitals and clinics can force residents to travel long distances for care, which can be especially challenging for those without reliable transportation.

  • Reduced Services: Remaining healthcare facilities may offer fewer services, limiting access to comprehensive care, including specialty services and mental health support.

2. Shortage of Healthcare Providers

Declining communities may also face a shortage of healthcare providers:

  • Healthcare Workforce: Economic decline can lead to an exodus of healthcare professionals seeking better opportunities elsewhere, exacerbating provider shortages.

  • Quality of Care: A shortage of providers can lead to overworked healthcare professionals and reduced quality of care for patients.

Addressing the Issues

To mitigate the health issues associated with declining underserved communities, a multifaceted approach is necessary:

1. Economic Revitalization

Investing in economic revitalization can help improve community health:

  • Job Creation: Programs focused on job training and placement can help reduce unemployment and improve economic stability.

  • Affordable Housing: Initiatives to increase access to affordable, quality housing can address housing instability and related health issues.

2. Strengthening Social Fabric

Efforts to strengthen social cohesion can have a positive impact on health:

  • Community Programs: Supporting community programs and organizations can foster social connections and provide essential services.

  • Public Spaces: Investing in public spaces and recreational facilities can promote physical activity and social interaction.

3. Improving Healthcare Access

Enhancing healthcare access is crucial for improving health outcomes:

  • Healthcare Infrastructure: Investing in healthcare infrastructure to ensure the availability of local hospitals and clinics.

  • Incentives for Providers: Providing incentives for healthcare providers to work in underserved areas can help address provider shortages.

4. Environmental Improvements

Addressing environmental degradation can lead to better health outcomes:

  • Pollution Control: Implementing measures to control pollution and clean up contaminated areas.

  • Green Spaces: Creating and maintaining green spaces to encourage physical activity and improve mental health.


The decline of underserved communities can lead to a host of health issues, from economic instability and housing problems to reduced social cohesion and limited healthcare access. Addressing these challenges requires a comprehensive approach that includes economic revitalization, social support, improved healthcare access, and environmental improvements. By taking these steps, we can work towards healthier communities and better health outcomes for all residents.


  1. Galea, S., Ahern, J., & Karpati, A. (2005). Urban Health: Evidence, Challenges, and Directions. Annual Review of Public Health, 26, 341-365.

  2. Braveman, P., & Gottlieb, L. (2014). The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Public Health Reports, 129(Suppl 2), 19-31.

  3. Marmot, M. (2005). Social Determinants of Health Inequalities. The Lancet, 365(9464), 1099-1104.

  4. Desmond, M. (2016). Evicted: Poverty and Profit in the American City. Crown Publishing Group.

  5. Berkman, L. F., & Kawachi, I. (2000). Social Epidemiology. Oxford University Press.


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