On the Driven to Discover podcast, Henry Louis Taylor explains how transforming neighborhoods will improve health outcomes

BUFFALO, N.Y. – As a young clinical audiologist in the 1960s, and one of few Black people in the profession at the time, Henry-Louis Taylor Jr. loved his job. But when he found that the socioeconomic realities of his Black patients affected his ability to help them, he knew he had to change fields. To truly serve his community, he realized, he needed to understand the root causes of their circumstances.

He quit his job and went back to school to get his doctorate in urban history. Now, as professor of urban and regional planning at the University at Buffalo’s School of Architecture and Planning, founding director of the Center for Urban Studies and associate director of the Community Health Equity Research Institute at the Jacobs School of Medicine and Biomedical Sciences, Taylor is on a mission to reverse the historic inequities that have created such a wide gap between Black and white lives.

In this episode of UB's Driven to Discover podcast, Taylor, a self-described activist scholar, talks about what led him to launch his latest and most ambitious project: the East Side Neighborhood Transformation Project.

Conditions of Black Buffalo

The idea for the project evolved from Taylor’s landmark studies that document the conditions of Black Buffalo over the past several decades. The Center for Urban Studies’ 2021 report, “The Harder We Run: The State of Black Buffalo in 1990 and the Present,” compared current conditions on the Black East Side to the conditions 30 years ago, clearly demonstrating that conditions in physical neighborhoods had deteriorated and there now was a new threat: gentrification.

“We learned that over a period of some 30 years, African Americans had made no progress,” said Taylor. “Now, progress is a tricky word and by that we meant the movement toward the transformation of their underdeveloped neighborhoods into great places to live, work and play, and raise a family.”

In purely socioeconomic terms, literally no significant changes had been made. Household income in 1990 averaged $39,000, while 30 years later, it averaged $42,000. Home ownership rates were nearly exactly the same over the three decades, and the poverty rate had dropped just a couple of points.

‘Nothing had changed’

“But the neighborhood conditions themselves, the places where they live, had actually worsened over that period of time,” said Taylor. “Nothing had changed. So we needed to begin to do something else to alter the realities of people living on Buffalo’s East Side.”

That was the focus of “How We Change the Black East Side: A Neighborhood Planning and Development Framework,” which Taylor’s team issued in 2023. The report describes a demonstration project that will transform a selected East Side neighborhood into “a great place to live, work, play and raise a family.”

The Eastside Transformation Project has now identified census tract 166, the northern area of Broadway-Fillmore, as the focus of this first demonstration project. Taylor has submitted grant applications for funding to support local staffers and resources.

Targeting health outcomes

“The neighborhood is where the everyday occurs,” Taylor explained. “So systemic structural racism is most pronounced at the neighborhood level, where it produces a whole series of what we call social determinants and these determinants shape the life chances of individuals, including their health outcomes.”

Among the outcomes targeted for improvement through the project are lower infant-mortality rates, lower levels of stress and related disease, and longer lifespans. These have also been identified by local organizations that are working together with Taylor to document and mitigate Buffalo’s health disparities, including the Buffalo Center for Health Equity, the Jacobs School of Medicine and Biomedical Sciences at UB and others that have joined together to improve the social determinants of health.

At the Jacobs School, Taylor has worked with faculty since 2018 to develop and co-teach “Health in the Neighborhood,” which educates medical students about how structurally racist policies cause poor health outcomes. In 2021, Taylor became associate director of the Community Health Equity Research Institute based in the Jacobs School, and the Center for Urban Studies joined the institute. The relationship has proved mutually beneficial.

“The vision of the Jacobs School was critical,” said Taylor. “That’s because the medical school is technically about saving lives and improving health outcomes. The question medicine asks is, ‘Ok we have sick people, people who are dying young. They’re unhealthier than everyone else. Why?’ So medicine was asking the kinds of questions that resonated with my quest for solutions.”

Those questions brought Taylor back to the same things that had drawn him to clinical audiology decades before. “It was coming full circle,” he said. “I was back where I had started when I left health care years before, when I was asking how could I transform the lives of my patients. Now I’m back and I know how.”