Ansell discusses how present-day racial and ethnic biases perpetuate poverty and poor health in segregated communities. Despite historical structural violence creating high-poverty neighborhoods, ongoing bias continues to exacerbate the situation. Ansell argues that the conditions in these high-mortality neighborhoods are remediable, but change requires empathy and solidarity from wealthier communities.

Ansell emphasizes the significant “empathy gap” in America, whereby affluent communities have distanced themselves from the poor, both physically and emotionally. The wealthy, who control a disproportionate amount of the national income, have little need for public programs and thus little incentive to support policies that aid the poor. This wealth gap has widened significantly due to tax policies favoring the rich, resulting in significant income inequality. Ansell quotes the data that, in 1955, the richest Americans paid over 51% of their income in federal taxes, but by 2007, this had dropped to just under 17%. The economic policies over recent decades have funneled more wealth to the richest individuals, while slashing safety-net programs for the poor.

Ansell argues that to transform high-mortality neighborhoods like Windora Bradley’s, substantial investments and wealth redistribution are necessary. This requires the wealthy to support higher taxes and policies that channel resources back into impoverished communities.