Urban inequality and health: structural pathways from income disparities to food insecurity in Staten Island, New York

Source abstract

Food insecurity and income inequality are increasingly recognized as critical urban health challenges. This paper examines how these factors shape health disparities in Staten Island, New York City’s least studied borough. Using a pilot survey (N = 300) combined with spatial analysis and structural equation modeling, we analyze the pathways through which socioeconomic vulnerability, neighborhood characteristics, and food access interact to influence health outcomes. Findings indicate that income inequality is associated with poorer self-reported health, both directly and indirectly through food insecurity and job insecurity, within spatially differentiated neighborhood contexts. The spatial analysis reveals clusters of high vulnerability and poor health outcomes, highlighting the geography of disadvantage within Staten Island. These results underscore that even within a high-income city, localized inequalities can drive significant health disparities. By situating Staten Island within the broader debate on social determinants of health, this study demonstrates the value of integrating quantitative and spatial approaches to urban health. The findings emphasize the need for community- and policy-level interventions that address not only food access but also the underlying socioeconomic structures that perpetuate urban health inequalities.