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Health Problems Take Root in a West Baltimore Neighborhood That Is Sick of Neglect

Annette Booth, 49, with her grandson. She lived in Upton-Druid Heights and receives care for several illnesses there. The life expectancy for residents is 68.Credit...Ruth Fremson/The New York Times

BALTIMORE — At 49, Annette Booth already feels old.

She is obese and has trouble walking a block, never mind playing with her grandchildren. She has had two knee replacements. She rattles when she breathes because of asthma, and takes about nine pills a day, including medications for anxiety and high blood pressure.

“I can’t walk too far,” she said. “If I do, I can’t breathe.”

In Upton-Druid Heights in West Baltimore — one of the city’s poorest neighborhoods and, in recent days, the scene of some of its most vocal protests — the cost of long-term poverty is counted in lives. Its residents die from nearly every major disease at substantially higher rates than the city as a whole — nearly double the rate from heart disease, more than double the rate from prostate cancer, and triple the rate from AIDS. Life expectancy here is just 68 years, one notch above Pakistan.

The fact that 94 percent of its population is black is lost on no one. “If the statistics that are present in these communities were present in any white community in Baltimore, it would be declared a state of emergency,” said Bishop Douglas Miles, the pastor at Koinonia Baptist Church in Northeast Baltimore. “Health disparities loom as a giant lurking in the shadows. They never get talked about.”

Protests that have rolled across the country since the killing of Michael Brown in Ferguson, Mo., last year may be largely about policing, but the anger and frustration that power them have come from a deeper, less visible set of issues that burden poor black Americans.

Poor health is a physical manifestation of systemic disadvantage. Years of industrial decline have left swaths of this city jobless. Half the people in Upton-Druid Heights live in poverty, slightly more than in 1970, and 64 percent of working-age black men are not employed, according to Marc V. Levine, a professor of history and economic development at the University of Wisconsin-Milwaukee, who has studied black employment in Baltimore.

Manufacturing jobs in the city have declined by 90 percent since the late 1960s, and much of what replaced them was too far away or required too many skills for the local work force. In 2010, the typical household in Upton-Druid Heights had an income of about $15,700.

“There are factors that build up and something makes it pop,” said Ralph Moore, 62, who grew up a few streets over in Sandtown-Winchester, where Freddie Gray, the man whose death sparked Monday’s riots, was chased by police officers. “Freddie Gray’s death made it pop. This isn’t just happening as a consequence of his death; it was always around.”

The legacy is a grim landscape with far more vacant buildings and liquor stores than in the rest of the city.

Mr. Moore, a program manager at Restoration Gardens, a shelter for homeless young people, recalls having to look hard for an abandoned building in Baltimore for a high school yearbook photograph he and his friends wanted to take in 1969. Now they are everywhere.

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Dynece Mayberry, 54, said: “We were marching for a rec center, we were marching for schools. We were marching for jobs.”Credit...Ruth Fremson/The New York Times

“People are angry,” he said. “They don’t feel a connection with any positive Baltimore existence. They feel like they are being ignored.”

Dynece Maberry, 54, who lives a few blocks from the CVS drugstore that was burned and looted on Monday night, agreed. “Freddie Gray was one thing, but what all triggered it off was years of frustration,” said Ms. Maberry, who joined the protests. “We were marching for a rec center, we were marching for schools. We were marching for jobs.”

At Total Health Care, a tidy brick community health center in Upton-Druid Heights where Ms. Booth had come Wednesday morning to figure out how to renew her prescriptions — she had been using CVS — clinicians see the problems up close.

Janice Stevenson, clinical director for the mental health program at Total Health Care, described a patient whose daughter, 18, was killed and thrown in a Dumpster. The patient’s grandson died in a drive-by shooting. In all, perhaps 10 people in the patient’s immediate family had died from disease or violence by the time she joined the program.

“It’s a lot like being in a war,” said Ms. Stevenson, who drew an analogy to the vacant houses that dot Baltimore’s streets like broken teeth. “There’s an emptiness inside of them that’s like the houses.”

She said children in the area had high rates of exposures to lead paint, which can cause mental and physical impairments. City data appeared to back that up: Upton-Druid Heights has twice the rate of lead paint violations compared with the rest of the city.

Marcia A. Cort, the chief medical officer for the clinic, used to work in the emergency room where patients from this neighborhood commonly went. She said rates of intubation for asthma there were two to three times those of a hospital just a mile and a half away downtown whose patients were less impoverished.

“Look at the life expectancy — you are old at 49,” said Faye Royale-Larkins, the chief executive of the clinic. But she said health disparities were not part of the anger of recent days. “You would be angry if something was taken away from you. But if you never had it,” she added, “it doesn’t make you angry.”

Ms. Booth, who grew up in Upton-Druid Heights and now lives farther south, lived in some of those abandoned buildings in her 20s. She was addicted to drugs and spending all her money getting high. She says those years permanently damaged her health. But she has something unusual: a partner, who stayed with her throughout. They got clean together.

She said she was not surprised by the low life expectancy in the neighborhood. Recovering drug addicts are not given too many years to live, she said. But she has signed up for nutrition classes at the Total Health clinic and aims to lose 100 pounds.

“I don’t like broccoli, but I’m going to eat it,” she said. “I want to live long enough to see my grandkids get married. I really want to be here for that.”

A version of this article appears in print on  , Section A, Page 19 of the New York edition with the headline: Health Problems Take Root in a Neighborhood That Is Sick of Neglect . Order Reprints | Today’s Paper | Subscribe

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