PITTSBURGH'S INEQUALITY ACROSS GENDER AND RACE 2019 CITY OF PITTSBURGH'S GENDER EQUITY COMMISSION ABOUT THE AUTHORS Junia Howell, Ph.D. is an Assistant Professor of Sociology at the University of Pittsburgh. Howell's research focuses on how cities can foster equity for all residents. Sara Goodkind, Ph.D., M.S.W., is Associate Professor of Social Work, Sociology, and Gender, Sexuality, and Women’s Studies at the University of Pittsburgh. Her research focuses on social service programs and systems that work with young people. Leah A. Jacobs, Ph.D., M.S.W., is an Assistant Professor in the School of Social Work at the University of Pittsburgh. She studies criminal justice involvement and behavioral health, focusing on related socio-structural risk factors and points of intervention. Dominique Branson, is a graduate student in the Department of Linguistics at the University of Pittsburgh. She studies the correlation between African American Language and the social outcomes of Black Americans, particularly in the U.S. Criminal Justice System. Liz Miller, M.D., Ph.D. is Professor in Pediatrics, Public Health, and Clinical and Translational Science at the University of Pittsburgh and Director of the Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh. Her research addresses interpersonal violence prevention and adolescent health promotion in clinical and community settings. ACKNOWLEDGEMENTS We would like to thank the students of University of Pittsburgh's Pittsburgh Area Study who assisted in the preliminary research for this report: Sarah Barker, Briza Carrillo, Emily Costanzo, Allyson Fenton, Maurice Ffrench, Jesse Fulkerson, Robert Garland, Jalissia Haynes, Olivia Kelley, Jorden King, Nisa Konstantin-Raz, Francesca Manriquez, Harsha Mikkilineni, Megan Palmiter, Emily Pembridge, Kelli Slogan, Savannah Sowell, Caroline Stilley, Jazzee Stocker, and Laura Wicker. We would also like to thank Siera Meaux as well as Lisa Brush, Ray Engel, and Melanie Hughes for their keen editing and suggestions. To cite this study: Howell, Junia, Sara Goodkind, Leah Jacobs, Dominique Branson and Elizabeth Miller. 2019. "Pittsburgh's Inequality across Gender and Race." Gender Analysis White Papers. City of Pittsburgh's Gender Equity Commission. 2 City of Pittsburgh Gender Equity Commission September 2019. As a representative of Mayor William Peduto’s Office of Equity, I want to convey my deep thanks to the interdisciplinary research team that produced this groundbreaking report. It examines equity indicators in Pittsburgh and introduces an innovative tool that compares data across cities and helps identify which local interventions are likely to be most effective. The intersectional methodology and analyses of disaggregated data expose patterns that may otherwise be invisible. This is the first component in a city-wide Gender Analysis which is being undertaken collaboratively by a research team from the University of Pittsburgh and members of Pittsburgh’s Gender Equity Commission (GEC). Created by local ordinance in late 2016, the GEC is part of a coalition of CEDAW (The Convention on the Elimination of all Forms of Discrimination Against Women) cities in the U.S. The GEC currently consists of the Executive Director and 13 volunteer Commissioners who live or work in the City of Pittsburgh. We are tasked with identifying and overcoming barriers to gender equity in local government. The mission of the Gender Equity Commission is to achieve equity for women and girls in the City of Pittsburgh. Its vision is a future in which everyone in the City of Pittsburgh, regardless of gender identity or expression, is safe in all spaces, empowered to achieve their full potential, and no longer faces structural or institutional barriers to economic, social, and political equality. Based on the findings from the completed Gender Analysis, the GEC in 2020 will begin making recommendations for City policy and legislation to mitigate inequalities and promote gender inclusiveness. Our recommendations will incorporate input from diverse local communities and draw on the expertise of staff in City departments and authorities. 3 This report is notable for remedying research gaps that occur when gender and race lenses are not used to assess the equity challenges confronting our cities. Such gaps routinely lead to the proposal of allegedly universal or neutral solutions for social problems. In fact, people experience those problems differently, depending on their varied identities and the impact of systems of power, privilege, and resource allocation. The report “Pittsburgh’s Inequality Across Gender and Race” will be an exemplar in modeling how inequity needs to be measured in order to make real, sustainable change. Our city must be livable for all, and we need analyses like this one to empower us to enact changes for the greater good of people in Pittsburgh. anupama jain, Ph.D. Executive Director Gender Equity Commission Office of Mayor William Peduto City of Pittsburgh genderequity@pittsburghpa.gov Learn more about Pittsburgh’s Gender Equity Commission: pittsburghpa.gov/gec Learn about the Cities for CEDAW Campaign: citiesforcedaw.org 4 EXECUTIVE SUMMARY The City of Pittsburgh has prioritized ensuring Pittsburgh is a livable city for all residents. As a part of this goal, the Gender Equity Commission commissioned this research to evaluate Pittsburgh's livability across gender and race. Specifically, this report examines health, income, employment, and education indicators for six sub-populations in Pittsburgh: White women, White men, Black women, Black men, AMLON (Asian, Multiracial, Latinx, Other, and Native American) women, and AMLON men. Reflecting broader trends in the nation, our results show gender and racial inequality persist across health, income, employment and education in Pittsburgh. For example, Pittsburgh’s White women make only 78 cents to every dollar Pittsburgh’s White men make. Likewise, Pittsburgh's AMLON women make only 59 cents and Pittsburgh's Black women make only 54 cents to every dollar Pittsburgh’s White men make. Moreover, Pittsburgh's Black women are five times more likely to live in poverty than Pittsburgh's White men. These inequalities are not limited to income; comparable patterns exist across the examined domains. However, we also find inequalities vary in their extent and direction. These descriptive results help illuminate the current status of Pittsburgh's six sub-populations. However, to rank Pittsburgh's livability and identify possible policy interventions, we introduce a new tool, the Relative Strengths Indicator. Using this tool, we calculate Pittsburgh's Index of Ranked Livability (IRL). This measure illuminates both Pittsburgh's standing relative to other cities and to what extent each outcome is driven by city-level factors. In doing so, the IRLs highlight Pittsburgh's strengths as well as areas where targeted interventions could make notable improvements to Pittsburgh's livability. Results suggest that for White residents, Pittsburgh ranks in the middle 50 percent of cities. That is, for the majority of indicators, Pittsburgh's White residents are comparable to their White counterparts in other U.S. cities. However, on some indicators, like poverty, the inequality between White men and White women is higher in Pittsburgh than in other cities. For AMLON residents, especially women, Pittsburgh ranks at or above average on the vast majority of indicators. However, for Black residents, Pittsburgh falls far below similar cities. Black women and men in other cities have better health, income, employment, and educational outcomes than Pittsburgh's Black residents. Using our Relative Strengths Indicator, we identify eight areas of focus for policy interventions. These include Black women's maternal mortality, employment, poverty, and college readiness; Black men's occupational segregation, homicide rate, cancer, and cardiovascular disease; as well as low enrollment in college admissions exams and school police referrals across students. We conclude with suggestions for how the City of Pittsburgh might address the structural factors contributing to these areas of concern. 5 TABLE OF CONTENTS Letter from Executive Director anupama jain.............................3 Executive Summary........................................................................................5 Introduction...........................................................................................................7 Health........................................................................................................................13 Poverty and Income.......................................................................................26 Employment........................................................................................................34 Education...............................................................................................................40 Summary................................................................................................................53 Cultivating Livability.......................................................................................62 Notes.........................................................................................................................66 Appendix A: Comparison Methodology.........................................71 Appendix B: List of Similar Cities..........................................................74 Appendix C: Data and Definitions........................................................77 Appendix D: Pittsburgh's Livability Outcomes...........................86 Appendix E: Pittsburgh's Index of Ranked Livability.............89 6 INTRODUCTION The City of Pittsburgh has been called one of the most “livable” cities in the United States.1 However, this title is based on rankings that do not consider whether Pittsburgh is “livable” for all residents.2 In alignment with the OnePGH initiative and its goal to ensure Pittsburgh is livable for everyone, this report examines the health, income, employment and education among Pittsburgh's city residents.3 Like previous initiatives we examine racial inequality in Pittsburgh;4 however, unlike existing reports we use an intersectional approach examining gender and race simultaneously. Additionally, we introduce a new tool, the Relative Strengths Indicator, that calculates Pittsburgh's Index of Ranked Livability (IRL). The IRLs highlight Pittsburgh's strengths as well as areas for improvement. As a guide for reading this report, we begin by defining gender, intersectionality, and race. We then describe our new tool and how this approach measures Pittsburgh's livability. DEFINING GENDER We conceptualize ‘gender’ as a socially defined categorization practice based on appearance and attributes. Like previous research, we use demographic sex categories to show the disparities that are created by gendered social relations. The governmental records we use in our research employ binary categories: men and women.5 These socially constructed categories are a dichotomous delineation of socially agreed upon physical characteristics. This binary excludes intersex persons and obscures the complexities of varied gendered identities (cis, trans, nonbinary), preventing us from examining the inequalities across these categories. However, it enables us to capture how gendered structures and processes contribute to observed inequities. Photographer: Kelli Slogan 7 INTRODUCTION DEFINING INTERSECTIONALITY Introduced by Kimberlé Crenshaw6, intersectionality recognizes that power-based hierarchies are simultaneously based on multiple classification categories: gender, race, education, income, age, sexuality, religion, ability and nationality, etc... In other words, a person is not only Black, or a woman, but rather a Black woman. Her multilayered identity has particular implications that are different from Black men or White women. In this report, we use an intersectional approach to examine gender and race as well as a combination of other factors including: age and socioeconomic status. DEFINING RACE Like gender, race is not a biological phenomenon but a socially defined classification scheme based on socially agreed upon criteria which usually includes: ancestry and phenotype. To capture this symbolic categorization scheme, we use self-identified racial groups. In governmental records residents are asked to classify their race using seven categories: non-Hispanic White (hereafter White), non-Hispanic Black (hereafter Black), Hispanic (hereafter Latinx), non-Hispanic Asian, non-Hispanic Native American, some other non-Hispanic race, and individuals who identify as two or more non-Hispanic races.7 In Pittsburgh, White residents make up 65 percent of the population followed by Black residents (22 percent), Asian residents (6 percent), multiracial residents (3 percent), Latinx residents (3 percent), residents who identified as another race (less than 1 percent) and Native American residents (less than 1 percent). Racial Categories in Pittsburgh 8 INTRODUCTION To protect individuals' privacy, data are not delineated when categories are too small. In Pittsburgh, this includes individuals who Racial and Gender Categories Children (ages 0 to 17) identified as Asian, Multiracial, Latinx, other racial groups or Native American (ordered by population size). Thus, for analytical purposes we combine these individuals into a single category and refer to them by an acronym, AMLON. Although not ideal, this approach provides an initial examination of Pittsburgh's livability. Specifically, in this report, we examine six Young Adults (ages 18 to 24) groups: White women, White men, Black women, Black men, AMLON women, and AMLON men. When indicators vary drastically across age, we also examine these categories by age cohorts. One of the reasons that indicators vary by age is that the representation of racial and gender categories themselves differ across age cohorts in Pittsburgh. Gender Adults (ages 25 to 64) categories are distributed more equally among children compared to older adults— where women are the majority. Likewise, Pittsburgh's children are more racially diverse than its adults. Less than half (46 percent) of Pittsburgh’s children are White, while three quarters (74 percent) of Pittsburgh’s older adults are White. These differences reflect national Older Adults (ages 65 and over) trends of immigration and diversification as well as the fact that parents are more likely to classify their children as multiracial but these children often self identify as monoracial when they become adults.8 In fact, ten percent of Pittsburgh's children are classified as multiracial compared to only two percent of the adult population. 9 INTRODUCTION INDEX OF RANKED LIVABILITY (IRL) In order to evaluate Pittsburgh's livability, we introduce a new tool: the Relative Strengths Indicator. We use this tool to calculate Indexes of Ranked Livability for Pittsburgh's health, income, employment and educational outcomes. The Relative Strengths Indicator evaluates relative standing on a given outcome as well as the likelihood each outcome is affected by local policies. For every outcome of interest, we compare Pittsburgh to other similar cities by arranging all the cities from the most to the least "livable." For example, for infant mortality, the city with the lowest infant mortality is ranked as the most livable. Conversely, for college graduation rates, the city with the highest proportion of college graduates is ranked as most livable. We then calculate the percent of cities that are "worse" than Pittsburgh. The Relative Strengths Indicator then weights Pittsburgh's relative ranking by the likelihood the outcome is influenced by local conditions. Building off the assumption that outcomes with more variation across cities are more influenced by local conditions than outcomes that are relatively similar across all cities, we calculate our weight using a standardized measure of variability. The result of this weighted relative ranking is the Index of Ranked Livability (IRL). This number encompasses both Pittsburgh's livability and the degree to which this livability is likely driven by local factors. These rankings can be zero, positive, or negative. An IRL of zero indicates Pittsburgh is in the middle of the distribution. In other words, half the cities are more livable than Pittsburgh and half the cities are less livable. A positive IRL indicates a strength. The larger the ranking, the better Pittsburgh is doing relative to other cities and the more that particular indicator is driven by local factors. Negative rankings suggest an area where Pittsburgh can improve. Pittsburgh is average Large negative numbers suggest areas where Pittsburgh falls below average and the indicator could likely be addressed by local interventions. After we examine all the outcomes of interest, we use the IRLs to compare across outcomes and sub-populations. By comparing across the IRLs we are able to identify the Area for improvement areas of relative strength for Pittsburgh as well as the categories and sub-populations where Pittsburgh should consider targeted interventions. Finally, since we included other cities in the analysis, we are able to identify which cities are strong in areas where Pittsburgh desires to improve. This provides an opportunity to investigate and learn from how these other cities address various outcomes and foster equity among their populations. A strength in Pittsburgh 10 INTRODUCTION VISUALIZING THE INDEX OF RANKED LIVABILITY To help the reader comprehend the rankings, we visualize these rankings throughout the report. These visualizations capture Pittsburgh's relative livability for each indicator. Pittsburgh is represented by the diamond. The vertical line represents a rank of zero denoting the "average" city. When the diamond is on the vertical line, Pittsburgh is at the 50th percentile. Diamonds to the right of the line represent Pittsburgh's strengths. Diamonds to the left of the line represent areas where Pittsburgh can improve. To compare Pittsburgh's livability across groups, we calculate a ranking for each of our six groups: White men, White women, Black men, Black women, AMLON men, and AMLON women. The horizontal line length varies between groups and indicators. The length of the lines represents how much the indicator varies from city to city. Longer lines represent indicators that have more variability and thus are more influenced by local interventions. Shorter lines represent indicators that are comparable across all cities. Absolute distance from the center line denotes the IRL or weighted relative ranking of Pittsburgh on that specific outcome for that sub-population. The hypothetical example below serves as a guide for interpreting the visualizations. A more complete discussion of our methods can be found in Appendix A and Pittsburgh's numeric rankings are listed in Appendix E. A diamond all the way to the left indicates Pittsburgh is the least livable city for Black men on this indicator.  The longer lines denote more variation across cities. Indicators with longer lines are more likely to be affected by city interventions. The diamond represents Pittsburgh. The further to the right, the more livable Pittsburgh is for White men compared to other cities. Being on the center grey line means Pittsburgh is in the middle of the distribution. 50 percent of cities are more livable for White women and 50 percent are less livable. The overall weighted ranking is visualized by the diamond's distance from the center line. Here, Pittsburgh is most livable for AMLON women. 11 INTRODUCTION COMPARING INEQUALITY ACROSS CITIES In addition to examining how each sub-population compares to their counterparts in other cities, we also compare Pittsburgh's inequality to inequality in other cities. Inequality, in and of itself, can elevate stress and reduce livability, even when outcomes are relatively good. Thus, we also measure how Pittsburgh's inequality compares to other cities. Gender Inequality To conceptualize what this entails, consider an example: residents' income. In our analysis, we first examine how Pittsburgh's White men's income Pittsburgh has greater inequality between White men and women than other cities.  compares to White men's income in similar cities. We then consider how Pittsburgh's White women's income compares to White women's income in similar cities, and so on for each of our six groups of interest. We then calculate the difference between White men and White women's income. Using our Relative Strengths Indicator, we then derive Pittsburgh has less inequality between Black men and women than other cities.  Pittsburgh's IRL for White gender income inequality. This IRL tells us how Pittsburgh's gender inequality compares to other cities. Inequality IRLs with negative values denote areas where Pittsburgh's inequality between groups is larger than that same inequality in other cities. Conversely, positive rankings indicate areas were Pittsburgh's inequality is lower than other cities. Ranking both absolute outcomes and inequalities between groups helps us delineate the mechanisms contributing to Pittsburgh's livability. COMPARISON CITIES The Relative Strengths Indicator calculates Pittsburgh's livability by comparing Pittsburgh to other demographically similar cities. Since we are interested in Pittsburgh's livability for specific racial and gender categories, we define demographically similar cities as municipalities with enough Black and White residents for the Census Bureau to provide subgroup calculations. This includes cities that Pittsburgh is often compared to including: Baltimore, Buffalo, Charlotte, Cincinnati, Cleveland, Columbus, Detroit, Indianapolis, Louisville, Milwaukee, Philadelphia, and Richmond. Yet, it also includes a broader swath of cities from across the country that have substantial White and Black populations. We define demographically similar cities empirically ensuring our sample is not biased by perceptions of comparable places but based on a full count of places with comparable demographics. However, as a supplemental test of our main findings, we also calculated IRLs using only the cities commonly compared to Pittsburgh. Results were comparable, providing additional support for our findings. For a full discussion of how cities were selected, see Appendix A. For the complete list of demographically similar cities included in the study and an explanation of the supplemental test, see Appendix B. 12 HEALTH A key indicator of Pittsburgh's livability is the physical and mental well-being of its residents. Well-being can be measured in a plethora of ways including the absence of disease or infirmity, physical fitness, emotional stress, and access to healthcare. Each of these measures have their benefits and shortcomings. Yet, ultimately they all directly or indirectly affect the length of residents' lives. Thus, we first summarize Pittsburghers' health by examining mortality rates and causes. We begin by comparing the average age of death Average Age of Death for our six groups. As is true nationally, women in Pittsburgh live longer than men. Yet, the extent to which this is true differs across racial groups. On average, White women live 8 years longer than White men while Black women only live 6 years longer than Black males. Additionally, both White women and men live longer than Black women, Black men, and AMLON men. This summary indicator illuminates clear racial inequality in Pittsburgh. However, exploring the mechanisms contributing to these divergent lifespans across both race and gender will require looking into more specific subcategories. To do this, we examine mortality by age—starting with fetal and maternal health. 13 HEALTH Fetal Mortality Rate (per 1,000 pregnancies) Fetal deaths are relatively common in Pittsburgh. Pennsylvania counts fetal deaths as all pregnancies, at least 16 weeks gestation, where the fetus shows no signs of life once born. Fetal deaths are influenced by the quality of maternal health. Thus, high fetal deaths serve as an indicator of women's overall health. For Pittsburgh's Black women, 18 out of every 1,000 pregnancies end in a fetal death. This is compared to only 9 out of every 1,000 White pregnancies and 2 out of every AMLON pregnancies. Fetal deaths are 2 times more likely among Pittsburgh's Black women compared to White women. By itself, this inequality is startling. Yet, even more striking is the fact that Pittsburgh's Black Fetal Mortality fetal mortality is higher than Black fetal mortality in 94 percent of similar cities. As visualized by the long line in the graph to the right, Black women's fetal mortality varies drastically across the country. That is, some cities have as few as 5 Black fetal deaths while others have as many as 72 per 1,000 pregnancies. The bad news is Pittsburgh is in the bottom 6 percent of these cities. The good news is fetal mortality could improve with citylevel interventions. Notably, Pittsburgh's White fetal mortality also ranks in the bottom 7 percent of similar cities. Conversely, AMLON fetal mortality is average. In short, although it is most pressing for Black women, Pittsburgh's maternal health has room for improvement across all groups. 14 HEALTH Fetal deaths have a myriad of causes. Yet, contrary to Month Prenatal Care Began common assumptions, Pittsburgh's relatively high rates of fetal deaths are not due to lack of prenatal care. On average, Pittsburgh's women—across race—start prenatal care at 10 weeks. This not only demonstrates racial equality in duration of prenatal care, but Pittsburgh's women begin prenatal care sooner than women in other cities. In particular, Pittsburgh's Black women begin care sooner than Black women in 92 percent of similar cities. Prenatal Care Began Pittsburgh's women start prenatal care earlier than women in the vast majority of similar cities. 15 HEALTH Likewise, cases of gestational diabetes, hypertension, and infections are relatively equal across racial groups. Black women do experience slightly higher rates of gestational hypertension and infection whereas AMLON women experience higher rates of gestational diabetes, but Pittsburgh's women overall have fewer cases of gestational diabetes and hypertension than women in 90 percent of similar cities. Taken together, these rates suggest that inequality in prenatal care or manageable health conditions is not contributing to racial inequality in fetal demise. Gestational Diabetes Gestational Hypertension Gestational Infection 16 HEALTH Extremely Low Birth Weight Low Birth Weight (less than 1000 grams) (less than 500 grams) The observed racial inequality in fetal mortality is also present in infant health. Fourteen percent of babies born to Black mothers are born with low birth weight (less than 1000 grams or 2.2 lbs). This is twice the rate of babies born to White mothers and 1.5 times more than babies born to AMLON mothers. Moreover, Pittsburgh babies born to Black mothers are three times more likely to be under 500 grams or 1.1 lbs than babies born to White and AMLON mothers. And this inequality is not due to educational or economic differences. In fact, when only considering college educated mothers or when only considering mothers on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the inequities persist—suggesting racial inequality, not education or income, drives the observed inequities. Compared to White mothers, Black mothers are 3 times more likely to give birth to extremely low weight babies. Extremely Low Birth Weight College Educated Mothers Extremely Low Birth Weight Mothers Enrolled in WIC 17 HEALTH In addition to birth weight, infants born to Abnormal Conditions Black mothers are also more likely to have abnormal conditions (e.g., seizures, infection, needing ventilation, admission to the NICU) and congenital anomalies (e.g., Down's Syndrome, cleft palate, chromosomal disorder, spina bifida, heart diesase). Abnormal conditions are rare. Out of every 10,000 babies born to Black mothers, only 64 have abnormal conditions. Yet, this is over twice the rate for babies born to White mothers (28 in Congenital Anomalies every 10,000) and over 1.5 times the rate for babies born to AMLON mothers (39 in every 10,000). Congenital anomalies are more common, affecting 17 percent of babies born to Black mothers—which is 5 and 3 percent higher than White and AMLON mothers, respectively. These inequities are striking, particularly when we take into consideration that not all cities have such stark inequities in maternal health. For example, Pittsburgh's White women have fewer extremely under weight babies than 81 percent of cities but Pittsburgh ranks in the bottom 25 percent of cities for Black women's baby weight—making the inequality larger than 90 percent of cities. Less racial inequality exists in the rates of congenital anomalies and abnormal conditions. However, across all racial groups Pittsburgh has considerably higher rates of these conditions. In fact, for all racial groups, Pittsburgh has higher rates of congenital anomalies compared to 80 percent of cities. Extremely Low Birth Weight Abnormal Conditions Congenital Anomalies 18 HEALTH C-Section Deliveries Yet, the observed racial inequality in fetal mortality is also present in infant health. The racial inequality in infant conditions is not mirrored in delivery or breastfeeding rates. Across all three racial groups, 1 in every 3 Pittsburgh babies are delivered by C-section. This is higher than the World Health Organization's recommended rate, yet lower than 80 percent of similar cities. Conversely, the rate of breastfeeding mothers in Pittsburgh is slightly below the national average and is lower among Black and White mothers compared to their AMLON counterparts. Yet, this racial inequality dissipates for college educated women suggesting education and economic stability are key contributors to this inequality. Breastfeeding All Mothers Breastfeeding College Educated Mothers 19 HEALTH Post delivery, the racial inequality in infant health continues. Regardless of sex assigned at birth,9 13 of every 1,000 Black Pittsburgh babies die before they turn one. In comparison, 2 of every 1,000 White babies assigned female at birth, virtually no White babies assigned male at birth, and virtually no AMLON babies die before turning one. For these non-Black babies, Pittsburgh has fewer infant deaths than the vast majority of cities. Yet, for Black babies this is not true. Male Black infant mortality in Pittsburgh is average but female Black infant morality is higher than 70 percent of similar cities. Infant Mortality Rate (per 1,000 live births) Once children turn one, mortality rates decrease. However, Pittsburgh generally fairs worse in child mortality compared to other cities, and racial inequalities persist. Using this definition, 10 in every 10,000 Black boys die. This is over three times the rate of White boys (3 in every 10,000) and double the rate of AMLON boys (4 in every 10,000). Pittsburgh's male child mortality is higher than other cities; specifically Black and AMLON boys' mortality rate which is higher than 93 percent of similar cities. Mirroring national trends, Pittsburgh female mortality is lower than male mortality. However, Black girls still have a higher mortality rate than Pittsburgh's White and AMLON girls. Child Mortality Rate (per 10,000 children ages 1-17) 20 HEALTH Young Adult Mortality Rate (per 1,000 young adults ages 18 to 24) The patterns observed among Pittsburgh's children continue throughout the life course. Men continue to be more likely to die than their female counterparts. However, racial inequities are more pronounced than gender inequality. Black young men (ages 18-24) are 13 times more likely to pass away than White young men and 7 times more likely than Adult Mortality Rate (per 1,000 adults ages 25 to 64) AMLON men. Black young women die at half the rate as their male counterparts but still die at higher rates than White and AMLON men. As expected, adults (ages 2564) are more likely to die than young adults. Yet, the same race and gender patterns persist. Of course, older adults (ages 65 and older) are most likely to die. Yet, the rates still Older Adult Mortality Rate (per 1,000 elders ages 65 and over) differ by race. Black men (76 out of every 1,000) are most likely to pass away followed by Black women (47 out of 1,000), White men (34 out of 1,000), White women (30 out of 1,000), AMLON men (2 out of 1,000), and AMLON women (1 out of 1,000). It is notable that for Whites and AMLON residents gender inequality is minimal, but Black men are 1.5 times more likely to die than Black women. 21 HEALTH Not only is the mortality rate for Pittsburgh's Black men higher than the rest of Pittsburgh's population, but Black men are more likely to die in Pittsburgh than Black men in other cities. This is particularly true for adults. The mortality rate for Black men in Pittsburgh is higher than 98 percent of similar cities. In fact, this is also true for Black women. That is, Black adult women living in virtually all other cities are less likely to die than Pittsburgh's Black women. In fact, Pittsburgh consistently ranks among the worst for Black women's mortality across all age groups. On the other hand, young White Pittsburghers have a lower mortality rate than over 90 percent of cities. However, Pittsburgh's White adult morality rate is slightly higher than the majority of similar cities. This is particularly true for Black adult mortality rates are higher in Pittsburgh than in 98 percent AMLON men and women have average or above of similar average mortality rates. In particular, AMLON women cities. are less likely to die than AMLON women in the vast White older adult women who have a higher mortality rate than 65 percent of similar cities. majority of other cities. The vastly different experiences of AMLON, White and Black Pittsburghers further illustrate the anomaly of Pittsburgh's Black mortality rates. To understand these inequities further, we now turn to examining the primary causes of death in Pittsburgh. Young Adult Mortality Adult Mortality Older Adult Mortality (ages 18 to 24) (ages 25 to 64) (ages 65 and over) 22 HEALTH Cause of Death: Cardiovascular Disease (per 1,000 residents) Reflecting the national trend, cardiovascular or heart disease is the most common cause of death in Pittsburgh. Nearly 6 of every 1,000 Black men in Pittsburgh die of cardiovascular disease each year. Similarly, each year, Pittsburgh loses 5 of every 1,000 Black women to cardiovascular disease. More Black residents die of cardiovascular disease in Pittsburgh than 98 percent of similar cities. Black residents are 1.5 times more likely than their White neighbors and 6.5 times more likely than their AMLON neighbors to die of heart disease. Cancer is the next most common cause of death in Pittsburgh. Once again, we see Black residents are more likely to die of cancer than their White and AMLON neighbors, although the inequities are not as great. Pittsburgh's Black residents, White women, and AMLON men are more likely to die of cancer than their counterparts in the majority of similar cities. Cause of Death: Cancer (per 1,000 residents) 23 HEALTH Other common causes of death include: Tobacco related Tobacco (per 1,000 residents) deaths, Drug Overdoses, and Suicides. Men are more likely to die of these three causes than their female counterparts. Overall, tobacco related deaths are more common in Pittsburgh than other similar cities. Yet, this is most true for Black women. Black men and women have comparable rates of tobacco related deaths with nearly 1 in every 1,000 residents dying of a tobacco Drug Overdose (per 1,000 residents) related cause. For all men, drug overdoses are more common than tobacco related deaths. In fact, across all three racial groups, male overdose rates in Pittsburgh are higher than 92 percent of other cities. Although not as high as Pittsburgh's men, women in Pittsburgh also have high drug overdose rates relative to other cities. Finally, completed suicide also Suicide (per 1,000 residents) disproportionately affects men compared to women. Suicide is most common among White men. Yet, Pitsbrugh's White male suicide rate is lower than similar cities. In contrast, Pittsburgh has a relatively high rate of death by suicide among AMLON men, Black men and Black women. 24 HEALTH Finally, we turn to homicides. Homicides are rare occurrences. And they disproportionately affect Black men. Across all age groups, Black men are most likely to lose their life to homicide—including children and older adults. This is most true for young adults. Twentyseven out of 10,000 young Black men die by homicide. Young Black men are 42 times more likely than young White men and 11 times more likely than AMLON men to die from homicide. Although not as high as Black men, Black women also have high homicide rates across all the age groups. In fact, much like their male counterparts, Black women in Pittsburgh are more likely to die of homicide than Black women in 93 percent of similar cities. Moreover, Pittsburgh's young adults and older adults of all racial groups are more likely to die from homicide than the national average. Homicides (per 10,000 residents) Children (ages 0-17) Adults (ages 25-64) Young Adults (ages 18-24) Older Adults (ages 65 and up) 25 POVERTY AND INCOME Multiple factors contribute to the observed heath inequalities. One of these key factors is poverty. Living in poverty limits access to quality health care and balanced diets, contributing to premature deaths. Poverty also increases stress, constrains children’s educational opportunities, and much more. To measure poverty, we use the 2017 federal poverty line which classifies households as poor based on total household income and household size. For a family of four, those making less than $25,750 a year are considered poor, while single individuals must make less than $12,490 to be considered poor.10 Although not a perfect measure, the federal poverty line identifies families who do not have sufficient income to meet their basic needs. It does not, however, denote a livable wage. Some families who live above the poverty line are still not able to meet all their needs. In this way, the federal poverty line is a conservative measure of poverty, or more precisely, a measure of severe economic deprivation. In Pittsburgh, White and Black women are more likely to live in poverty than their men counterparts. However, the racial differences are much larger than the gender distinctions. Pittsburgh’s Black women are twice as likely as Pittsburgh’s White women to live in poverty. Over one-third of Pittsburgh’s Black women live below the federal poverty line. To further understand these racial and gender differences, it is helpful to examine how poverty rates differ across age cohorts. Proportion of the Population Living in Poverty 26 POVERTY AND INCOME Gender differences are smaller than Population Living in Poverty racial differences amongst children— partly because boys and girls are just as Children (ages 0 to 17) likely to be raised in poor households. Yet, Pittsburgh’s Black boys are over 6 times more likely to live in poverty than White boys. Gender differences are more pronounced among adults, but racial differences still persist. Nearly 40 percent of Pittsburgh's Black adult women live in poverty, compared to Young Adults (ages 18 to 24) only 27 percent of Black men and 8 percent of White men. In contrast, Black young adult women (ages 18 to 24) are least likely to live in poverty. The majority of impoverished individuals in this age category are college students who live on their own but have limited or no income. This explains the high number of AMLON young men living in poverty Adults (ages 25 to 64) —many of whom are international students. In fact, this group is why AMLON men overall are slightly more likely to live in poverty than AMLON women. Pittsburgh's Black adult women are 5 times more likely to live in poverty than White adult men Older Adults (ages 65 and over) 27 POVERTY AND INCOME Poverty (Total Population) Putting Pittsburgh's poverty in the context of other U.S. cities, we see across all groups Pittsburgh has higher poverty rates than the average city. Even White men who are doing the best of our six groups, rank in the bottom third of U.S. cities. Pittsburgh's Black women not only have higher poverty than others in Pittsburgh, but their poverty rates are higher than Black women in most cities. In fact, Black women in 85 percent of U.S. cities are doing better than Black women in Pittsburgh. Although Black women have the lowest ranking, Black men and AMLON men are not far behind. Black women's poverty is higher in Pittsburgh than 85 percent of cities. Childhood Poverty Similar to overall poverty rates, childhood poverty is also higher in Pittsburgh than in most cities. Pittsburgh's poverty rate for White boys is average compared to other cities, but poverty rates for all other groups fall below average. Black boys and Black girls have particularly low rankings. Poverty rates among Black boys are higher in Pittsburgh than 96 percent of U.S. cities. In other words, Black children in virtually all U.S. cities are less likely to live in poverty than Pittsburgh's Black children. More Black children in Pittsburgh grow up in poverty than 95 percent of similar cities. 28 POVERTY AND INCOME White-Black Inequality in Poverty Pittsburgh's Black poverty rates are striking. However, it could be the case that White-Black inequality in Pittsburgh is similar to other cities and Pittsburgh's higher overall poverty creates the striking Black rankings. To differentiate whether the high Black poverty in Pittsburgh is mainly due to Pittsburgh's overall poverty or an unusually high inequality between Whites and Blacks, we compare White-Black inequality across U.S. cities. Across gender and age categories, White-Black inequality in poverty rates is notably higher in Pittsburgh than most cities. This is particularly true for the inequality between Black and White boys. Ninety-eight percent of cities have more equality between White and Black boys than Pittsburgh. Gender Inequality in Poverty Unlike racial inequality, gender inequality in Pittsburgh is varied. Pittsburgh's gender inequality within the Black population is average compared to other cities while Pittsburgh ranks in the top 10 percent for equality among AMLON men and women. Conversely, Pittsburgh ranks in the bottom 20 percent of cities when it comes to White gender equality. Together, this demonstrates that both overall poverty rates and inequality between groups contribute to Pittsburgh's low rankings. Additionally, this highlights that compared to White men in other cities, Pittsburgh's White men are even more privileged than the remainder of Pittsburgh's population—including White women and people of color. 29 POVERTY AND INCOME Median Annual Income for All Workers As discussed above, the definition of poverty takes into account both income and family size which is important for understanding lived realities. Yet, to understand how inequality manifests specifically in income, we now examine income inequality explicitly.11 Pittsburgh's women make less than men in every racial group. However, both White men and White women make more than AMLON men and women who both make more than Black men and women. On average, White men make $8,000 more than White women, $12,000 more than AMLON men, $15,000 more than AMLON women, $16,000 more than Black men, and $17,000 more than Black women. Said another way, White men make nearly twice as much as Black women. Activists commonly discuss wage gaps as the number of cents women make compared to every dollar made by men. Using this metric, Pittsburgh’s White women make only 78 cents to every dollar Pittsburgh’s White men make—which is similar to the national average. However, when we compare Black women to White men, we see they make only 54 cents to every dollar Pittsburgh's White men make and AMLON women make only 59 cents to every dollar Pittsburgh's White men make. This once again emphasizes the persistent gender Pittsburgh's White women make  78 cents to every dollar made by Pittsburgh's White men; Black women make 54 cents. and racial inequalities in Pittsburgh. 30 POVERTY AND INCOME The median annual income across all workers, presented previously, is a helpful overview. Yet, some of this inequality is due to the fact that women disproportionately conduct unpaid labor, like taking care of family members. As a result, women are more likely to work part time with lower annual incomes. To differentiate how much of the observed inequality is due to women spending fewer hours conducting paid labor, we now examine the median income of full time workers. As expected, across all categories the income of full time workers is higher than their part time counterparts. The gender inequality across all racial groups persists. However, patterns across racial groups are slightly different. Median Annual Income for Full Time Workers Full time AMLON men and women make more than White women. This suggests that much of the inequality between White women and AMLON individuals is due to lower wages among part time AMLON workers. Additionally, the gender pay gap decreases among AMLON individuals when only the full time workers are considered. Yet, full time Black and White workers have larger gender gaps than their overall populations. Specifically, the gender pay gap for Black workers nearly doubles from $1,600 across all workers to $3,600 for full time workers. Suggesting gender inequality within the Black community has less to do with who is working full time and more to do with equitable pay for comparable hours worked. To unpack these differences further, we once again use the cent-to-dollar ratio. 31 POVERTY AND INCOME Income Compared to White Men's Dollar for Full Time Workers Full time White women make 86 cents to every dollar made by White men working full time. AMLON men make 91 cents to every dollar White men make and AMLON women make 87 cents to every dollar made by White men. Likewise, Black men working full time make only 70 cents and Black women only make 63 cents to every dollar Gender Inequalities Within Race made by White men. Clearly the racial differences continue to be most striking. But it is important to note that within each racial group gender inequality persists. Much like with poverty, this gender inequality is greatest within the White population. As just noted, White women make only 86 cents to every dollar made by White men. Gender parity is greater among the Black and AMLON, with Black women making 90 cents to every dollar made by Black men and AMLON women making 96 cents to every dollar made by AMLON men. 32 POVERTY AND INCOME Like poverty, Pittsburgh's income ranks on the Income (All Workers) lower end of U.S. cities. This is partly due to low cost of living relative to other cities. Yet, Black Pittsburghers have lower relative income than their White counterparts. Black women in 90 percent of cities have higher median income than the Black women in Pittsburgh. Black women in 90 percent of cities have higher median income than Black women in Pittsburgh. Despite the relatively low income for all of Pittsburghers, inequality between groups is on par or better than other cities. This is particular true for racial inequality between Black and White women and gender inequality between Black men and Black women. Racial inequality between Black and White men and gender inequality between White Pittsburghers and AMLON Pittsburghers is lower than two-thirds of U.S. cities. White-Black Inequality in Income Gender Inequality in Income 33 EMPLOYMENT Income, poverty, and health are all influenced by and influence residents' employment. Thus, to further unpack the factors contributing to observed inequities we explore employment. Explicitly examining employment helps us illuminate to what extent the observed inequalities are the product of employers' inequitable hiring versus their compensation practices. As seen in the graph below, 67 percent of Pittsburgh's White men are employed—the highest proportion across all six categories. At 63 percent, AMLON men are the next most likely to be employed. White and AMLON women are less likely to be employed than their male counterparts. In fact, as observed with median income, gender inequality is greatest among Whites. Yet, for Blacks the story is reversed. Black women are slightly more likely to be employed than Black men with 49 compared to 47 percent of the population. However, the largest inequities are, once again, not between gender categories but by race and, more specifically, the difference between the Black population and everyone else. Understanding this inequality requires a more detailed assessment regarding who is not employed because of their decision to leave the work force versus who is actively seeking a job but is unable to obtain work. Proportion of the Population Employed 34 EMPLOYMENT Looking for Work Young Adults (ages 16 to 24) Adults (ages 25 to 64) Out of the Labor Force Young Adults (ages 16 to 24) Adults (ages 25 to 64) Across all the racial groups, men are more likely than women to be unemployed and actively searching for work. This is particularly true for the Black population. Black men are the least likely to be employed and most likely to be actively looking for work—meaning they have applied and interviewed for jobs in the last month. Young Black men (ages 16 to 24) are particularly likely to be actively searching for jobs (three times more likely than White men) and least likely to be out of the labor force. Yet, with persistently high unemployment, adult Black men (ages 25 to 64) are still the most likely to be actively looking for work but also the most likely to have left the labor force all together. Black women, on the other hand, are much more likely to be out of the labor force in young adulthood—in part due to their enrollment in higher education. Yet, like their male counterparts, Black women ages 25 to 64 are more likely than any other group to be actively looking for work and to be out of the labor force, illustrating that some inequality in poverty and income is due to Black workers not being hired even when actively searching for work. For Whites and AMLON, young women and men have comparable proportions of the population out of the labor force. Yet, White and AMLON women older than 25 are more likely to be out of the labor force and less likely to be looking for work. Together, this highlights employment is not simply gendered or racialized, but rather that it is the intersection of these factors with age that shapes who is employed. 35 EMPLOYMENT Employment Comparing Pittsburgh's employment to other cities, we see that White and AMLON women have above average employment rates in Pittsburgh. Yet, Black women, Black men, and men of other races have lower employment rates in Pittsburgh than other similar cities. Pittsburgh is in the bottom 15 percent of cities for Black employment. 85 percent of cities have higher Black employment than Pittsburgh. Gender equality in employment is relatively high in Pittsburgh, especially among AMLON residents. This is due to relatively high employment among AMLON women and low employment among AMLON men. Although still above the average city, White gender equity ranks lower in comparison to other cities than Black and AMLON gender equity. Gender Inequality Racial equality in employment, on the other hand, is lower in Pittsburgh than other similar cities. For both men and women, the White-Black gap in employment is higher in Pittsburgh than 85 percent of similar cities. This reinforces White-Black Inequality that Pittsburgh's strikingly low Black employment is likely not due to the city's economy, but the failure of employers to hire Black workers who are seeking jobs. 36 EMPLOYMENT Looking for Work Out of the Labor Force Pittsburgh's women are less likely to be actively looking for work (as indicated by diamonds to the right of the center indicating Pittsburgh is doing relatively well) than women in other cities. This pattern is extremely gendered. Women of all races are less likely to be actively looking for work in Pittsburgh than women in 80 percent of similar cities. Conversely, Black and AMLON men are more likely than their counterparts in other cities to be unemployed and actively looking for work. Likewise, compared to other cities, Pittsburgh's men are also more likely to be out of the labor force all together. This includes individuals who have left the labor force to conduct unpaid labor like child-rearing or elder-care and those who have given up on finding employment. However, for Pittsburgh's women, it depends on the racial group. White and AMLON women are less likely than White and AMLON women in other cities to be out of the labor force while a higher proportion of Pittsburgh's Black women are out of the labor force than Black women in 97 percent of similar cities. Pittsburgh has more Black women out of the labor force than 97 percent of cities. 37 EMPLOYMENT Occupations with Median Income above $50,000 Lawyers Computer Programmers Mathematicians Architects Engineers Scientists Police Business and Finance Doctors and Nurses Athletes and Artists Occupations with Median Income between $30,000 and $50,000 Construction Workers Contractors Farmers and Fishers Teachers Social Service Workers Sales Office Administrators Maintenance Fire Fighters Transit Workers Factory Workers Occupations with Median Income less than $30,000 Heath care support Personal care workers Cooks Servers Caterers Custodians Having the opportunity to work is critical for staying out of poverty and maintaining healthy lifestyles. Yet, not all jobs are created equal. To further unpack the distribution across job types, we categorize occupations by their median income. Jobs like lawyers and engineers which pay on average above $50,000 a year are disproportionately filled by Pittsburgh's White men. Conversely, jobs that pay less than $30,000 a year (e.g. health care support workers, servers, and custodians) are disproportionately filled by Pittsburgh's Black population. White and AMLON women are also more likely than their male counterparts to be employed in low versus high paying occupations. 38 EMPLOYMENT Occupations with Highest Concentrations White Men 1. 2. 3. 4. 5. Farmers/Fishers Construction/Contractors Police Lawyers Computer Programmers Black Men 1. 2. 3. 4. 5. 1. Office Administrators 2. Social Service Workers 3. Health Care Support 4. Doctors and Nurses 5. Teachers Black Women Maintenance Fire Fighters Factory Workers Food Service Construction/Contractors AMLON Men 1. 2. 3. 4. 5. White Women 1. Health Care Support 2. Personal Care 3. Office Administrators 4. Maintenance 5. Factory Workers AMLON Women Police Computer Programmers Teachers Fire Fighters Sales 1. 2. 3. 4. 5. Fire Fighters Doctors and Nurses Entertainment Teachers Sales Taking a more granular approach, we examine where workers of each group are clustered. Occupational Work Segregation segregation occurs across gender and race categories. Some occupations like construction, for men, and office administrators, for women, are gendered, while others like maintenance and factory workers are clustered more by race. Using an occupational segregation index, we see segregation is fairly high for all six groups. Yet, this is true across the nation. In fact, when we compare Pittsburgh's occupational segregation to other cities, we see Pittsburgh's White work force is more equally distributed across occupational categories than 90 percent of other cities. Yet, our Black workforce, in particular Black men, is more concentrated than the Black male workforce in 99 percent of other cities. 39 EDUCATION Employment and occupational inequality are due to many factors, including differential access to the networks that have information and connections to jobs as well as employers’ biases in the application process. Yet, they are also due to differences in educational attainment. To be a lawyer, accountant, or doctor, individuals need to obtain the requisite degrees. Thus, inequality in Pittsburgh's education contributes to inequality in employment, leading to inequality in poverty and health outcomes. Further, holding income and occupation constant, education is also related to mental and emotional health. Recognizing the important role of education, in this section we examine educational inequality in Pittsburgh. We begin by looking at the adult population's (those 25 years old or older) educational attainment. In this way, we isolate those who are in the workforce from young adults who are more likely to still be pursuing their education. We then turn to our public school children and what opportunities Pittsburgh is providing the next generation. 40 EDUCATION Proportion with a Bachelor's Degree Gender equality in bachelor's and graduate degrees is extremely high in Pittsburgh. Few differences exist across men and women. Yet, the racial inequality is striking. White residents are nearly 3 times more likely, and AMLON are 3.5 times more likely, than Black residents to have a bachelor's degree. Similarly, White residents are 3.5 times more likely and AMLON are 5 times more likely than Black residents White residents are 3 times more likely to have a college degree than Black residents to obtain a graduate degree. Proportion with a Graduate Degree 41 EDUCATION Those Who Did Not Finish High School Racial inequality is also present among those with less education. The majority of all Pittsburghers finish high school, but Black men are twice as likely as Black women to drop out of high school and 2.5 times more likely than White students. Sixteen percent of Black men in Pittsburgh do not have a high school diploma or GED. Across all groups, boys are more likely to drop out of school than girls. Yet, of the students who finish high school, men are more likely to attend college. AMLON men and women are most likely to attend college (92 and 87 percent respectively) followed by White students. Although Black students are less likely than their classmates to continue, the majority of Black students who finish high school attend college. High School Graduates Who Attend College Men are less likely to finish their degrees but when they do they are more likely to pursue further education. College Attendees Who Do Not Finish Bachelor's Like with high school, men are more likely than women to not finish their bachelor's. Yet, the larger inequities exist across racial categories. Over 60 percent of Black students drop out, which is over double the rate for White and AMLON students. In short, the majority of Black students who finish high school start college but only 40 percent finish. 42 EDUCATION Bachelor's Degree The proportion of Pittsburgh's residents with bachelor's degrees is higher than most cities. Specifically, Pittsburgh's White population is more likely to have a bachelor's degree than White populations in other similar cities. Additionally, Pittsburgh ranks first for the proportion of AMLON populations with bachelor's degrees. Even Pittsburgh's Black men are more educated than Black men in 60 percent of similar cities. Yet, when it comes to Black women the story is reversed. 60 percent of cities have higher college completion rates for Black women than Pittsburgh. The story is fairly comparable for graduate degrees. Relative to other cities, Pittsburgh ranks even higher for Black men with graduate degrees but still falls below average for Black women. Predictably, the inequality rankings demonstrate Pittsburgh's relative advantage between White and Black men but relative Graduate Degree disadvantage between White and Black women. Yet, what is perhaps even more noteworthy is Pittsburgh's higher rankings for education than employment or income. Pittsburgh has a relatively educated population but this is not translating into equality in the workplace. Pittsburghers are more educated than most, except for Pittsburgh's Black women who have less education than Black women elsewhere. 43 EDUCATION Didn't Finish High School Although Pittsburgh's White men, White women, and Black men have above average proportions of residents with bachelor's degrees, high school drop out rates among these groups in Pittsburgh are also slightly higher than average. Yet, Pittsburgh's Black and AMLON women have relatively low drop out rates. This suggests that Pittsburgh's Black women's low higher educational attainment is not due to their failure to finish high school. Didn't Finish Bachelor's Attend College Instead, what we see is that, compared to Black women in other cities, Pittsburgh's Black women who finish high school are less likely to go to college. Although not nearly as dramatic, we see the same pattern among Pittsburgh's White women who, compared to their male counterparts, are less likely to go to college. Once Pittsburgh's women go to college, their completion rates are similar to those found across the country. 44 EDUCATION Passed At Least One AP Test Took AP or IB Course Having examined adult educational attainment in Pittsburgh, we now turn to exploring our public school students in order to illuminate possible origins of the observed inequities. One way researchers measure student achievement in high school is Advanced Placement (AP) tests. AP tests are standardized college preparatory tests that cover a wide range of topics. In Pittsburgh's public high schools, 7 percent of White students received a passing score on at least one AP exam. This is over twice the passing rate of AMLON students and over 7 times the zero percent of Black students who passed these exams. High school girls are considerably more likely to take college prep courses and tests but this does not translate into advantages post-high school. Part of this inequality is due to students not getting equal access to college preparatory courses—both AP and International Baccalaureate (IB) classes. White students are most likely to be enrolled in these courses as well as signed up to take ACT and SAT tests. Yet, for both accelerated courses and ACT/SAT tests, there are notable gender differences, with girls being more likely to take these classes and tests than their male counterparts. Proportion of High Schoolers Who Took SAT or ACT Test Photographer: Megan Palmiter 45 EDUCATION Pittsburgh's enrollments in college preparatory courses and the corresponding inequities are comparable to similar cities. Across all six groups, enrollment in these courses is at or near the 50 percent mark—suggesting half the cities have more and half the cities have fewer students enrolled in these courses. However, when it comes to passing AP tests, Pittsburgh's students are below average. Black girls in Pittsburgh are less likely to pass AP courses than Black girls in 98 percent of cities. This highlights that while students are enrolled in these courses, they are not being equipped with the tools to pass the associated tests. Finally, Pittsburgh's students across groups admissions tests as their counterparts in true for Pittsburgh's girls, who are are not as likely to take these college other similar cities. This is particularly even less likely than girls in other cities to take these tests. Pittsburgh's high schools rank in the bottom 20% for students taking ACT/SATs. AP or IB Class Passing AP SAT or ACT 46 EDUCATION Enrolled in 8th Grade Alegbra Passed 8th Grade Algebra Even before students get to high school, early tracking into advanced classes influences their high school performance and eventual college preparedness. The most common early tracking of students occurs with middle school algebra. Although students might be placed in other advanced classes, algebra is the most consistent course across the country. In Pittsburgh, middle school boys are more likely to be placed in algebra than their girl counterparts. Five percent of White and AMLON boys are enrolled in middle school algebra. This is compared to only 3 percent of Black students and 4 percent of White and AMLON girls. Despite these inequalities in enrollment, Black students enrolled in middle school algebra are almost as likely as their White classmates to pass. Moreover, girl students are more likely to pass the course, even though their enrollment is lower. In fact, Black girls are more likely to pass than middle school White boys. Girls are less likely to be enrolled in middle school algebra despite being more likely to pass, Photographer: Megan Palmiter 47 EDUCATION Before middle school, students often receive advanced instruction if they are enrolled in Gifted and Talented programs. These programs are designed to challenge students showing aptitude in particular subjects. How students are selected for the programs varies across schools, but research demonstrates racial and gender biases influence these decisions. Pittsburgh reflects these national patterns, with White students almost 5 times more likely to be selected for such programs than their Black classmates and 3 Enrollment in Gifted and Talented Programs times more likely than their AMLON classmates. Although girls are slightly more likely than boys to be enrolled in these programs, the more noticeable differences are across race. Likewise, across all grades, students of color are much more likely to be held back in school than their White classmates. Black boys, in particular, are twice as likely to be held back as their White peers. Grade Retention Rates Photographer: Megan Palmiter 48 Gifted and Talented EDUCATION As mentioned previously, the inequality we observe in Pittsburgh's classrooms is a common pattern across the country. However, Pittsburgh's inequality is higher than in similar cities. In Pittsburgh, an above average proportion of White students and AMLON students are enrolled in Gifted and Talented programs. Pittsburgh's Black students are enrolled in these programs at similar rates to other cities. Yet, this gap makes the racial inequality in Gifted and Talented programs greater in Pittsburgh than in over 70 percent of similar cities. Retention Algebra Enrollment Conversely, compared to other cities, Pittsburgh's middle schoolers are less likely to be enrolled in algebra across all the racial and gender categories. This is particularly true for White girls. Pittsburgh's grade retention rates are at or below average, with fewer students being held back than the majority of cities. Yet, Pittsburgh's rankings are consistently lower for girls than their male classmates. Across all groups, Pittsburgh's students are less likely to be enrolled in middle school algebra than students in other cities—especially Pittsburgh's girls. 49 EDUCATION DISCIPLINE Finally, to understand educational opportunities for our students we need to consider school discipline. Although discipline is used to address inappropriate or dangerous behavior, researchers have repeatedly demonstrated that students of color are more likely to be disciplined than White students who commit the same transgressions. Discipline that takes students out of the classroom interferes with students' educational success. Pittsburgh's boys are more likely to be suspended than their same race girl classmates. Yet, girls of color are more likely to be suspended than White girls. In fact, Black girls are more likely to be suspended than AMLON or White boys. One in five Black girls and one in three Black boys enrolled in Pittsburgh's public schools are suspended at least once during the school year. Black boys are 4.5 times more likely to get suspended than White girls. At Least One Suspension Photographer: Megan Palmiter 50 EDUCATION More than One Suspension Similar patterns play out for the more extensive punishments. Yet, as punishments go from multiple suspensions, to police referrals, to arrest, the gender inequality decreases and the racial inequality increases. Black boys are seven times more likely than White girls to be Police Referrals suspended multiple times in one school year. Black boys and girls experience the same number of police referrals and arrests, at rates 3 to 5 times their White classmates. Thus, while overall girls are less likely than boys to be disciplined, Black girls experience the harshest punishments at School Related Arrest the same rate as Black boys. It is also noteworthy that other students of color experience higher multiple suspensions, referrals to police, and arrests than their White classmates. Photographer: Megan Palmiter 51 EDUCATION Pittsburgh's public schools refer more students to police than 95 percent of school districts in similar cities. Generally speaking, Pittsburgh has average suspension rates across all groups. This means the inequalities observed above reflect national patterns. This is reflected in the inequality rankings that demonstrate Black-White inequality in Pittsburgh is lower than 70 percent of cities. Yet, it is noteworthy that the ranking of Pittsburgh's suspension rates for girls is worse than Pittsburgh's ranking for boys. Unlike suspension rates, Pittsburgh's schools stand out for their high referrals to police. Across all groups Pittsburgh's schools are referring students to police more often than 95 percent of other school districts. For Black girls, Pittsburgh refers more Black girls to the police than 99 percent of similar cities. Suspensions Police Referrals 52 SUMMARY In recent years, the City of Pittsburgh has seen an increase in prosperity, amenities, and quality of life. In fact, as noted in the introduction, it has been ranked one of the most "livable" cities in the United States. However, prosperity, amenities, and quality of life are not equally shared across all of Pittsburgh residents. To explore whether Pittsburgh's livability varies across subgroups, this report examined the health, income, employment, and education of Pittsburgh's White men, White women, Black men, Black women, AMLON (Asian, Multiracial, Latinx, Other, and Native American) men, and AMLON women. Overall, Pittsburgh's White men experience more economic privileges than White women and residents of color. White women, on the other hand, have more favorable health outcomes than White men and residents of color. And the group with the most favorable educational outcomes depends on the specific indicator being considered. These descriptive overviews are helpful to illuminate persistent disparities within Pittsburgh. However, these inequities are the result of both national and local policies and practices. Thus, to help illuminate Pittsburgh's specific strengths and weaknesses, we ranked Pittsburgh's livability on each indicator for each group. As discussed in the introduction, to derive this ranking, we first compare Pittsburgh to 89 similar cities and calculate the proportion of cities that perform more favorably than Pittsburgh. We then weight the proportion by the indicator's range. This weight helps us identify which indicators vary based on local (compared to national) factors. Together, our weighted proportion—or ranking— helps identify the areas where Pittsburgh is more Pittsburgh is average or less livable than similar cities. Although we have presented these rankings throughout the report, this final section focuses on them more explicitly. To do this, we rearrange the rankings and examine the various indicators for each subgroup. Additionally, we add a grey Area for improvement bar to the visualization. This grey bar represents the average city. All indicators to the right of this bar symbolize Pittsburgh's strengths. Indicators to the left of the bar suggest areas where Pittsburgh should strive to improve. A Strength in Pittsburgh 53 SUMMARY White Men First, we consider Pittsburgh's livability for White men. For the vast majority of our key indicators, Pittsburgh has an average ranking. In other words, Pittsburgh's livability for White men is comparable to the majority of other cities. However, there are three notable strengths and three areas for improvement. For White men, Pittsburgh has higher than average livability rankings on infant deaths, young adult deaths, and occupational segregation. That is, compared to White men in other cities, Pittsburgh White male infants are less likely to die, as are Pittsburgh's White young adult men. Additionally, Pittsburgh's working White men are spread relatively equitably across different industries. Conversely, White men in Pittsburgh have relatively low enrollment in middle school algebra and college admissions tests. They also experience high police referrals. In short, Pittsburgh is a livable city for White men, scoring on or above average for most indicators. Pittsburgh could improve its livability for White men with a few educational interventions. 54 SUMMARY White Women Much like Pittsburgh's rankings for White men, Pittsburgh has average livability rankings for White women. However, Pittsburgh does have ten notable strengths and four areas of needed improvement. Pittsburgh's White women have lower rates of gestational diabetes, gestational hypertension, C-section deliveries, babies with extremely low birth weight, deaths related to pregnancy, infant deaths, and young adults deaths. Likewise, Pittsburgh's White women are employed across occupational industries, have high rates of graduate degrees and low rates of college drop out. These strengths should be praised and built upon. Conversely, Pittsburgh should aim to improve the rate of congenital anomalies (e.g., folic acid supplementation) in babies born to White women, the proportion of White girls enrolling in middle school algebra, college admissions exams, and passing advanced placement courses. In summary, Pittsburgh's livability for White women is similar to other cities with a particular strength in maternal health and higher education—reflecting Pittsburgh's strength in the "Eds and Meds" sectors. 55 SUMMARY Black Men Unlike Pittsburgh's average livability rankings for White residents, Pittsburgh ranks below average for Black men on the majority of indicators. Pittsburgh has only one notable strength when it comes to livability of Black men and 15 areas for improvement. Pittsburgh has a higher proportion of Black men with graduate degrees than most cities, which is likely a reflection of the higher education, technology and medical industries that recruit highly educated Black employees. Conversely, for Black men Pittsburgh ranks relative low on childhood, adult and older adult mortality, cardiovascular disease, cancer, drug overdoses, suicide, homicide, poverty, median income, employment rate, those still looking for work, occupational segregation, proportion taking college admissions tests, and referrals to the police by school officials. In short, Pittsburgh is considerably less livable for Black men than other similar cities. This is particularly true when it comes to health and employment outcomes. 56 SUMMARY Black Women For Black women, the story is similar. Pittsburgh's Black women have less favorable outcomes than Black women in the vast majority of US cities. Despite these 22 areas for improvement, Pittsburgh does still have four notable strengths. Black women in Pittsburgh have lower than average rates of gestational diabetes, gestational hypertension, gestational infection, and high school dropouts. However, for the vast majority of outcomes, Pittsburgh's Black women have lower livability rankings than the majority of cities. These outcomes include: fetal death rates, abnormal conditions, congenital anomalies, maternal mortality, death rates among young adults, adults and older adults, cardiovascular diseases, cancer, tobacco related deaths, suicide, homicide, poverty, child poverty, income, employment rates, proportion out of labor force, proportion passing advanced placement tests, taking college admissions tests, and referrals to the police by school officials. Pittsburgh is arguably the most unlivable for Black women. Interventions should strive to improve life in the city by targeting these indicators. 57 SUMMARY AMLON Men The livability of Pittsburgh for AMLON men varies depending on the indicator. Pittsburgh has seven notable strengths and seven areas for improvement. Pittsburgh's strengths include: low infant death rates, high income for full time workers, low occupational segregation, high proportions of bachelor's and graduate degrees, and low high school and college dropout rates. Yet, Pittsburgh also has room for improvement. Compared to other cities, AMLON men in Pittsburgh have high rates of mortality in childhood, tobacco related deaths, suicide, poverty, child poverty, unemployment, out of the labor force, referrals to police by school officials and low rates of taking college admissions tests. The relatively high educational attainment and occupational integration of Pittsburgh's AMLON men, along with the relatively high poverty, unemployment, and suicide, suggest a bifurcation of experiences for AMLON men in Pittsburgh. This might be due to diversity within the AMLON classification that needs to be further examined to identify what factors can improve livability for this group of Pittsburghers. 58 SUMMARY AMLON Women On our livability indicators for AMLON women, Pittsburgh has 14 strengths and five areas for improvement. Pittsburgh's strengths include: the low rates of gestational diabetes, gestational hypertension, infant, child, young adult, and adult deaths, suicide, homicide, occupational segregation, college and high school dropouts; high rates of bachelor's and graduate degrees; and high average income for full time workers. Pittsburgh can strive to improve on the rates of AMLON women having babies born with congenital anomalies, living in poverty and child poverty, passing advanced placement courses and taking college admissions exams. Once again, much like AMLON men, the divergent outcomes of AMLON women suggest more needs to be unpacked to understand the diversity of lived experiences among AMLON women in Pittsburgh. In particular, future research should differentiate the experiences of AMLON residents growing up in Pittsburgh compared to those who moved to Pittsburgh as adults with advanced degrees. 59 SUMMARY Pittsburgh's Strengths Our results confirm that Pittsburgh stands out as an exceptional place to live on some indicators. Below are the outcomes with the highest IRL rankings: #2 #1 #3 Low High School Dropout Low Suicide Rates Low Young Adult Mortality for AMLON students & Black women for AMLON Women for AMLON & White women #4 #5 Low Infant Mortality Bachelor's Degrees for AMLON & White men for AMLON residents #6 Low Rates of Gestational Hypertension for White & AMLON women #8 #7 Low Occupational Segregation Low Maternal Mortality for White women #9 Graduate Degrees for AMLON adults & Black men for White & AMLON workers #10 Low Childhood Mortality for AMLON girls 60 SUMMARY Indicators with Room for Improvement Likewise, our data demonstrates several areas where Pittsburgh should improve its livability. #1 #3 #2 Maternal Mortality Low Rates in the Labor Force for Black Women Occupational Segregation for Black Men for Black Women #4 #5 Poverty Homicide for Black Children and Black Women for Black Men #6 #8 Tobacco Related Deaths #7 Cancer for Black Men for Black Women #9 Low Average Income for Black Men Low College Admissions Tests for all students #10 Cardiovascular Disease for Black Men 61 CULTIVATING LIVABILITY To achieve Pittsburgh's goal to be a city that is livable for all residents, the City will need to address several of these areas for improvement. Recognizing that previous research has shown how several of these indicators are interconnected, we summarize where the city might focus attention to begin to address Pittsburgh's ongoing gender and racial inequality. Despite state of the art health 1 Black Women's Maternal Mortality care, Pittsburgh's Black maternal mortality is higher than the vast majority of cities. High maternal mortality is caused by several factors, including health care providers' stereotypes of Black women that influence diagnoses and care.12 Additionally, stress—particularly the stress related to racially charged assumptions, comments, and discriminatory behavior—has negative effects on health.13 Pittsburgh should consider targeted interventions that address the racially discriminatory biases in the health care system, increase the number of Black health care providers, and reduce broader socioeconomic inequities faced by Pittsburgh's Black women. Although Pittsburgh's Black women are similarly educated to Black women in other cities, they are much more likely to be under or unemployed. Despite applying for jobs, Pittsburgh's Black women are not securing employment. This 2 Black Women's Employment and Poverty contributes to their high poverty and the high poverty rates of their children. Poverty, under and unemployment, and corresponding stressers also contribute to high tobacco use and eventual death.14 The City should consider interventions that incentivize and/or regulate employment practices to ensure Black women are receiving well-paying employment opportunities. For possible policy interventions, the City should examine practices in Raleigh, North Carolina and Virginia Beach, Virginia, which both have low poverty and high employment rates among Black women. 62 CULTIVATING LIVABILITY Pittsburgh's Black men are highly 3 Black Men's Occupational Segregation segregated into a few occupational sectors. These sectors are also disproportionately those with lower incomes—contributing to the lower than average income for Pittsburgh's Black men. Ensuring Black men are not only employed but employed across occupational sectors will reduce socioeconomic inequality. As Pittsburgh considers ways to foster occupational integration, the City might consider how Los Angeles, Houston, and San Antonio have maintained low occupational segregation for Black men. Pittsburgh has one of the highest Black male homicide rates in the country. In fact, only Miami, Florida, Fort Wayne, Indiana, and St. Louis, Missouri have higher rates. As with the other indicators discussed here, 4 Black Men's Homicide factors contributing to homicide are multilayered. Addressing the broader occupational and socioeconomic inequality faced by Pittsburgh's Black men will certainly help reduce rates of homicide. However, the City should also consider targeted interventions to address these reoccurring tragedies. Cities with low Black male homicide rates such as New York, Tallahassee, Florida and Virginia Beach, Virginia might provide insights into how Pittsburgh can reduced homicide rates among Black men. The stress of economic insecurity 5 Black Men's Cancer and Heart Disease and environmental hazards more common in certain occupations are likely contributing to Black men's higher rates of cancer and cardiovascular disease.15 However, future research should investigate the primary causes of these conditions in Pittsburgh. Based on this future research, interventions should strive to adjust environmental and socioeconomic factors contributing to the abnormally high rates of cancer and cardiovascular disease in Pittsburgh's Black men. 63 CULTIVATING LIVABILITY Across all six groups, Pittsburgh ranks lower than most cities in the percent of students who take the ACT or SAT. However, the data we are using for this report are from the 2015-2016 school year. These 6 College Admissions Exams are the most recent data available (see Appendix C). Last academic year (2018-2019), Pittsburgh Public Schools transformed their process for administering the ACT and SAT tests. These interventions have increased the percentage of students taking the exams. This is exactly the kind of intervention that can address the observed inequities in this report. Future research will illuminate whether the new approach has reduced differences between Pittsburgh and other cities or whether additional interventions are needed. Pittsburgh's Black girls are less 7 likely than Black girls in other College Bound Black Girls cities to drop out of high school or college once they begin. However, fewer of Pittsburgh's Black girls go on to college after finishing high school. Additionally, Pittsburgh has one of the lowest rates of Black girls passing Advanced Placement tests in high school. Pittsburgh should consider new interventions that target Pittsburgh's Black high school girls to encourage, equip, and support them to enter college after graduating high school. Pittsburgh students, no matter their race or gender, are more likely to be referred to the police than students in other cities. Although discipline in schools is important, police referrals are disproportionately affecting 8 Police Referrals in Schools Pittsburgh's Black children and have a lasting impact on their educational attainment and economic well-being.16 Thus, Pittsburgh's schools should consider new policies that reduce police referrals and severe discipline across the board as well as targeted efforts to address racial and gender biases in the schools' disciplinary practices. 64 CULTIVATING LIVABILITY Based on the results of this report, these eight areas are the most pressing concerns that need to be addressed to increase Pittsburgh's livability. However, it is critical to note effective interventions will require a recognition of the structural factors contributing to the observed disparities. For example, often when issues like Black maternal mortality, unemployment, and poverty are discussed, policymakers and organizations default into individualistic social capital models that encourage Black women to seek earlier prenatal care, provide job readiness training, or resource assistance programs for impoverished women. Under certain conditions, these approaches can have some beneficial effects on residents' well-being. However, as we demonstrate in this report, Pittsburgh's high rates of Black maternal mortality are not the result of Black women's lack of access to prenatal health care. Likewise, Black women's unemployment and poverty are not explained by their educational levels. Instead, Pittsburgh's Black women have poor health and economic outcomes because of the individual and structural racism and sexism they face. Thus, effective interventions will aim to transform the institutions that perpetuate these inequities, not the individuals who experience the exclusion and marginalization. Addressing systematic exclusion and marginalization will require multifaceted approaches aimed at increasing residential integration, awareness, resources, and new systems of regulation. A creative intervention could include providing tax incentives for companies and organizations who hire and pay employees equitably across gender and race categories. This includes paying employees with the same job titles equitably. It also includes hiring and pay practices that result in equal proportions of women and men, White, Black, and AMLON workers filling positions at all levels and pay scales. Well constructed policies that ensure the City government itself as well as our local institutions are hiring and paying residents equally will go a long way in fostering livability for all residents. Comprehensive policies like these that push for institutional transformation are often seen as impossible and unattainable. Yet, Pittsburgh's own history proves this wrong. In the early 20th century, Pittsburgh's unions and labor movement led the way in fighting for livable wages and working conditions. Once again, Pittsburgh can lead the way. Pittsburgh is a city of much promise and possibility with state of the art universities, medical institutions, and technology companies. These strengths can be harnessed to fight for a city that is livable for all residents across gender and racial categories. 65 NOTES 1 As it has been covered in multiple news outlets, Pittsburgh has been ranked one of the most livable U.S. cities by the Economist Intelligence Unit's Global Livability Index. For example see, Eberson, Sharon. 2018. "Pittsburgh Is The No. 2 Most Livable City in America." Pittsbrugh Post-Gazette. https://www.postgazette.com/local/neighborhood/2018/08/20/Pittsburgh-No-2-most-livable-city-America-32-globalliveability-index-Economist/stories/201808200090 2 The primary livability ranking referenced in the news is the Economist Intelligence Unit's Global Livability Index (http://www.eiu.com/topic/liveability). This index examines 140 cities to help companies estimate whether they should give employees additional incentives when requiring them to relocate to less "livable" cities. The index selects "representative" cities in each country. For the United States, they use 15 cities including: Pittsburgh, Pennsylvania; Honolulu, Hawaii; Washington D.C.; Minneapolis, Minnesota; Boston, Massachusetts; Chicago, Illinois; Miami, Florida; Seattle, Washington; San Francisco, California; Atlanta, Georgia; Los Angeles, California; New York, New York; Houston, Texas; Detroit, Michigan; and Lexington, Kentucky. Compared to cities in Canada, Europe and Australia, U.S. cities do relatively poorly, ranking between the 30th and 70th in the world. Since the indicator is designed to be a global comparison, using this index to discuss differences between U.S. cities has limited validity. At the very least, we must recognize being ranked one of the most livable cities in the United States on this index means the "most livable" compared to the other 14 cities selected. Moreover, this index is calculated by an Economist Intelligence Unit in-house expert who ranks 30 different indicators as "acceptable, tolerable, uncomfortable, undesirable or intolerable." These indicators span five categories and include: Stability (petty crime, violent crime, threat of terrorism, threat of military conflict, threat of civil unrest); Healthcare (availability of private and public health care, quality of private and public healthcare, availability of over-the-counter drugs); Culture & Environment (humidity and temperature, tourist perception of climate, corruption, social or religious restrictions, censorship, availability of sports, culture, food, drink and consumer goods); Education (availability and quality of private education, children enrolled in school, expenditure per pupil, literacy); and Infrastructure (quality of road network, public transport, international flights, availability of quality housing, quality of available electricity, water and telecommunications). 66 NOTES Although all of these indicators are important, they focus primarily on the availability of services and not the access various populations within the city have to such services. Thus, for our purposes we are focusing on indicators more communally associated with livability: health, poverty and income, employment, and education. 3 OnePGH is Mayor Bill Peduto's strategy to enhance Pittsburgh's resilience through ensuring the city is livable for all residents. To read more about the initiative visit: http://pittsburghpa.gov/onepgh/index.html 4 Recent reports that also considered Pittsburgh's racial inequality include: Pittsburgh’s Racial Demographics 2015: Differences and Disparities created by the University of Pittsburgh's Center on Race and Social Problems and Pittsburgh's Equity Indicators (2017; 2018) created as a collaboration between OnePGH and the RAND corporation. The primarily focus of all three reports is racial inequality. We add to their findings by simultaneously examining both race and gender inequalities. Additionally, these reports evaluate Pittsburgh's inequality by either comparing Pittsburgh to Allegheny County, Pennsylvania, and the nation or comparing different indicators to one another. Although both of these approaches make important contributions, neither illuminate which inequalities are likely due to local conditions and thus what could possibly be improved upon with local policy interventions. By comparing Pittsburgh to other cities using our Relative Strengths Indicator we are able to provide more concrete suggestions for policy interventions. 5 For some of our data (e.g. birth and death certificates), sex category is assigned by the medical professional. Other data (e.g. Census surveys) are self identified categories. Finally, for some of the data (e.g. public school records) it depends on the institution whether sex categories are determined by parents, students or school officials. 6 Crenshaw, Kimberlé. 1989. "Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics." University of Chicago Legal Forum 1989(8). 67 NOTES 7 Throughout this report, we use White and Black to denote non-Hispanic White and non-Hispanic Black individuals. We use Black and White instead of African American or Caucasian as they are more inclusive terms. For example, African American often denotes descendants of the transatlantic slave trade. However, our classification includes residents who trace their heritage to Africa but migrated to the United States after the transatlantic slave trade. Thus, we elect to use the more inclusive and colloquially preferred term, Black. Moreover, we follow the lead of W.E.B. Du Bois and recent Critical Race Scholars who intentionally capitalize 'Black' and 'White' to denote they are not merely adjectives describing skin color but proper nouns signifying socially constructed racial groups. We also use the word 'Latinx' to denote all individuals who identify as Hispanic. Latinx is the gender neutral or nonbinary alternative to Latino and Latina. Latinx denotes all individuals of Latin American descent. Finally, those who identify as "some other race" are individuals who do not identify as Latinx and selected the category, "other," when filling out the Census or their governmental records (e.g. birth certificates). Since we have no further information about their heritage it is hard to know exactly the ancestry of these respondents. However, in recent years, the majority of individuals in the United States who select "other" identify as "Middle Eastern." Starting in the 1990's, global conflicts and immigration patterns have increasingly created a notion of "Middle Eastern" as a distinct group not encapsulated in the listed racial categories. Thus many, although not all, individuals from "Middle Eastern" countries select "other" when asked to racially identify. 8 Bratter, Jenifer. 2007. “Will ‘Multiracial’ Survive to the Next Generation? The Racial Classification of Children of Multiracial Parents.” Social Forces 86(2): 821–849. 9 Newborns are categorized by medical professionals as male or female based on their external genital. Since they have yet to have agency in self classifying their gender, we use the terms “assigned female at birth” or “assigned male at birth.” 10 The amounts are averages across family type. For a more complete list of thresholds and more details regarding the federal poverty line see: https://www.thebalance.com/federal-poverty-level-definitionguidelines-chart-3305843 68 NOTES 11 In this section, we define income as earned wages or salary from work. However, we do note that the federal poverty line includes all sources of income (e.g. interest, child support, etc...) when determining total household income. 12 Dusenbery, Maya. 2017. Doing Harm: The Truth about How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. San Francisco, CA: HarperOne. 13 Collins Jr, James W., Gayle Soskolne and Kristin M. Rankin. 2017. "African-American: White Disparity in Infant Mortality due to Congenital Heart Disease." Journal of Pediatrics. 181: 131–136. 14 Kendzor, Darla E., Lorraine R. Reitzel, Carlos A. Mazas, Ludmila M. Cofta-Woerpel, Yumei Cao, Lingyun Ji, Tracy J. Costello, Jennifer Irvin Vidrine, Michael S. Businelle, Yisheng Li, Yessenia Castro, Jasjit S. Ahluwalia, Paul M. Cinciripini, and David W. Wetter. 2012. "Individual-and Area-Level Unemployment Influence Smoking Cessation among African Americans Participating in A Randomized Clinical Trial." Social Science & Medicine 74(9): 1394-1401. Poghosyan, Hermine, Erika L. Moen, Daniel Kim, Justin Manjourides and Mary E. Cooley. 2019. "Social and Structural Determinants of Smoking Status and Quit Attempts Among Adults Living in 12 US States, 2015." American Journal of Health Promotion 33(4): 498-506. 15 See the following for resources on the connection between one's environment and health outcomes. Havranek, Edward P., Mahasin S. Mujahid, Donald A. Barr, Irene V. Blair, Meryl S. Cohen, Salvador CruzFlores, George Davey-Smith, Cheryl R. Dennison-Himmelfarb, Michael S. Lauer, Debra W. Lockwood, Milagros Rosal, and Clyde W. Yancy. 2015. "Social Determinants of Risk and Outcomes for Cardiovascular Disease: A Scientific Statement from the American Heart Association." Circulation 132(9): 873-898. Rushton, Lesley, Sally J. Hutchings, Lea Fortunato, Charlotte Young, Gareth S. Evans, Terry Brown, Ruth Bevan, Rebecca Slack, Phillip Holmes, Sanjeev Bagga, John W Cherrie and Martie Van Tongeren. 2012. "Occupational Cancer Burden in Great Britain." British Journal of Cancer 107: S3-S7 69 NOTES Krieger, Nancy. 2005. "Defining and Investigating Social Disparities in Cancer: Critical Issues." Cancer Causes & Control 16(1): 5-14. Ramsey, S. D., Bansal, A., Fedorenko, C. R., Blough, D. K., Overstreet, K. A., Shankaran, V., & Newcomb, P. (2016). Financial insolvency as a risk factor for early mortality among patients with cancer. Journal of Clinical Oncology, 34(9), 980. 16 See the following references for more information on the connections between school punishment and well-being in adulthood. Rios, Victor M. 2011. Punished: Policing the Lives of Black and Latino Boys. New York, NY: University Press. Morris, Edward W., and Brea L. Perry. 2016. "The Punishment Gap: School suspension and Racial Disparities in Achievement." Social Problems 63(1): 68-86.3. Huguley, James P., Ming-Te Wang, Kathryn Monahan, Gina Keane and Abel J. Koury. 2018.  Just Discipline in Greater Pittsburgh: Local Challenges and Promising Solutions. Pittsburgh, PA: Center on Race and Social Problems. http://www.heinz.org/UserFiles/Library/Just_Discipline_and_the_School_to_Prison_Pip eline_in_Pittsburgh.pdf 70 APPENDIX A Comparison Methodology Numbers by themselves communicate very little information. Just like isolated words, numbers must be combined with other numbers to communicate meaning. Even without realizing it, any time we interpret a number we are comparing it to other numbers. We could compare it to what we expect the number to be, what an ideal number would be, what similar numbers in the past have been, or to similar numbers across other groups. To contextualize the numbers in this report, we compare our outcomes across our six groups (White men, White women, Black men, Black women, AMLON men and AMLON women). These comparisons help demonstrate how different Pittsburghers experience the livability of the city. However, since the outcomes have unique ranges and are affected by national and local factors, it is impossible to use these intergroup comparisons to illuminate which inequalities are particular to Pittsburgh and thus which might be addressed with city-level interventions. To further contextualize our outcomes and identify Pittsburgh's relative strengths and weaknesses, we model off previous livability indexes and compare Pittsburgh to demographically similar cities. For the purposes of this intersectional analysis, we conceptualize similar cities as places with substantial Black and White populations. Specifically, we include all census defined places in the United States whose Black and White populations are large enough to disclose their intersectional data publicly. This is partially a methodological decision as these are the cities for which we can access all the required data. Yet, it is also a theoretical decision as cities with extremely small White or Black populations will likely have very different dynamics than Pittsburgh and thus limit the utility of the comparison. For the full list of these cities and their basic demographic characteristics, see Appendix B. For each outcome, we use the full list of demographically similar cities to help us contextualize Pittsburgh's proportions and medians. We then apply our new tool, the Relative Strengths Indicator. This tool starts by comparing how each of our six groups compare to their counterparts in similar cities. For example, how does the proportion of White men living in poverty in Pittsburgh compare to the proportion of White men living in poverty in all the other similar cities? We quantify this comparison by using a percentile (centile). In other words, what percentage of the similar cities have less poverty among their White men than Pittsburgh? 71 COMPARISON METHODOLOGY For consistency, we reconfigured all outcomes such that higher centiles would represent Pittsburgh doing "better" than the majority of cities and lower centiles would indicate Pittsburgh's relatively low ranking. For outcomes like median income, proportion with a bachelor's degree, or employment, no adjustments were necessary as higher numbers on these outcomes are generally conceptualized as "better." Yet, for outcomes like poverty, the proportion of students with multiple suspensions, or infant deaths, the centiles were inversed. This reversal ensures the higher numbers correspond to what is seen as more "preferable" such as lower poverty, suspensions and deaths. These centiles give us a helpful way to compare across groups and outcomes to illuminate Pittsburgh's strengths and weaknesses. Yet, they are unable to take into account that some outcomes vary dramatically across cities while others are relatively constant. For example, let us consider grade retention and poverty. Across school districts, grade retention is fairly constant. Even the schools that have the grade lowest retention rates are only a few percentage points less than the districts with the highest rates. Adult educational attainment, on the other hand, ranges dramatically from city to city. When outcomes, like grade retention rates, are similar across cities they are likely driven more by national policies and factors. Thus, Pittsburgh's ability to address these outcomes might be more limited. Conversely, outcomes with large ranges suggest similar cities to Pittsburgh are more livable; implying Pittsburgh might be able to adopt interventions to increase our livability. To capture the variability in outcome ranges, we weighted the centiles by their corresponding variability. Specifically, we started by calculating the mean absolute deviation of each outcome across all the cities. Like standard deviation, mean absolute deviation is a measure of the average variation from the mean. Yet, unlike standard deviation, mean absolute deviation is more appropriate for non-random samples as it does not presume normality by imposing a quadratic transformation. Mean absolute deviation is calculated as follows: The mean absolute deviation helps us estimate the variation between cities. However, mean absolute deviations are not comparable across units. For example, income, which is measured in dollars, is going to have a larger mean absolute deviation than poverty which is measured as a proportion. To standardize units, we divide the mean absolute deviation by the range (maximum value minus the minimum value). In other words, we are estimating to what extent an outcome varies across cities given its possible range. We use this measure of variability to weight Pittsburgh’s centile ranking. Additionally, we center the ranking such that 50 percent is at zero. We operationalize this using the following equation: 72 COMPARISON METHODOLOGY As mentioned above, we calculate this relative ranking, which we call an Index of Relative Livability (IRL), for all outcomes across all six race and gender groups. This enables us to examine how Pittsburgh's groups compare to those same groups in other similar cities, for example, how Pittsburgh's Black men compare to Black men in other demographically similar cities. Yet, it does not examine whether the inequality between these groups is similar across cities. To this end, we also calculate inequality measures and their corresponding rankings. For every outcome, we calculate the inequality between 15 pairings: White men and White women, White men and AMLON men, White men and AMLON women, White men and Black men, White men and Black women, White women and AMLON men, White women and AMLON women, White women and Black men, White women and Black women, AMLON men and AMLON women, AMLON men and Black men, AMLON men and Black women, AMLON women and Black men, AMLON women and Black women, Black men and Black women. To calculate inequality, we first subtracted the value of the first group from the value of the second group. To enable comparisons across inequalities, we then divide the difference by the average value across the entire population. We then used this normalized difference to calculate Pittsburgh's centile and the mean absolute deviation across cities. Much like the outcomes themselves, we invert differences. when needed, so that lower centiles represent more inequality and higher centiles outcomes more equality. In the end we have 21 weighted rankings for each outcome. 73 APPENDIX List of Similar City Total Population White Proportion Black Proportion Dothan, Alabama Huntsville, Alabama Mobile, Alabama 1\ Alabama Phoenix, Arizona Little Rock, Arkansas Fresno, California Long Beach, Calitornia Los Angeles, California Oakland, Cali?3rnia Sacramento, California San Diego, California San Francisco, California Aurora, Denver, C(i)lorado New Haven, Connecticut DC. Jacksonville, Florida i\[iami, Florida Orlando, Florida Tallahassee, Flmida Tampa, Florida Atlanta, Georgia Augusta, Columbus, Ge