The Body: The Complete HIV/AIDS Resource Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App 
Professionals >> Visit The Body PROThe Body en Espanol

A Winter Tour of Harlem

What Can the "Psychology of Place" Tell Us About HIV?

March 2003

A Winter Tour of Harlem

How does our environment affect how we feel, physically and emotionally, on any given day? How does it affect our health? The risks we take with it?

These are questions that Dr. Mindy Fullilove, Associate Professor of Clinical Psychiatry and Public Health at Columbia University and a pioneer in the concept of the "psychology of place," has wrestled. Fullilove has engaged these issues on an intimate level, both in the context of her own life through her autobiographical book, The House of Joshua: Meditations on Family and Place (1999), and within the cities and neighborhoods hard hit by decline and disease.

Harlem, a community known for its glory days as a center of African-American community and creativity and its subsequent devastating decline has provided much of the inspiration for Fullilove's musings. She was shocked to its crumbling facades and the bleak atmosphere on its streets twelve years ago, upon her return to Columbia University, her medical school alma mater. This prompted Fullilove to wonder how the environment, which had been decimated by the crack epidemic, had contributed to the high rate of mental and physical distress in those who lived there.


A Winter Walking Tour

On one of the coldest days of winter, I meet Fullilove in Harlem, in front of The Schomburg Center for Research on Black Culture, at 135th Street and Lenox Avenue. The plan is for us to walk the surrounding neighborhood, and for Fullilove, who has walked and driven these streets regularly for the past decade, to show me how the environment affects the health of those who live here, specifically, the risk-taking behavior that can lead to the spread of HIV/AIDS, a disease that has disproportionately affected the Harlem community.

As of 1998, for example, East Harlem represented 1.4% of New York City's population, yet it had the second highest cumulative AIDS rate in the city, according to The East Harlem Health Department. And while the majority of the infected appear to be male, the AIDS rate for women is the highest in the City. The vast majority of AIDS cases can be traced to intravenous drug use, although other factors, such as high rates of sexually transmitted diseases, exacerbate the risk of HIV transmission. And while crack hastened the area's environmental decline, according to Fullilove, the environmental decline has hastened the spread of the disease.

Two blocks up, we stand on the corner, and Fullilove points west, down 137th Street. She is pointing at the windows of several buildings near the corner, or rather what used to be windows. Now they are boarded up, making the buildings look like faces without eyes. She tells me that there is not one block in Harlem in which there isn't a burned out building.

Further down, she points out two empty spaces, like lost teeth in the landscape. The name for this pattern of chronic building loss is "Contagious Building Syndrome," she says. Whenever one building is in trouble, those near it are at risk. It is a disease that has particularly plagued Harlem. Between 1960 and 1990, 30% of its buildings succumbed.

How, I ask, as we walk, does this ambient decay translate into a higher risk for HIV and AIDS? "Because," she says simply, "It's a desolate environment. People look around and they see hopelessness, they see that there's no point. They see that people don't live too long in this environment, that life is short. Why not enjoy yourself if life is short? Why not?"

A Desolate Landscape

A Winter Tour of Harlem
We head further north on Lenox Avenue, passing a deli, a check-cashing store, and an assortment of stores in which padlocked cages cover the doorfronts. Fullilove explains that the things you tend to notice about your environment are the things that bother you. They stand out, bear down on you, make you feel helpless and victimized.

Harlem is a prime example of this. "It's a desolate landscape," Fullilove says. "That can be all you see," she says, gesturing up to the grand old building frames that surround us, many of which are either burned out or boarded or bricked up. With the loss of the buildings, she says, comes the loss of the social networks that once existed in and around them.

Relationships and communities, she says, are destroyed along with the geography. These are hard elements to regain. In Harlem, a notoriously underserved area of New York City, much of the community rebuilding that has occurred has done so on a grass roots level.

What is less obvious, she says, is what makes a place work for you, and how people take individual steps to make it work for them. "How do people in this environment keep going?" We come to another corner. There is a deli on the opposite side, in front of which several young men hover, looking neither like they want to stay in one place nor like they have someplace to go.

Painted on the brick side of the deli is a black and white mural depicting the face of a young man wearing glasses and a solemn expression. At the base of the wall, a series of candles rest under the protection of a cardboard box canopy jerry-rigged to keep the rain off.

"There are a lot of make-shift memorials and shrines,"says Fullilove. "They function on a lot of levels. The people who made it, whose friend it was, do it out of respect. Those who pass by take an interest and ask questions. The people who live nearby end up being protectors." It is a homespun form of community building, she explains, that creates a subtle coalition of people who might otherwise not connect.

We turn left down this street. Fullilove points out a big gaping lot full of garbage. "A building fell down there one day," says Fullilove. "With people in it." Then she is pointing out the things people on the block have done to "lift their spirits." She spots a few flags in flowerpots, flags in windows.

From the "Worst Block" to Striver's Row

We walk across Adam Clayton Powell, Jr. Boulevard, which divides us from the next set of cross streets, and across the other side of 140th Street. On the left are a series of refurbished cream-colored apartment buildings with fire escapes painted blue. On the right, separated by a building are two very different gardens where buildings used to be, one manicured, with precisely edged gravel walkways and tasteful low foliage, the other with cement tables surfaced with terracotta tiles that have checkerboards etched into them.

This, she tells me, was once the worst street in the city, at least according to The New York Times. "It had been taken over by the crack trade," she says. All of those apartments, she gestures to the cream colored buildings, were full of dealers. "People used to stop you on the corner and tell you not to go down this street."

We round the corner to the left, onto Frederick Douglass Boulevard, take another quick left onto 139th Street, walking the block parallel to the one we'd been on, and find ourselves on a street of elegant brick townhouses.

Fullilove looks at me to see if I get it. "Millionaires," she says. She points me to the street sign midway up the block that signals that this is a historic block. It is, in fact, Striver's Row, a famous row of neo-Italian and neo-Georgian townhouses built in the late 19th century, and which have been described by architecture critics as one of the best examples of planning and urban living in New York City.

One feature that has won it acclaim is a wide back alleyway that runs between the houses and the block behind it where cars can be parked off the street and trash cans hidden from sight. "How did it survive?," asks Fullilove, shaking her head. We walk up the street and Fullilove begins to point out how. A blue ribbon hangs from the black iron latticework that surrounds one doorway. "Someone has recently tied balloons there in celebration of some event," she says. She points up to a stained glass butterfly hanging from the black iron windowbox of another home, at a blaze of potted red flowers sitting in front of another. Yet another has a small trellis planted on its stamp of a front lawn, laced with a small bundle of ivy, now brown and dry with the cold.

I ask her about other communities which, like Harlem, may have a high rate of HIV and AIDS, but don't resemble it at all in population or place. I cite another Manhattan neighborhood, Chelsea, an affluent predominately gay community clustered around 8th Avenue, just above Greenwich Village.

From Harlem to ... Chelsea?

A Winter Tour of Harlem
Chelsea, like Harlem, is known to have been a hot-spot of the AIDS epidemic, though on the surface, one could easily assume that that has to do with the large gay population, not its environment.

"I have a game I like to play with pictures of landscapes," says Fullilove. "I show people different pictures and ask them which one has the AIDS epidemic. They always pick wrong. It's just that you have to look a little harder," she explains, "past the cultural script, past what you expect to find.

"If you live in Chelsea, privilege is obvious. But the risk is still an issue here. Here risk doesn't have to do with privilege, as it does in Harlem. So what is it there that people are living with?" she asks.

"In Chelsea," says Fullilove, "people are fighting for their lives in all kinds of ways." And though it seems like a territory, it really is anti-space, explains Fullilove, which is not the same as space. It exists in its own environment, outside the space that mainstream culture claims. That creates a certain low-level tension, says Fullilove, that can lead to the same bleakness of feeling that a resident of Harlem might feel, for utterly different reasons.

"And it's very sexualized," she says. "People try to sell a lot of sex oriented things to gay men, who tend to have a lot of money, so they're being exploited, too.

"Also, Eighth Avenue is a big thoroughfare. There's little feel of safeness in the community. Someone could come in and beat them up for being gay. That doesn't happen in Harlem, that's not part of Harlem's problem, but it is down there." She pauses. "So on the surface it looks like a very privileged environment, but just like Harlem, you have to look at it beyond the surface and see what works and what doesn't."

"There are a lot of things in Chelsea that could still contribute to the feeling of environmental stress and hopelessness -- the sense that life is short can contribute to risk-taking behavior, just as in Harlem."

Looking at Langston

A Winter Tour of Harlem
We make our way back toward the Schomburg Center, where Fullilove wants to show me the mosaic honoring the poet Langston Hughes, who lived in Harlem, that illustrates his famous poem "The Negro Speaks of Rivers." His ashes are buried beneath it. But when we arrive a horde of schoolchildren are sitting on it. We head outside and get in Fullilove's car.

"One thing I really like about Langston Hughes," she tells me, as she navigates a corner, "is his acceptance speech once when he won a prize. He thanked all of the people of Harlem for being who they are and their folk wisdom, because without them his art wouldn't exist."

She pulls up, in front of a newly refurbished building some twenty blocks uptown. We get out and head down a side street on which there is not one building that is not burned out. "What I want to say, if I haven't said it clearly enough," says Fullilove, "is that we'd all benefit a little bit by learning to be like Langston Hughes. He saw the folk wisdom and the beauty around him and he had the ear to hear it."

We stop in front of a home-made garden. It is thoroughly unlike the manicured garden we saw earlier. It has a myriad of pathways paved first with terracotta tiles, then paving stones. Chairs sit at various points along them, looking like they are simply cast-off. But a certain homespun order and charm is also discernible. On one stretch of path, a handmade fence has been erected on either side, lending that particular stretch of walkway the look of a an arched bridge, though in fact, it lies flat against the ground. "It's a folk garden," says Fullilove simply, peering in.

We turn to leave and as we walk away, I point out, in passing, a touch of humor -- a broomstick with a grass green bristle, partially missing, that has been propped in a tree just on the inside of the garden. It looks like a tree limb, with brilliant green new growth, spring grass. Or, alternatively, it looks like a broom with bright green grass bristles. Fullilove stops in her tracks.

"That's it," she says. "That's what it's all about." The grass broom is like the flags in pots, the bit of ribbon. The humor, the things you do to "lift your spirits" in your environment, whatever and wherever it may be. It's what helps you get beyond the obvious bad things that make you lose hope, make you less protective of yourself and others. It is how the people who have weathered the bad days in Harlem have survived.

Thinking About Your Own Neighborhood

  1. WALK around your neighborhood and think, "If I had to give a stranger a tour of this area, what would I want to show them?"

  2. TALK about the neighborhood with people who have lived there for a long time and people who have just arrived -- what do they point out about the area?

  3. DRAW a map of the places that you have identified. These may not be "important" places in the usual sense but they may be important to you -- the laundromat, for example, might be a favorite place to meet neighbors and a good stop on your personal tour.

  4. THINK about the images you have seen, and the words you have heard -- how do they make you feel? What do they bring to mind?

  5. WRITE about the stories of good and bad times you have spent in the neighborhood. Share them with friends and neighbors, your local paper, favorite Internet sites.

Elizabeth DeVita is a freelance writer in New York City.

This article was provided by Body Positive. It is a part of the publication Body Positive.
See Also
More on the Mind-Body Connection