It’s now commonly accepted that a person’s zip code is the best predictor of how healthy a person is and will be. And what determines your zip code? Income, wealth – and the racialized public policies and practices over generations that have herded people of color into neighborhoods that are underserved by design, and that encouraged white families to move to suburbs with publicly funded amenities and subsidized mortgages.

Zip codes determine how long you can expect to live. Whites in 1950 could expect to live to 69; it wasn’t until 40 years later that blacks attained that life expectancy. It seems to be common sense that teen-age women who get pregnant will have more sickly babies than those who delay child bearing

until their more stable 20’s. That is in fact true for white women. But black women in their 20’s have more babies who die in their first month of life than black teen mothers. What’s up? There is a “weathering” effect of living in zip codes where there is no grocery store with fresh food, which are sited close to toxic dumps or incinerators spewing particulate matter, which have few jobs, where houses contain mold and mice, and whose only abundances are liquor stores, fast food joints, and payday loan shops. The effect is cumulative, the harm residing and growing in the bodies of neighborhood residents.

But it is not just poor living conditions that take their toll. Racism itself is a major factor.

First, there is the perpetual state of stress that African Americans live in. It is not just the fear of being attacked by a policeman or a vigilante, although that fear is real and justified. It is also everyday experiences of discrimination such as not being treated with equal courtesy as whites, receiving poorer services when shopping, sensing people fear you, and other “micro-aggressions” that put the body into constant “fight or flight” mode. The stress response includes suppression of the immune system, increased heart rates, adrenaline and cortisol rushes – again, with cumulative effects.

Second, even when it comes to getting health care, it was found that when blacks and whites had the same symptoms and the same levels of income and insurance and went to the doctor, black patients were not given equal access to heart surgeries. With all factors but race held constant, they were even up to seven times less likely to receive pain medication! Their only abundance in treatment is amputations. It’s not just the police who “mis-treat” African Americans.

African Americans still live, as Martin Luther King described, “in islands of poverty in a sea of prosperity.” We need to install zip lines out of the zip codes of concentrated poverty so that people are enabled to freely migrate into the sea of prosperity. This will require our fighting for resources targeted to those zip codes and the people who live in them that have been denied services and access to opportunities in the past, and which therefore have the most needs today. Such local reparations are the only way that we can un-zip the connection between place and health.

Whatever issue we are working on, whether it be police brutality or health care, black lives matter. The good news is that being in control of our own destiny counteracts some of the stress reactions in our bodies. Hopelessness is debilitating. Organizing is good for our health, so let’s keep on keeping on.

Meizhu Lui is a member of Liberation Road and co-author of The Color of Wealth: The Story Behind the U.S. Racial Wealth Divide.