Ansell explores the impacts of public policies, social inequities, and healthcare system factors on health outcomes across different neighborhoods. He examines how some communities manage to resist structural violence and achieve better health and longer life expectancy despite facing similar challenges.

The chapter opens with the story of Officer Thomas Wortham, who was killed in Chicago’s Chatham neighborhood. Wortham’s death was a result of a robbery gone wrong, in which Wortham was a bystander. The Chatham community faced issues like increasing crime and economic decline. Despite these issues, Chatham had historically maintained a middle-class status and better health outcomes compared to neighboring Roseland, a community with similar demographics but poorer health metrics.

Ansell suggests that the difference lies in social cohesion and collective efficacy. Social cohesion refers to the connectedness and trust among neighbors, while collective efficacy is the willingness of a community to work together for the common good. Chatham’s strong social fabric and community engagement have helped it achieve better health outcomes, even in the face of economic and social challenges.

The chapter also looks at Oak Park, a suburb bordering the impoverished Austin neighborhood in Chicago. Oak Park successfully managed racial integration and maintained good health outcomes through proactive community policies and strong social cohesion.