Beyond Bodies: Spatializing Harm Reduction Ecology in Upper Manhattan
How social infrastructure emerges in public health crises
By Tori Gruber
The fear of drugs undermining the safety, security, and strength of the United States borders, neighborhoods, and public welfare was folded into conservative and protectionist national consciousness in the 1980s. Within the country, multiple drug epidemics were occuring, including opiates, crack, and powder cocaine, and Congress passed a federal mandate in line with the tough on drugs policies coming out of New York State, a major leader in “tough-on-drugs” agendas. The polemical national re-narrating of the city sought to control the activity around drugs and presented drug consumption as treasonous. This polemical history, combined with land-use agendas and moral opposition towards welfare policy creates contentious conditions for harm reduction today.
This urban design engagement is a mapping project to visualize harm reduction ecology. Harm reduction ecology is defined as mutually oriented human behaviors leading to spatialized interventions to create safer practices of drug-use. These simple actions are done in repetition to create a larger visual pattern to discuss how governance navigates the Narcotic City. Through action, data is created on foot and by motion.
Medical redlining is a term emerging in the public sphere by community members in the Harlem community disillusioned by the presence of services for substance users. At Marcus Garvey park in the summer of 2021, in the aftermath of the COVID-19 epidemic, residents in Harlem gathered in protest to contest the placement of drug-related services at what is perceived to be an unsubstantiated rate and an overwhelming presence of treatment facilities, including methadone clinics and new safe injection sites; However, the term provides an important lens through which we can look back at previous moments that revolutionized access to healthcare for at-risk populations, whose “risk” was determined by anti-poverty and racial discrimination.
The use of the term risk is critical to evaluate the intersections of land-use and public health policy, as redlining is traditionally defined as the systemic and discriminatory practice of refusing financial help and services, typically for homeownership and business loans, to neighborhoods perceived as financial risks. The most obvious question becomes what does redlining have to go with harm reduction, and how can existing literature on the social determinants of health respond to community opposition to furthering harm reduction efforts?
Today, medical redlining, as a public vernacular, a historical discriminatory land-use operative tool, and a contextualizing lens, provides a grounding question to evaluate how existing land-use and public funding policies determine the majority type of interventions mobilized by harm reductionists, even as they are supplemented by inventive forms of harm reduction, and how community responses are grounded in longer histories of discriminatory policy.
As citizens, urbanists, and harm reductionists, we want to have spatial and political fluency in harm reduction ecology, which is the mutually oriented behaviors leading to spatialized interventions that create safer practices for and in response to drug-use for the substance user and community members. It is essential to develop methods for identifying existing harm reduction interventions in order to consider its design at grassroots, ad-hoc, and institutional levels to develop spatial and political fluency of harm reduction ecology, which is the mutually oriented behaviors leading to spatialized interventions that create safer practices for and in response to drug-use for the substance user and community members.
The approach I use to urban research is inspired by Francesco Carreri’s Walkscapes, Mindy Fullilove’s method of situation analysis, and AbdouMaliq Simone’s theory of inventive political technologies and people as infrastructure. This project began with a spatialized exploration of harm reduction ecology, healthy communities, and medical redlining to ground theoretical analysis into urban contexts. I repeatedly visited populated spaces within the 125th Street Commercial Corridor over the course of four months, writing down indications of healthy community responses, such as hot tea stands during rainy days, clothing donation bins, elderly community members playing games in the park or congregating on sidewalks outside of shops and residential buildings, flourishing community gardens and older women sharing words on a warm afternoon. Simple markers to begin to describe the healthy community that exists.
As I walked and traced my own path, I began to narrate a mapping process countering the available public data that pathologized neighborhoods, and my intention was just this: to contextualize harm reduction ecology in healthy community practices rather than only as a crisis response to visible unhealthy community conditions. Harm reduction is a healthy community response, and I visited sites and identified indicators of healthy community standards to demonstrate how the healthy community already exists. After conducting fieldwork, I decided to design a process for urban researchers and urban planners that would help articulate plainly how the healthy community is hidden beneath the overwhelming data that reflects a reality that is real, worrisome, and politically charged (meaning the conditions are a result of a history of policy and politics that have created social conditions that lead to its current reality) but not entirely catastrophic. One role of the urban planner, researcher, and designer is to critically examine, or situationally analyze, as Mindy Fullilove would describe, the contested political spaces and find solutions that mediate oppositional voices. In other words, the role of the urban planner is to justly mediate, in order to identify conditions, resources, and networks that support community values created by and created for community members.
The final design was a mock-up for a design project workshop that allows participants to identify their own markers of healthy communities and situate them accordingly on a printed map. Because I was researching harm reduction ecology, I interpreted the icons from my own perspective of entering into a given field and looking for markers or indicators of harm reduction ecology in the urban environment. In order to visually communicate what is meant by this term and how harm reduction ecology can describe existing realities in the community where contestation occurs, I wanted to first ground the values and ideals within and surrounding harm reduction, such as the safe injection facility, the syringe disposal box, or the community library, in an existing urban context to then conceptualize how harm reduction ecology is structured beyond the tangible, such as how programs evolve in the Parks Department or how harm reduction providers and activists work with the Department of Transportation or other non-profit and grassroots homeless services. In the spirit of Francesco Carreri and the Situationalists, all of the icons are collected from images during my walks and come from physical signs at parks, metro stations, and street signs, or items found on the sidewalk.
The purpose is to investigate what governing bodies are responsible for public facing interventions should the need arise. We use Mindy Fullilove’s situation analysis in some ways to investigate and in other ways to predict strategies should situations arise. The icons are turned into cards, and an example of a situation is prompted. Participants will have to play the cards for those governing bodies or interventions to respond to the situation at hand. The game simplifies urban research so that urban planners, harm reductionists, and community members can all play and use the information based on the exchange of knowledge from one another, as a community member may have first hand knowledge of how a situation is dealt with in their community that others may not be aware of, and a harm reductionist may have knowledge of how a situation is dealt with in their line of practice that others may not be aware of. The outcome is an exchange of knowledge, a conversation of shared strategies, and a grounding exercise to role-play what could occur as harm reduction ecology becomes more widely practiced, perceived, and relied upon.