Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Health Promotion and Behavioral Sciences

Degree Program

Public Health Sciences with a specialization in Health Promotion, PhD

Committee Chair

Wendel, Monica

Committee Co-Chair (if applicable)

Kerr, Jelani

Committee Member

Kerr, Jelani

Committee Member

Harris, Lesley

Committee Member

Benitez, Joseph

Author's Keywords

banks; Louisville; fringe banks; health; public health; wealth


Centuries of discriminatory policies and practices in the United States have created racially segregated, resource-poor urban communities. Differential benefits of banking and housing legislation were among the consequences of these policies as they contributed to drastic racial inequities in wealth. Today, racial differences in banking status and financial practices persist. However, a void exists in the literature exploring what alternative financial services (AFS) are used in lieu of banks by Black Americans, why those services are used, the thoughts and beliefs of Black Americans about the use of those services, the impact of bank locations on financial behavior patterns, and how these factors may relate to health outcomes. As such, the current study posed three distinct research questions: 1. To what extent does the density of community banks in a census tract relate to prevalence of heart disease, prevalence of cancer, and homicide in that census tract? 2. What alternative banking methods are utilized by Black West Louisville residents and for what purposes? 3. What factors influence the Black community’s banking and financial practices? A mixed-methods study design using ordinary least squares and zero-inflated Poisson regression was used to assess research question one, while qualitative interviews were used for research questions two and three. The findings show: 1.There is no significant relationship between the density of banks in a census tract and homicide, prevalence of heart disease, or prevalence of cancer. 2. Consumers recognize the financial harm caused by the use of AFS, but still opt to utilize alternative financial services considering them the best of many less than ideal choices. Participants expressed that banks were not a viable option due to racial discrimination, expensive overdraft fees, and hidden fees which led to general feelings of distrust regarding traditional banking institutions. 3.The findings indicate that banks exist as one of many predatory, structurally violent institutions that disproportionately harm Black Americans, particularly those in lower income brackets.

Included in

Public Health Commons