Mindy Thompson Fullilove, MD, is a Black social psychiatrist with wide-ranging interests; her book analyzes factors that support or diminish the health of cities as places that sustain its citizens. Over many years, she has visited and studied 178 cities in 14 countries, and she draws on the work of experts from several disciplines to address the fundamental question: how may we best live together?  

Her discussion moves through five concepts for understanding the health of a city by describing a dozen cities ranging from Paris to Jersey City. Each features a “Scroll,” a two-page presentation of photos, graphics, and text. Her discussions give an inductive basis for her concepts that become criteria for assessing the health of any city.     

(1) Box (“in all sizes and shapes”): the surrounding shape of buildings, street, and sky; it gives an identity to the city’s center with its useful assets such as stores, post office, bank, food, and entertainment.
(2) Circle: the larger area surrounding a Box—maybe a half a mile in radius. Its health requires ease of travel to and from the box.
(3) Line: usually the Main Street that runs through the box, therefore a central path to town. Good transportation is important, and the main street can be quite long, for example Palisades Avenue in Englewood, New Jersey.
(4) Tangle: a dense network of streets and highways that connect to main streets and the Box.
(5) Time: no city is static; as years go by, there are changes for good or ill.  

Fullilove mentions politics, capitalism, poverty, disincentives, tribalism, racism, highways, malls, interstates, and “urban renewal” that destroyed neighborhoods of minorities, as well as redlining against Blacks and gerrymandering school districts to segregate Black and white students. 

In “Naming and Framing the Problem,” she turns to a larger overview of challenges for cities in many places, but especially in the US:
(1) “deep structure of inequality” (p. 211), such as the legacies of slavery, lynching, the 3/5 Compromise, and the Trail of Tears, as well as white supremacy today (2) ecological damage, including industrial farming, deforestation, and global warming, and (3) the inertia of the status quo. 

Citing Dr. Martin Luther King, Jr., and Father Richard Rohr, Fullilove affirms love as the root  for social justice, political activism (p. 211) so that cities might become what Thomas Edison termed “factories of invention” that will support the mental health and well-being of all of its citizens. 


This book is clear, convincing and important. It is also a pleasure to read because of the author’s personable voice and the many figures, photos, and tables that give variety and precision to the text. Readers will immediately make comparisons to cities where they have lived or visited. They may even have insights into their current city and, therefore, contemplate changes that might be made, especially through social and political activism. 

Fullilove expands her outlook as a social psychiatrist by drawing on work of anthropologists, urban and landscape architects, city planners, and other theorists, include George Engel’s classic biopsychosocial model. For some cities, she walks streets with such colleagues, for example Broadway in NYC and Chartres, France (pp. 40—52). She refers to poets and other writers, films, and popular songs such as Petula Clark’s “Downtown” (1964). She visits Sauk Centre, Minnesota, the model for Sinclair Lewis’ novel Main Street (1920). She draws on her own family history and the history of Africans enslaved in America and elsewhere. 

With 18 pages of endnotes and bibliography, the book is interdisciplinary, intelligent, and scholarly. Further, it has a style that is inviting, even personal. In the Introduction, she writes, “When we go to Main Street, we take in fashion, culture, and sociability. We shop, mail letters, get library books, and have coffee. Or we loiter, whether on a bench or in a Starbucks window. Sometimes we take our laptops to be in the flow and in the know while ostensibly working. This makes us happy. It is a Machine for Living” (p. 14). 


New Village Press

Place Published

New York



Page Count