A/HRC/15/18 prosecute violations of fair housing law that are brought to its attention, many more go unreported. In order to address these realities, the Government has a number of programmes designed to improve housing availability to racial and ethnic minorities as well as to actively combat racial segregation. 35. In its meetings with Government departments, the members were told that many people of African descent are geographically isolated from the mainstream culture, as de facto residential segregation is often a stark reality. In an attempt to address this problem, the current strategy in urban planning is to build low-rise public housing on scattered sites instead of tall, densely populated buildings. Also, rental assistance is being used so that those who would have previously lived in public housing now enter the free market and choose where they wish to live. In reality, choice is limited because there is no federal law that requires landlords to accept rental assistance from the Government. This shift in policy has led to the loss of 150,000 units of public housing over the past 15 years. 36. The members were informed that in the city of Washington, D.C., there is a dramatic wealth disparity between African descendants, who make up 55 per cent of the population, and the white population. Given the disadvantaged economic circumstances of a large proportion of the population of African descent in that city, they have been adversely affected by some urban development plans. When land becomes valuable, real estate is developed and the poor are forced to move out as they can no longer afford the cost of living in the neighbourhood. In order to address this problem, the Government is implementing strategies that ensure urban development makes all communities more attractive, inter alia, by including services such as public transport. 37. In its meetings with NGOs, the members were informed that access to affordable housing is a serious problem for many people of African descent and that as neighbourhoods that were traditionally home to large communities of African descent, such as Harlem and Brooklyn in New York, are redeveloped, the African descendent population is being gradually forced to move out due to the now unaffordable cost of living there. The members were also informed that in the city of New York public spending is being funnelled towards short-term emergency accommodation shelters rather than public housing. As people of African descent are increasingly unable to afford to live in the neighbourhoods where they have traditionally built their communities, there is an increasing need for, but declining availability of, public housing. Some NGOs stressed that changes in the urban environment have had a negative impact on the life of people of African descent, such as the closing of small markets and shops and the opening of large supermarkets, which makes it difficult for people without cars to satisfy their needs and obtain necessary supplies. They also highlighted the lack of participation by people of African descent in the decision-making process concerning these changes as well as a lack of consideration of their real needs during this process. 4. Access to health care 38. The members found during their meetings that health and access to health care is an issue of great importance to the population of African descent in the United States, particularly to women of African descent. Although discrimination in access to health-care services is prohibited in Title VI of the Civil Rights Act, which prohibits discrimination based on race, colour or national origin in programmes or activities that receive federal funding, including health-care services, health disparities between people of African descent and the white population continue to be of concern. 39. According to information contained in the 2007 periodic report of the United States (CERD/C/USA/6), to which the members were referred by the Department of State, there are persistent health disparities between the African American population and the white population. For example, the age-adjusted death rate for cancer for African Americans was 11