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Patterns of local growth, decline, inequality, and segregation are not purely a natural result of free choice and the workings of a free market. Governmental actions, especially a “hidden urban policy,” have had a great influence in shaping spatial patterns of growth and decline. The manipulations, discriminations, and the self-interested machinations of private institutions too greatly influence a community’s health. The chapter reviews the evolution of metropolitan areas, including the growth of the suburbs, pointing to the impact of such factors as: changes in transportation; new communications technology, the rise of edge cities and edgeless development; redlining; racial steering; blockbusting; the home loan insurance programs of the Federal Housing Administration (FHA) and the Veterans’ Administration (VA); the federal tax code, federal highway and military spending; fair housing laws; the Community Reinvestment Act (CRA); predatory lending practices; home loan foreclosures; right-to-work laws; and the exclusionary zoning and land-use restrictions of local governments. The growth of a city’s “second ghetto” reveals that ghettoization is not purely natural. Special attention is given to Trump-era changes—the Tax Cuts and Jobs Act of 2017; the creation of Opportunity Zones; and the proposed simplification of the Community Reinvestment Act—and their likely impact on America’s communities.