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Cheung ESL. Neighborhood Gentrification and Food Insecurity Among Urban Older Adults: Evidence From New York City. THE GERONTOLOGIST 2024; 64:gnae048. [PMID: 38761043 DOI: 10.1093/geront/gnae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Gentrification is a prevalent neighborhood development process in urban areas across the United States. Prior studies have identified the influence of gentrification on late-life health and quality of life, yet little is known about its relationship with food insecurity, an important public health issue for older adult populations. Using New York City as a case study, this study investigated associations between living in a gentrifying neighborhood and food insecurity, as well as the mediating roles of neighborhood environment factors-social cohesion, public transportation, and food environment. RESEARCH DESIGN AND METHODS This study adopted 2 waves of annual data from the Poverty Tracker Study (2015-2016; N = 703) merged with American Community Survey and spatial data sets to measure gentrification and neighborhood factors. Adjusted logistic regressions were used to examine the associations between gentrification and food insecurity. Further mediation analyses were conducted to test the mechanisms of such associations. RESULTS Older adults in gentrifying neighborhoods were more likely to have food insecurity than those in moderate- to high-income neighborhoods. Compared to low-income neighborhoods, older adults in gentrifying neighborhoods had a lower likelihood of reporting food insecurity. Two significant mediators were found when comparing gentrification with moderate- to high-income neighborhoods: social cohesion and healthy food outlets. DISCUSSION AND IMPLICATIONS This study highlights the importance of gentrification in determining late-life food insecurity and identifies possible mechanisms with policy and social service implications to reduce the risk of food insecurity in urban areas.
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Affiliation(s)
- Ethan Siu Leung Cheung
- Department of Family and Consumer Studies, The University of Utah, Salt Lake City, Utah, USA
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2
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Breton-Carbonneau AC, Anguelovski I, O'Brien K, Echevarría-Ramos M, Fina N, Genty J, Seeder A, Binet A, Williams PC, Cole HV, Triguero-Mas M. Exploring ownership of change and health equity implications in neighborhood change processes: A community-led approach to enhancing just climate resilience in Everett, MA. Health Place 2024; 89:103294. [PMID: 38941653 DOI: 10.1016/j.healthplace.2024.103294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/08/2024] [Accepted: 06/07/2024] [Indexed: 06/30/2024]
Abstract
Traditional planning processes have perpetuated the exclusion of historically marginalized communities, imposing vulnerability to climate (health) crises. We investigate how ownership of change fosters equitable climate resilience and community well-being through participatory action research. Our study highlights the detrimental effects of climate gentrification on community advocacy for climate security and health, negatively impacting well-being. We identify three key processes of ownership of change: ownership of social identity, development and decision-making processes, and knowledge. These approaches emphasize community-led solutions to counter climate health challenges and underscore the interdependence of social and environmental factors in mental health outcomes in climate-stressed communities.
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Affiliation(s)
- Andréanne C Breton-Carbonneau
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z (ICTA-ICP), Carrer de les Columnes s/n, Campus de la UAB, 08193, Cerdanyola del Vallès, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability (BCNUEJ), Carrer de Sant Antoni Maria Claret, 171, 08041, Barcelona, Spain.
| | - Isabelle Anguelovski
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z (ICTA-ICP), Carrer de les Columnes s/n, Campus de la UAB, 08193, Cerdanyola del Vallès, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability (BCNUEJ), Carrer de Sant Antoni Maria Claret, 171, 08041, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Passeig de Lluís Companys, 23, 08010, Barcelona, Spain.
| | - Kathleen O'Brien
- Everett Community Growers (ECG), 471 Broadway, Suite 8, Everett, MA, 02419, USA; Healthy Neighborhoods Research Consortium, Massachusetts, USA.
| | | | - Nicole Fina
- Everett Community Growers (ECG), 471 Broadway, Suite 8, Everett, MA, 02419, USA; Healthy Neighborhoods Research Consortium, Massachusetts, USA.
| | - Josée Genty
- Everett Community Growers (ECG), 471 Broadway, Suite 8, Everett, MA, 02419, USA; Healthy Neighborhoods Research Consortium, Massachusetts, USA.
| | - Andrew Seeder
- Conservation Law Foundation (CLF) Massachusetts, 62 Summer Street, Boston, MA, 02110, USA; Healthy Neighborhoods Research Consortium, Massachusetts, USA.
| | - Andrew Binet
- School of Community and Regional Planning (SCARP), University of British Columbia (UBC), 1933 West Mall, Vancouver, BC, Canada, V6T 1Z2; Healthy Neighborhoods Research Consortium, Massachusetts, USA.
| | - Patrice C Williams
- School of Public Policy and Urban Affairs, Northeastern University, 310 Renaissance Park, 1135 Tremont Street, Boston, MA, 02120, USA; Healthy Neighborhoods Research Consortium, Massachusetts, USA.
| | - Helen Vs Cole
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z (ICTA-ICP), Carrer de les Columnes s/n, Campus de la UAB, 08193, Cerdanyola del Vallès, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability (BCNUEJ), Carrer de Sant Antoni Maria Claret, 171, 08041, Barcelona, Spain.
| | - Margarita Triguero-Mas
- Barcelona Lab for Urban Environmental Justice and Sustainability (BCNUEJ), Carrer de Sant Antoni Maria Claret, 171, 08041, Barcelona, Spain; Department of Urban Studies and Planning (DUSP), Massachusetts Institute of Technology (MIT), 77 Massachusetts Avenue, Cambridge, MA, 02138, USA; Barcelona Institute for Global Health, ISGlobal, Barcelona Biomedical Research Park (PRBB). Doctor Aiguader, 88, 08003, Barcelona, Spain.
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3
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Westbrook M. The embodiment of exclusionary displacement pressure: Intersections of housing insecurity and mental health in a Hispanic/Latinx immigrant neighborhood. Soc Sci Med 2024; 351:116996. [PMID: 38788428 DOI: 10.1016/j.socscimed.2024.116996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/03/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Gentrification, growing income inequality, urban development, and the affordable housing crisis necessitate understanding the impact of the concern of displacement on health - prior to or even in the absence of a displacement event. In this paper, I use the term "exclusionary displacement pressure" to unify the literature on exclusionary displacement and displacement pressure, highlighting the disproportionate and inequitable impacts of displacement pressure among communities of color. Through following 35 residents over 2.5-years (2019-2022) in one predominantly low-income Hispanic/Latinx immigrant neighborhood in Denver, Colorado, I examine how exclusionary displacement pressure shapes their health and wellbeing over time. Through paying attention to how participants' lived experience is shaped by structural vulnerability (e.g. lack of documentation status, inadequate work, limited access to safety net systems), I identify how exclusionary displacement pressure is constantly internalized and responded to as a unique embodied health experience, wearing on individuals over time and reproducing population health inequities. The framework of embodied health experiences captures the wide range of health-related impacts, from diagnosable health conditions to idioms of distress, using participant's own language of suffering to express how they were feeling, battling, and enduring the pressure. Theorizing on structural vulnerability within specific subpopulations with intersecting identities, such as low-income immigrant Hispanic/Latinx communities, provides a bottom-up refinement to existing theories of embodied health. Understanding the place-health experiences of individuals in changing neighborhoods over time is also critically important to define time points at which context-specific supports and interventions are appropriate.
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Affiliation(s)
- Marisa Westbrook
- OHSU-PSU School of Public Health, Portland State University, 1810 SW 5th Avenue, Suite 510, Portland, OR. 97201, USA.
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Fields ND, Tristan Urrutia A, Morris AA, Kramer MR, Lewis TT, Patel SA. Historical Redlining and Heart Failure Outcomes Following Hospitalization in the Southeastern United States. J Am Heart Assoc 2024; 13:e032019. [PMID: 38563370 PMCID: PMC11262499 DOI: 10.1161/jaha.123.032019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Historical redlining, a discriminatory lending practice, is an understudied component of the patient risk environment following hospital discharge. We investigated associations between redlining, patient race, and outcomes following heart failure hospitalization. METHODS AND RESULTS We followed a hospital-based cohort of Black and White patients using electronic medical records for acute heart failure hospitalizations between 2010 and 2018 (n=6800). Patient residential census tracts were geocoded according to the 1930s Home Owners' Loan Corporation map grades (A/B: best/still desirable, C: declining, D: redlined). We used Poisson regression to analyze associations between Home Owners' Loan Corporation grade and 30-day outcomes (readmissions, mortality, and their composite). One-third of patients resided in historically redlined tracts (n=2034). In race-stratified analyses, there was a positive association between historically declining neighborhoods and composite readmissions and mortality for Black patients (risk ratio [RR], 1.24 [95% CI, 1.003-1.54]) and an inverse association between redlined neighborhoods and 30-day readmissions among White patients (RR, 0.58 [95% CI, 0.39-0.86]). Examining racial disparities across Home Owners' Loan Corporation grades, Black patients had higher 30-day readmissions (RR, 1.86 [95% CI, 1.31-2.65]) and composite readmissions and mortality (RR, 1.32 [95% CI, 1.04-1.65]) only in historically redlined neighborhoods. CONCLUSIONS Historical redlining had potentially mixed impacts on outcomes by race, such that residing in less desirable neighborhoods was associated with an elevated risk of an adverse outcome following heart failure hospitalization in Black patients and a reduced risk in White patients. Moreover, racial disparities in patient outcomes were present only in historically redlined neighborhoods. Additional research is needed to explore observed heterogeneity in outcomes.
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Affiliation(s)
- Nicole D. Fields
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGAUSA
- Hubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGAUSA
| | | | | | - Michael R. Kramer
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGAUSA
| | - Tené T. Lewis
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGAUSA
| | - Shivani A. Patel
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGAUSA
- Hubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGAUSA
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Kunnath AJ, Sack DE, Wilkins CH. Relative predictive value of sociodemographic factors for chronic diseases among All of Us participants: a descriptive analysis. BMC Public Health 2024; 24:405. [PMID: 38326799 PMCID: PMC10851469 DOI: 10.1186/s12889-024-17834-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Although sociodemographic characteristics are associated with health disparities, the relative predictive value of different social and demographic factors remains largely unknown. This study aimed to describe the sociodemographic characteristics of All of Us participants and evaluate the predictive value of each factor for chronic diseases associated with high morbidity and mortality. METHODS We performed a cross-sectional analysis using de-identified survey data from the All of Us Research Program, which has collected social, demographic, and health information from adults living in the United States since May 2018. Sociodemographic data included self-reported age, sex, gender, sexual orientation, race/ethnicity, income, education, health insurance, primary care provider (PCP) status, and health literacy scores. We analyzed the self-reported prevalence of hypertension, coronary artery disease, any cancer, skin cancer, lung disease, diabetes, obesity, and chronic kidney disease. Finally, we assessed the relative importance of each sociodemographic factor for predicting each chronic disease using the adequacy index for each predictor from logistic regression. RESULTS Among the 372,050 participants in this analysis, the median age was 53 years, 59.8% reported female sex, and the most common racial/ethnic categories were White (54.0%), Black (19.9%), and Hispanic/Latino (16.7%). Participants who identified as Asian, Middle Eastern/North African, and White were the most likely to report annual incomes greater than $200,000, advanced degrees, and employer or union insurance, while participants who identified as Black, Hispanic, and Native Hawaiian/Pacific Islander were the most likely to report annual incomes less than $10,000, less than a high school education, and Medicaid insurance. We found that age was most predictive of hypertension, coronary artery disease, any cancer, skin cancer, diabetes, obesity, and chronic kidney disease. Insurance type was most predictive of lung disease. Notably, no two health conditions had the same order of importance for sociodemographic factors. CONCLUSIONS Age was the best predictor for the assessed chronic diseases, but the relative predictive value of income, education, health insurance, PCP status, race/ethnicity, and sexual orientation was highly variable across health conditions. Identifying the sociodemographic groups with the largest disparities in a specific disease can guide future interventions to promote health equity.
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Affiliation(s)
- Ansley J Kunnath
- Vanderbilt University Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Daniel E Sack
- Vanderbilt University Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Consuelo H Wilkins
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End, Suite 600, Nashville, TN, 37203, USA.
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Acolin A, Crowder K, Decter-Frain A, Hajat A, Hall M, Homandberg L, Hurvitz PM, Woyczynski L. Gentrification Yields Racial And Ethnic Disparities In Exposure To Contextual Determinants Of Health. Health Aff (Millwood) 2024; 43:172-180. [PMID: 38315921 PMCID: PMC11322854 DOI: 10.1377/hlthaff.2023.01034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This article examines racial and ethnic disparities in the relationship between gentrification and exposure to contextual determinants of health. In our study, we focused on changes in selected contextual determinants of health (health care access, social deprivation, air pollution, and walkability) and life expectancy during the period 2006-21 among residents of gentrifying census tracts in six large US cities that have experienced different gentrification patterns and have different levels of segregation: Chicago, Illinois; Los Angeles, California; New York, New York; Philadelphia, Pennsylvania; San Francisco, California; and Seattle, Washington. We found that gentrification was associated with overall improvements in the likelihood of living in Medically Underserved Areas across racial and ethnic groups, but it was also associated with increased social deprivation and reduced life expectancy among Black people, Hispanic people, and people of another or undetermined race or ethnicity. In contrast, we found that gentrification was related to better (or unchanged) contextual determinants of health for Asian people and White people. Our findings can inform policies that target communities identified to be particularly at risk for worsening contextual determinants of health as a result of gentrification.
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Affiliation(s)
- Arthur Acolin
- Arthur Acolin , University of Washington, Seattle, Washington
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Zhou EG, Schwartz AE, Elbel B. Gentrification and childhood obesity: Evidence from New York City public school students in public housing. Obesity (Silver Spring) 2024; 32:390-397. [PMID: 37984557 DOI: 10.1002/oby.23947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The study objective was to determine the effect of gentrification on the weight outcomes of New York City public school students living in public housing. METHODS In a prospective cohort of 19,022 New York City public school students in public housing followed during 2009-2017, weight outcomes of students living in public housing buildings in gentrified neighborhoods were compared to those living in consistently low-socioeconomic-status neighborhoods; assignment was quasi-random in each borough. RESULTS Among the 42,182 student-year observations, gentrification did not increase weight outcomes significantly, for BMI z scores (0.037; 95% CI: -0.012 to 0.086), obesity (0.6 percentage points [pp]; 95% CI: -0.9 to 2.1), or overweight (1.3 pp; 95% CI: -0.7 to 3.2). However, heterogeneous effects by borough were found, where the gentrification in Manhattan increased students' BMI z scores by 0.19 (95% CI: 0.09-0.29), obesity by 3.4 pp (95% CI: 0.03-6.5), and overweight by 9.2 pp (95% CI: 6.3-12.1). No heterogeneity by race and ethnicity, gender, or age was found. CONCLUSIONS With strong internal validity, this study shows that neighborhood gentrification differentially influenced children's health through obesity, based on borough of residence. Such findings could inform policies or interventions focused on subpopulations and geographies.
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Affiliation(s)
- Eric G Zhou
- NYU Robert F. Wagner Graduate School of Public Service and NYU Grossman School of Medicine, New York, New York, USA
| | - Amy Ellen Schwartz
- Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware, Newark, Delaware, USA
| | - Brian Elbel
- NYU Robert F. Wagner Graduate School of Public Service and NYU Grossman School of Medicine, New York, New York, USA
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Serrano N, Schmidt L, Eyler AA, Brownson RC. Perspectives From Public Health Practitioners and Advocates on Community Development for Active Living: What are the Lasting Impacts? Am J Health Promot 2024; 38:80-89. [PMID: 37612243 PMCID: PMC10748458 DOI: 10.1177/08901171231198403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE Evidence suggests differential impacts of community development, including gentrification and displacement. Public health practitioners and advocates are key stakeholders involved in the community development process related to active living, yet little is known about their perceptions of its impacts. We explored the perspectives of relevant leaders of public health departments and key community and advocacy organizations on community development, gentrification, and displacement. APPROACH Purposive key informant interviews. SETTING CDC State Physical Activity and Nutrition (SPAN) funding recipients. PARTICIPANTS CDC SPAN recipient leadership (n = 10 of 16) and advocacy organizations they partnered with (n = 7 of 16). METHOD Interviews were recorded, transcribed, coded, and thematically analyzed with direct quotes representing key themes. RESULTS Both groups felt community development held important benefits, specifically by creating healthy living opportunities, but also potentially leading to the displacement of long-time residents. Practitioners reported the benefits were for all community members, whereas advocates noted the benefits were seen in those with privilege, and the consequences were disproportionately seen in disadvantaged communities. Both mentioned the importance and difficulty of getting diverse representation for community engagement. CONCLUSIONS Learning how key stakeholders perceive and navigate the community development process can help inform recommendations for better equity in active living community improvements. More work is needed to further elucidate best practices for health and social equity in the community development process.
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Affiliation(s)
- Natalicio Serrano
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laurel Schmidt
- Office of Educational Innovation and Evaluation, Kansas State University, Manhattan, KS, USA
| | - Amy A. Eyler
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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Pichardo CM, Ezeani A, Pichardo MS, Agurs‐Collins T, Powell‐Wiley TM, Ryan B, Minas TZ, Bailey‐Whyte M, Tang W, Dorsey TH, Wooten W, Loffredo CA, Ambs S. Association of neighborhood gentrification with prostate cancer and immune markers in African American and European American men. Cancer Med 2024; 13:e6828. [PMID: 38151903 PMCID: PMC10807554 DOI: 10.1002/cam4.6828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Prior studies showed that neighborhood deprivation increases the risk of lethal prostate cancer. However, the role of neighborhood gentrification in prostate cancer development and outcome remains poorly understood. We examined the relationships of gentrification with prostate cancer and serum proteome-defined inflammation and immune function in a diverse cohort. METHODS The case-control study included 769 cases [405 African American (AA), 364 European American (EA) men] and 1023 controls (479 AA and 544 EA), with 219 all-cause and 59 prostate cancer-specific deaths among cases. Geocodes were linked to a neighborhood gentrification index (NGI) derived from US Census data. Cox and logistic regression, and MANOVA, were used to determine associations between NGI, as continuous or quintiles (Q), and outcomes. RESULTS Adjusting for individual socioeconomic status (SES), continuous NGI was positively associated with prostate cancer among all men (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14). AA and low-income men experienced the highest odds of prostate cancer when residing in tracts with moderate gentrification, whereas EA men experienced reduced odds of regional/metastatic cancer with increased gentrification in SES-adjusted analyses. Continuous NGI also associated with mortality among men presenting with localized disease and low-income men in SES-adjusted Cox regression analyses. NGI was not associated with serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression. CONCLUSIONS Findings show that neighborhood gentrification associates with prostate cancer and mortality in this diverse population albeit associations were heterogenous within subgroups. The observations suggest that changing neighborhood socioeconomic environments may affect prostate cancer risk and outcome, likely through multifactorial mechanisms.
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Affiliation(s)
| | - Adaora Ezeani
- Division of Cancer Control and Population Sciences, NCINIHRockvilleMarylandUSA
| | - Margaret S. Pichardo
- Department of Surgery, Hospital of the University of PennsylvaniaPenn MedicinePhiladelphiaPennsylvaniaUSA
| | - Tanya Agurs‐Collins
- Division of Cancer Control and Population Sciences, NCINIHRockvilleMarylandUSA
| | - Tiffany M. Powell‐Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute (NHLBI)National Institutes of HealthBethesdaMarylandUSA
- Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD)National Institutes of HealthBethesdaMarylandUSA
| | - Brid Ryan
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - Tsion Zewdu Minas
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - Maeve Bailey‐Whyte
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
- School of MedicineUniversity of LimerickLimerickIreland
| | - Wei Tang
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
- Data Science & Artificial Intelligence, R&DAstraZenecaGaithersburgMarylandUSA
| | - Tiffany H. Dorsey
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - William Wooten
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center Biostatistics Shared ServiceBaltimoreMarylandUSA
| | - Christopher A. Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer CenterGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
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Kershaw KN, Magnani JW, Diez Roux AV, Camacho-Rivera M, Jackson EA, Johnson AE, Magwood GS, Morgenstern LB, Salinas JJ, Sims M, Mujahid MS. Neighborhoods and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2024; 17:e000124. [PMID: 38073532 DOI: 10.1161/hcq.0000000000000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
The neighborhoods where individuals reside shape environmental exposures, access to resources, and opportunities. The inequitable distribution of resources and opportunities across neighborhoods perpetuates and exacerbates cardiovascular health inequities. Thus, interventions that address the neighborhood environment could reduce the inequitable burden of cardiovascular disease in disenfranchised populations. The objective of this scientific statement is to provide a roadmap illustrating how current knowledge regarding the effects of neighborhoods on cardiovascular disease can be used to develop and implement effective interventions to improve cardiovascular health at the population, health system, community, and individual levels. PubMed/Medline, CINAHL, Cochrane Library reviews, and ClinicalTrials.gov were used to identify observational studies and interventions examining or targeting neighborhood conditions in relation to cardiovascular health. The scientific statement summarizes how neighborhoods have been incorporated into the actions of health care systems, interventions in community settings, and policies and interventions that involve modifying the neighborhood environment. This scientific statement presents promising findings that can be expanded and implemented more broadly and identifies methodological challenges in designing studies to evaluate important neighborhood-related policies and interventions. Last, this scientific statement offers recommendations for areas that merit further research to promote a deeper understanding of the contributions of neighborhoods to cardiovascular health and health inequities and to stimulate the development of more effective interventions.
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11
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Booker SQ, Merriwether EN, Powell-Roach K, Jackson S. From stepping stones to scaling mountains: overcoming racialized disparities in pain management. Pain Manag 2024; 14:5-12. [PMID: 38193345 PMCID: PMC10825727 DOI: 10.2217/pmt-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Affiliation(s)
- Staja Q Booker
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, PO Box 100197, Gainesville, FL 32610, USA
| | - Ericka N Merriwether
- Department of Physical Therapy, New York University, NYU Steinhardt School of Culture, Education, & Human Development, NY 10010, USA
- Department of Medicine, NYU Grossman School of Medicine, NY 10010, USA
| | - Keesha Powell-Roach
- Department of Community & Population Health, University of Tennessee, Health Science Center, College of Nursing, College of Medicine, Genetics, Genomics & Informatics, Memphis, TN 38103, USA
| | - Simone Jackson
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, PO Box 100197, Gainesville, FL 32610, USA
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12
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Spitzer SA, Vail DG, Heindel P, Dey T, Cooper Z, Salim A, Jarman MP. Gentrification as a Factor in the Incidence of Firearm Injuries. JAMA Surg 2023; 158:1152-1158. [PMID: 37728889 PMCID: PMC10512160 DOI: 10.1001/jamasurg.2023.3939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/29/2023] [Indexed: 09/22/2023]
Abstract
Importance Firearm injuries are an epidemic in the US; more than 45 000 fatal injuries were recorded in 2020 alone. Gaining a deeper understanding of socioeconomic factors that may contribute to increasing firearm injury rates is critical to prevent future injuries. Objective To explore whether neighborhood gentrification is associated with firearm injury incidence rates over time. Design, Setting, and Participants This cross-sectional study used nationwide, urban US Census tract-level data on gentrification between 2010 and 2019 and firearm injuries data collected between 2014 and 2019. All urban Census tracts, as defined by Rural Urban Commuting Area codes 1 to 3, were included in the analysis, for a total of 59 379 tracts examined from 2014 through 2019. Data were analyzed from January 2022 through April 2023. Exposure Gentrification, defined to be an area in a central city neighborhood with median housing prices appreciating over the median regional value and a median household income at or below the 40th percentile of the median regional household income and continuing for at least 2 consecutive years. Main Outcomes and Measures The number of firearm injuries, controlling for Census tract population characteristics. Results A total of 59 379 urban Census tracts were evaluated for gentrification; of these tracts, 14 125 (23.8%) were identified as gentrifying, involving approximately 57 million residents annually. The firearm injury incidence rate for gentrifying neighborhoods was 62% higher than the incidence rate in nongentrifying neighborhoods with similar sociodemographic characteristics (incidence rate ratio [IRR], 1.62; 95% CI, 1.56-1.69). In a multivariable analysis, firearm injury incidence rates increased by 57% per year for low-income Census tracts that did not gentrify (IRR, 1.57; 95% CI, 1.56-1.58), 42% per year for high-income tracts that did not gentrify (IRR, 1.42; 95% CI, 1.41-1.43), and 49% per year for gentrifying tracts (IRR, 1.49; 95% CI, 1.48-1.50). Neighborhoods undergoing the gentrification process experienced an additional 26% increase in firearm injury incidence above baseline increase experienced in neighborhoods not undergoing gentrification (IRR, 1.26; 95% CI, 1.23-1.30). Conclusions and Relevance Results of this study suggest that gentrification is associated with an increase in the incidence of firearm injuries within gentrifying neighborhoods. Social disruption and residential displacement associated with gentrification may help explain this finding, although future research is needed to evaluate the underlying mechanisms. These findings support use of targeted firearm prevention interventions in communities experiencing gentrification.
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Affiliation(s)
- Sarabeth A. Spitzer
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Gillian Reny Stepping Strong Center for Trauma Innovation, Brigham and Women’s Hospital, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Patrick Heindel
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Tanujit Dey
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Zara Cooper
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Ali Salim
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Gillian Reny Stepping Strong Center for Trauma Innovation, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Molly P. Jarman
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Gillian Reny Stepping Strong Center for Trauma Innovation, Brigham and Women’s Hospital, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
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Rollings KA, Noppert GA, Griggs JJ, Melendez RA, Clarke PJ. Comparison of two area-level socioeconomic deprivation indices: Implications for public health research, practice, and policy. PLoS One 2023; 18:e0292281. [PMID: 37797080 PMCID: PMC10553799 DOI: 10.1371/journal.pone.0292281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVES To compare 2 frequently used area-level socioeconomic deprivation indices: the Area Deprivation Index (ADI) and the Social Vulnerability Index (SVI). METHODS Index agreement was assessed via pairwise correlations, decile score distribution and mean comparisons, and mapping. The 2019 ADI and 2018 SVI indices at the U.S. census tract-level were analyzed. RESULTS Index correlation was modest (R = 0.51). Less than half (44.4%) of all tracts had good index agreement (0-1 decile difference). Among the 6.3% of tracts with poor index agreement (≥6 decile difference), nearly 1 in 5 were classified by high SVI and low ADI scores. Index items driving poor agreement, such as high rents, mortgages, and home values in urban areas with characteristics indicative of socioeconomic deprivation, were also identified. CONCLUSIONS Differences in index dimensions and agreement indicated that ADI and SVI are not interchangeable measures of socioeconomic deprivation at the tract level. Careful consideration is necessary when selecting an area-level socioeconomic deprivation measure that appropriately defines deprivation relative to the context in which it will be used. How deprivation is operationalized affects interpretation by researchers as well as public health practitioners and policymakers making decisions about resource allocation and working to address health equity.
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Affiliation(s)
- Kimberly A. Rollings
- Institute for Healthcare Policy and Innovation, Health & Design Research Fellowship Program, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Grace A. Noppert
- Institute for Social Research, Social Environment and Health, Survey Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jennifer J. Griggs
- Department of Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Robert A. Melendez
- Institute for Social Research, Social Environment and Health, Survey Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Philippa J. Clarke
- Institute for Social Research, Social Environment and Health, Survey Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
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Gao X, Thomas TA, Morello-Frosch R, Allen AM, Snowden JM, Carmichael SL, Mujahid MS. Neighborhood gentrification, displacement, and severe maternal morbidity in California. Soc Sci Med 2023; 334:116196. [PMID: 37678111 PMCID: PMC10959124 DOI: 10.1016/j.socscimed.2023.116196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/29/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Gentrification, a racialized and profit-driven process in which historically disinvested neighborhoods experience an influx of development that contributes to the improvement of physical amenities, increasing housing costs, and the dispossession and displacement of existing communities, may influence the risk of severe maternal morbidity (SMM). Leveraging a racially diverse population-based sample of all live hospital births in California between 2006 and 2017, we examined associations between neighborhood-level gentrification and SMM. SMM was defined as having one of 21 procedures and diagnoses, as described in the SMM index developed by Centers for Disease Control and Prevention. We compared three gentrification measures to determine which operationalization best captures aspects of gentrification most salient to SMM: Freeman, Landis 3-D, and Urban Displacement Project Gentrification and Displacement Typology. Descriptive analysis assessed bivariate associations between gentrification and birthing people's characteristics. Overall and race and ethnicity-stratified mixed-effects logistic models assessed associations between gentrification and SMM, adjusting for individual sociodemographic and pregnancy factors while accounting for clustering by census tract. The study sample included 5,256,905 births, with 72,718 cases of SMM (1.4%). The percentage of individuals living in a gentrifying neighborhood ranged from 5.7% to 11.7% across exposure assessment methods. Net of individual and pregnancy-related factors, neighborhood-level gentrification, as measured by the Freeman method, was protective against SMM (OR = 0.89, 95% CI: 0.86-0.93); in comparison, gentrification, as measured by the Gentrification and Displacement Typology, was associated with greater risk of SMM (OR = 1.18, 95% CI: 1.14-1.23). These associations were significant among non-Hispanic White, non-Hispanic Black, and Hispanic individuals. Findings demonstrate that gentrification plays a role in shaping the risk of SMM among birthing people in California. Differences in how gentrification is conceptualized and measured, such as an emphasis on housing affordability compared to a broader characterization of gentrification's multiple aspects, may explain the heterogeneity in the directions of observed associations.
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Affiliation(s)
- Xing Gao
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Timothy A Thomas
- Urban Displacement Project, Institute of Governmental Studies, University of California Berkeley, Berkeley, CA, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management, University of California Berkeley, Berkeley, CA, USA; Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Amani M Allen
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Jonathan M Snowden
- School of Public Health, Oregon Health & Science University-Portland State University, OR, USA
| | - Suzan L Carmichael
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA; Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Stanford University, Stanford, CA, USA
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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Casey JA, Daouda M, Babadi RS, Do V, Flores NM, Berzansky I, González DJ, Van Horne YO, James-Todd T. Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021. Curr Environ Health Rep 2023; 10:312-336. [PMID: 37581863 PMCID: PMC10504232 DOI: 10.1007/s40572-023-00406-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods. RECENT FINDINGS We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.
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Affiliation(s)
- Joan A. Casey
- University of Washington School of Public Health, Seattle, WA USA
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Misbath Daouda
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Ryan S. Babadi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Vivian Do
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Nina M. Flores
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Isa Berzansky
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - David J.X. González
- Department of Environmental Science, Policy & Management and School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | | | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
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16
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Auchincloss AH, Mucciaccio F, Fang CY, Ruggiero DA, Hirsch JA, Zhong J, Li M, Egleston BL, Tseng M. Neighborhood gentrification, wealth, and co-ethnic density associations with acculturation stressors among Chinese immigrants. SSM Popul Health 2023; 23:101476. [PMID: 37583620 PMCID: PMC10424118 DOI: 10.1016/j.ssmph.2023.101476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 07/25/2023] [Indexed: 08/17/2023] Open
Abstract
Objective This study examined the cross-sectional relationships between neighborhood social composition and gentrification, and acculturation stressors. Methods Person-level data came from first-generation Chinese immigrants enrolled in the Immigrant Enclaves Study (Philadelphia, Pennsylvania, baseline 2018-2020, N = 512). A validated scale was used to assess 22 stressors associated with migration or acculturation. Neighborhood characteristics from the American Community Survey 2015-2019 and 2008-2012 included: tract proportion of foreign born Chinese, neighborhood wealth, and past decade gentrification. Most neighborhood exposures were modeled as continuous as well as binary variables (intended to represent highest level of neighborhood exposure). Multivariable negative binomial regression adjusted for age, gender, income, education, employment, language, years in the U.S., and neighborhood variables (proportion co-ethnic, and neighborhood per capita income). Results The majority of participants spoke Mandarin (68% vs Cantonese 32%), mean participant age was 52.7 years old, years in the US was 18, and nearly one-half of the sample had less than 8 years of education. Mean number of stressors was 5.9 with nearly 20% of participants reporting 11 or more stressors. Multivariable results found the number of acculturation stressors was 18% lower for residents in the highest co-ethnic density neighborhoods and 13% lower for residents in the highest wealth areas, compared to other areas (expβ 0.82, 95% CI [CI] 0.69, 0.98; expβ 0.87, CI 0.75, 1.01, respectively). Stressors were no different whether participants lived in gentrified areas or not. Conclusions Among middle-aged Chinese immigrants, acculturation stress was lower for residents in neighborhoods with higher proportion of Chinese immigrants and for residents in neighborhoods with higher wealth, whereas gentrification had no influence on acculturation stress. More work on this topic is needed with vulnerable populations such as this one, informed by local context.
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Affiliation(s)
- Amy H. Auchincloss
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Francesca Mucciaccio
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Carolyn Y. Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Dominic A. Ruggiero
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jana A. Hirsch
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Julia Zhong
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Minzi Li
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Brian L. Egleston
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Marilyn Tseng
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, USA
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17
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Fedina L, Moss L, Rousson AN, Smith ME, Bright C, Herrenkohl TI, DeVylder J. Effects of Neighborhood Disconnection on Psychological Distress and Suicide Risk Associated with Interpersonal Violence Within Racial Groups. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:681-697. [PMID: 37593058 PMCID: PMC10427586 DOI: 10.1007/s40653-023-00532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 08/19/2023]
Abstract
Negative mental health outcomes have been associated with adverse childhood experiences (ACEs) and intimate partner violence (IPV); however, few studies have identified risk and protective factors across levels of the social ecology that mitigate the onset of psychological distress and suicide risk associated with trauma. This study examines the relationship between ACEs, IPV, and mental health (i.e., psychological distress, suicidal ideation, and suicide attempts) within racial sub-populations of Black American, Latinx, and White adults. An online, cross-section survey was administered to a general population sample of adults in Baltimore and New York City. ACEs, IPV, and mental health outcomes were assessed within racial sub-populations of Black American (N = 390), Latinx (N = 178), and White (N = 339) adults, while accounting for within-group demographic differences. Moderating effects of social support and neighborhood disconnection on the relationship between ACEs, IPV, and mental health outcomes were also assessed. IPV was associated with psychological distress and suicidal ideation for Black and Latinx adults, but not for White adults. ACEs were associated with increased psychological distress for all three groups, and increased odds for suicidal ideation among Black and Latinx adults.. A significant negative interaction effect for neighborhood disconnection was found in the relationship between ACEs and psychological distress for Black adults. Findings highlight the significant mental health burdens of ACEs and IPV within racial and ethnic groups. Neighborhood disconnection may exacerbate psychological distress associated with ACEs among populations most impacted by interpersonal violence and mental health inequalities.
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Affiliation(s)
- Lisa Fedina
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105 USA
| | - Lolita Moss
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105 USA
| | | | | | | | - Todd I. Herrenkohl
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105 USA
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, NY USA
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18
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McIntosh A, Anguelovski I, Cole H. "The trauma machine expands faster than our services": Health risks for unhoused people in an early-stage gentrifying area. Health Place 2023; 83:103035. [PMID: 37331113 DOI: 10.1016/j.healthplace.2023.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 06/20/2023]
Abstract
While homelessness continues to be a prevalent problem throughout the United States, many urban neighborhoods are also concurrently experiencing an influx of affluent neighbors through gentrification, exposing the stark inequalities in housing access nationwide. Gentrification-induced changes in neighborhood dynamics have also been shown to affect the health of low-income and non-white groups, with high risks of trauma from displacement and exposure to violent crime and criminalization. This study addresses risk factors for health among the most vulnerable, unhoused individuals, and provides a detailed case study on the potential exposures to emotional and physical traumas for unhoused people in early-stage gentrifying areas. By conducting 17 semi-structured interviews with people who work with the unhoused community - health providers, nonprofit employees, neighborhood representatives, and developers - in Kensington, Philadelphia, we analyze how early-stage gentrification impacts the risks for negative health consequences among unhoused groups. Results show that gentrification impacts the health of unhoused people in four main areas that, all together, create what we identify as a "trauma machine" - that is compounding traumas for unhoused residents by 1) reducing and compromising spaces of safety from violent crime, 2) decreasing public services, 3) threatening the quality of healthcare, and 4) increasing the likelihood of displacement and associated trauma.
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Affiliation(s)
- Andrea McIntosh
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain.
| | - Isabelle Anguelovski
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain; Institución Catalana de Investigación y Estudios Avanzados (ICREA), Passeig de Lluís Companys, 23, 08010, Barcelona, Spain.
| | - Helen Cole
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain.
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19
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Chen KL, Zimmerman FJ, Ong PM, Jones A, Nuckols TK, Ponce NA, Choi KR, Li XX, Padilla A, Nau CL. Association of neighborhood gentrification and residential moves with hypertension and diabetes control in Los Angeles County, 2014-2019: A retrospective cohort study. Health Place 2023; 83:103109. [PMID: 37660584 DOI: 10.1016/j.healthplace.2023.103109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/19/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To examine whether gentrification exposure is associated with future hypertension and diabetes control. METHODS Linking records from an integrated health care system to census-tract characteristics, we identified adults with hypertension and/or diabetes residing in stably low-SES census tracts in 2014 (n = 69,524). We tested associations of census tract gentrification occurring between 2015 and 2019 with participants' disease control in 2019. Secondary analyses considered the role of residential moves (possible displacement), race and ethnicity, and age. RESULTS Gentrification exposure was associated with improved odds of hypertension control (aOR: 1.08; 95% CI: 1.00, 1.17), especially among non-Hispanic Whites and adults >65 years. Gentrification was not associated with diabetes control overall, but control improved in the Hispanic subgroup. Disease control was similar regardless of residential moves in the overall sample, but disparate associations emerged in models stratified by race and ethnicity. CONCLUSIONS Residents of newly gentrifying neighborhoods may experience modestly improved odds of hypertension and/or diabetes control, but associations may differ across population subgroups. POLICY IMPLICATIONS Gentrification may support-or at least not harm-cardiometabolic health for some residents. City leaders and health systems could partner with impacted communities to ensure that neighborhood development meets the goals and health needs of all residents and does not exacerbate health disparities.
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Affiliation(s)
- Katherine L Chen
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Suite 31-269, Los Angeles, CA, 90095, USA.
| | - Frederick J Zimmerman
- Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Suite 31-269, Los Angeles, CA, 90095, USA; Department of Urban Planning, UCLA Luskin School of Public Affairs, 337 Charles E. Young Drive East, Los Angeles, CA, 90095, USA
| | - Paul M Ong
- Department of Urban Planning, UCLA Luskin School of Public Affairs, 337 Charles E. Young Drive East, Los Angeles, CA, 90095, USA
| | - Andrea Jones
- Charles R. Drew University of Medicine & Science, 1731 E. 120th St., Los Angeles, CA, 90059, USA; Healthy African American Families II, 4305 Degnan Blvd., Suite 105, Los Angeles, CA, 90008, USA
| | - Teryl K Nuckols
- Division of General Internal Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Becker 118, Los Angeles, CA, 90048, USA
| | - Ninez A Ponce
- Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Suite 31-269, Los Angeles, CA, 90095, USA; UCLA Center for Health Policy Research, 10960 Wilshire Blvd., Suite 1550, Los Angeles, CA, 90024, USA
| | - Kristen R Choi
- Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Suite 31-269, Los Angeles, CA, 90095, USA; UCLA School of Nursing, 700 Tiverton Dr., Los Angeles, CA, 90024, USA; Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., Pasadena, CA, 91101, USA
| | - Xia X Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., Pasadena, CA, 91101, USA
| | - Ariadna Padilla
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., Pasadena, CA, 91101, USA
| | - Claudia L Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., Pasadena, CA, 91101, USA
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Linton S, Cruz AL, Arnold K. Public service providers' perspectives on and responses to the health and social consequences of gentrification in Atlanta, Georgia. JOURNAL OF SOCIAL SERVICE RESEARCH 2023; 49:494-509. [PMID: 37693303 PMCID: PMC10487345 DOI: 10.1080/01488376.2023.2237517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Service providers' perspectives on, and responses to the health and social impacts of gentrification have been underexplored. This study's objectives were to assess health and social service providers' perspectives on the causes and impacts of gentrification and their responses to gentrification's impacts. Qualitative in-depth interviews were conducted with 15 service providers sampled using maximum variation and snowball sampling, in Atlanta, Georgia, U.S.A. Inductive thematic analysis was used. Providers characterized gentrification as increases in community-level social and economic advantage and displacement of Black and Brown people. Neighborhood divestment and speculative development were reported determinants of gentrification. Revitalization and economic growth were reported positive effects of gentrification; negative ramifications included inflated housing costs, residential displacement, and reduced access to health and social services. Providers enacted multiple solutions to mitigate the negative consequences they observed, including educating residents on housing rights and collaborating with other organizations to expand outreach to displaced residents. Service providers are integral to contributing to knowledge on the causes and impacts of gentrification, and absolving problems resulting from gentrification. . Additional research documenting service provider's responses to the impacts of gentrification are needed to inform how future community development strategies are developed to create more benefits than harms.
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Affiliation(s)
- Sabriya Linton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health; 624 N. Broadway, Baltimore, MD 21205, Atlanta, USA
| | - Angie Lisbeth Cruz
- Department of Health Policy; Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Kimberly Arnold
- Family Medicine and Community Health, Perelman School of Medicine, Philadelphia, PA 19104, USA
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21
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Delong S. Urban health inequality in shifting environment: systematic review on the impact of gentrification on residents' health. Front Public Health 2023; 11:1154515. [PMID: 37546305 PMCID: PMC10399630 DOI: 10.3389/fpubh.2023.1154515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/09/2023] [Indexed: 08/08/2023] Open
Abstract
The impacts of changing neighborhoods, and the influence of neighborhood stability on residents' health have not received enough attention in the literature; one of the most important aspects is gentrification. Research on the impact of gentrification on residents' health has gradually increased in recent years, mainly from North America. Based on the guidelines of PRISMA 2020 and SCIE, 66 papers were included for analysis, six aspects of selected studies are discussed: the research design, theoretical framework, methods of analysis, definition and measurement of gentrification effects, and impact pathways. In general, most of the literature in this field can be seen as using an ecological research design, of which cross-sectional research accounts for a large proportion. The identified effects vary in their direction as well as strength due to difference in population, temporal, and geographical characteristics. Gentrification could affect health outcomes through the combination of economic, social, and physical environment factors. Existing research could be improved in the following aspects: (1) The definition and measurement of gentrification should be both generic and site-specific; Various measurement methods should be compared to enhance the robustness of the results. Furthermore, more consideration should be given to the impact of spatial issues; (2) As for health outcomes, it is suggested to expand the scope of the discussion of health outcomes and strengthen the biological explanation of the influencing mechanisms. It is also necessary to determine the research time points according to the characteristics of the incubation period of different diseases; (3) As for research design, applying longitudinal research design is more likely to improve the reliability; (4) Theoretical frameworks should be addressed to link the definition and measurement of gentrification, patterns of health outcomes, methodology and pathways.
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Affiliation(s)
- Sun Delong
- Key Laboratory of Ecology and Energy Saving Study of Dense Habitat, Ministry of Education, Shanghai, China
- School of Architecture, Tianjin University, Tianjin, China
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22
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Mentias A, Mujahid MS, Sumarsono A, Nelson RK, Madron JM, Powell-Wiley TM, Essien UR, Keshvani N, Girotra S, Morris A, Sims M, Capers Q, Yancy C, Desai MY, Menon V, Rao S, Pandey A. Historical Redlining, Socioeconomic Distress, and Risk of Heart Failure Among Medicare Beneficiaries. Circulation 2023; 148:210-219. [PMID: 37459409 PMCID: PMC10797918 DOI: 10.1161/circulationaha.123.064351] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/28/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND The association of historical redlining policies, a marker of structural racism, with contemporary heart failure (HF) risk among White and Black individuals is not well established. METHODS We aimed to evaluate the association of redlining with the risk of HF among White and Black Medicare beneficiaries. Zip code-level redlining was determined by the proportion of historically redlined areas using the Mapping Inequality Project within each zip code. The association between higher zip code redlining proportion (quartile 4 versus quartiles 1-3) and HF risk were assessed separately among White and Black Medicare beneficiaries using generalized linear mixed models adjusted for potential confounders, including measures of the zip code-level Social Deprivation Index. RESULTS A total of 2 388 955 Medicare beneficiaries (Black n=801 452; White n=1 587 503; mean age, 71 years; men, 44.6%) were included. Among Black beneficiaries, living in zip codes with higher redlining proportion (quartile 4 versus quartiles 1-3) was associated with increased risk of HF after adjusting for age, sex, and comorbidities (risk ratio, 1.08 [95% CI, 1.04-1.12]; P<0.001). This association remained significant after further adjustment for area-level Social Deprivation Index (risk ratio, 1.04 [95% CI, 1.002-1.08]; P=0.04). A significant interaction was observed between redlining proportion and Social Deprivation Index (Pinteraction<0.01) such that higher redlining proportion was significantly associated with HF risk only among socioeconomically distressed regions (above the median Social Deprivation Index). Among White beneficiaries, redlining was associated with a lower risk of HF after adjustment for age, sex, and comorbidities (risk ratio, 0.94 [95% CI, 0.89-0.99]; P=0.02). CONCLUSIONS Historical redlining is associated with an increased risk of HF among Black patients. Contemporary zip code-level social determinants of health modify the relationship between redlining and HF risk, with the strongest relationship between redlining and HF observed in the most socioeconomically disadvantaged communities.
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Affiliation(s)
- Amgad Mentias
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Mahasin S Mujahid
- Division of Epidemiology, UC Berkeley, School of Public Health, Berkeley CA
| | - Andrew Sumarsono
- Division of Hospital Medicine, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | | | | | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Utibe R. Essien
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA
- Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles, CA
| | - Neil Keshvani
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Saket Girotra
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Alanna Morris
- Division of Cardiology, Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Quinn Capers
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Clyde Yancy
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Milind Y. Desai
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Venu Menon
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Shreya Rao
- Division of Cardiology, Department of Internal Medicine, UTHSC San Antonio, San Antonio, TX
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX
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23
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Youngbloom AJ, Thierry B, Fuller D, Kestens Y, Winters M, Hirsch JA, Michael YL, Firth C. Gentrification, perceptions of neighborhood change, and mental health in Montréal, Québec. SSM Popul Health 2023; 22:101406. [PMID: 37114239 PMCID: PMC10127140 DOI: 10.1016/j.ssmph.2023.101406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
While census-defined measures of gentrification are often used in research on gentrification and health, surveys can be used to better understand how residents perceive neighborhood change, and the implications for mental health. Whether or not gentrification affects mental health may depend on the extent to which an individual perceives changes in their neighborhood. Using health and map-based survey data, collected from 2020 to 2021, from the Interventions, Research, and Action in Cities Team, we examined links between perceptions of neighborhood change, census-defined neighborhood gentrification at participant residential addresses, and mental health among 505 adults living in Montréal. After adjusting for age, gender, race, education, and duration at current residence, greater perceived affordability and more positive feelings about neighborhood changes were associated with better mental health, as measured by the mental health component of the short-form health survey. Residents who perceived more change to the social environment had lower mental health scores, after adjusting individual covariates. Census-defined gentrification was not significantly associated with mental health, and perceptions of neighborhood change did not significantly modify the effect of gentrification on mental health. Utilizing survey tools can help researchers understand the role that perceptions of neighborhood change play in the understanding how neighborhood change impacts mental health.
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Affiliation(s)
- Amy J. Youngbloom
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Benoit Thierry
- Université de Montréal/Centre de Recherche Du CHUM, Pavillon S, 850 Rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Daniel Fuller
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada
- Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's, Newfoundland, A1C 5S7, Canada
| | - Yan Kestens
- Université de Montréal/Centre de Recherche Du CHUM, Pavillon S, 850 Rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- Corresponding author.
| | - Jana A. Hirsch
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Yvonne L. Michael
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Caislin Firth
- Center for Studies in Demography & Ecology, University of Washington, Seattle, WA, USA
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24
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Dickerson AS, Frndak S, DeSantiago M, Mohan A, Smith GS. Environmental Exposure Disparities and Neurodevelopmental Risk: a Review. Curr Environ Health Rep 2023; 10:73-83. [PMID: 37002432 PMCID: PMC11108231 DOI: 10.1007/s40572-023-00396-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 04/03/2023]
Abstract
PURPOSE OF REVIEW Neurotoxicant exposures are of particular concern in historically marginalized communities. Often a consequence of structural racism, low-income minoritized populations experience a disproportionate burden of hazardous exposures through proximity to industrial facilities, high traffic roads, and suboptimal housing. Here, we summarize reports on exposures and neurodevelopment focused on differences by education, income, race/ethnicity, or immigration status from 2015 to 2022, discuss the importance of such investigations in overburdened communities, and recommend areas for future research. RECENT FINDINGS We found 20 studies that investigated exposure disparities and neurodevelopment in children. Most were conducted in the USA, and many focused on air pollution, followed by metal exposures and water contamination. Although several studies showed differences in exposure-outcome associations by income and education, many examining differences by race/ethnicity did not report notable disparities between groups. However, measures of individual race and ethnicity are not reliable measures of discrimination experienced as a consequence of structural racism. Our review supports scientific evidence that the reduction of individual and widespread municipal exposures will improve child development and overall public health. Identified research gaps include the use of better indicators of economic status and structural racism, evaluations of effect modification and attributable fraction of outcomes by these factors, and considerations of multidimensional neighborhood factors that could be protective against environmental insults. Considering that vulnerable populations have disparities in access to and quality of care, greater burden of exposure, and fewer resources to incur associated expenses, such populations should be prioritized.
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Affiliation(s)
- Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Hopkins Center for Health Disparities Solution, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Seth Frndak
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Melissa DeSantiago
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ankita Mohan
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Genee S Smith
- Hopkins Center for Health Disparities Solution, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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25
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Sheehan C, Louie P, Li L, Kulis SS. Exposure to neighborhood poverty from adolescence through emerging adulthood and sleep duration in US adults. Health Place 2023; 81:103004. [PMID: 36940492 PMCID: PMC10164711 DOI: 10.1016/j.healthplace.2023.103004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/22/2023]
Abstract
Does exposure to neighborhood poverty from adolescence to early adulthood have differential influence on sleep duration across racial/ethnic groups? We used data from the National Longitudinal Study of Adolescent to Adult Health that consisted of 6756 Non-Hispanic (NH) White respondents, 2471 NH Black respondents, and 2000 Hispanic respondents and multinomial logistic models to predict respondent reported sleep duration based on exposure to neighborhood poverty during adolescence and adulthood. Results indicated that neighborhood poverty exposure was related to short sleep duration among NH White respondents only. We discuss these results in relation to coping, resilience, and White psychology.
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Affiliation(s)
- Connor Sheehan
- School of Social and Family Dynamics, Arizona State University, USA; T. Denny Sanford School of Social and Family Dynamics, Arizona State University, P.O. Box 873701, Tempe, Arizona, 85287-3701, USA.
| | - Patricia Louie
- Department of Sociology, University of Washington, 211 Savery Hall, Seattle, WA, 98195-3340, USA.
| | - Longfeng Li
- Department of Psychology, The Pennsylvania State University, 140 Moore Building, University Park, PA, 16802, USA.
| | - Stephen S Kulis
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, P.O. Box 873701, Tempe, Arizona, 85287-3701, USA.
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26
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Willis MD, Wesselink AK, Hystad P, Pescador Jimenez M, Coleman CM, Kirwa K, Hatch EE, Wise LA. Associations between Residential Greenspace and Fecundability in a North American Preconception Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47012. [PMID: 37098782 PMCID: PMC10132140 DOI: 10.1289/ehp10648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Residential green space can have positive physiological effects on human health through various mechanisms, including reducing stress and/or depression or facilitating physical activity. Although green space has been consistently associated with improved birth outcomes in several studies, there has been limited study of its effect on other reproductive outcomes, including fertility. OBJECTIVE We examined associations between residential green space and fecundability, the per-cycle probability of conception. METHODS We analyzed data from 8,563 female participants enrolled between 2013 and 2019 in Pregnancy Study Online (PRESTO), a prospective preconception cohort study of North American couples attempting conception. Participants completed a baseline questionnaire on sociodemographic, behavioral, and reproductive factors, and bimonthly follow-up questionnaires for up to 12 months to ascertain pregnancies. Using geocoded addresses, we calculated residential green space exposure using the Normalized Difference Vegetation Index (NDVI) within 50-, 100-, 250-, and 500 -m buffers across multiple temporal scales: annual maximum, seasonal maximum, and seasonal mean. We used proportional probabilities regression models to estimate fecundability ratios (FRs), adjusting for sociodemographic, behavioral, and neighborhood characteristics. We also evaluated the extent to which associations were mediated by reductions in perceived stress or depressive symptoms and increased physical activity. RESULTS When comparing the highest (≥ 0.8 ) with the lowest (< 0.2 ) NDVI exposures within 50 m , we observed positive associations in the annual maximum NDVI [FR: 1.33; 95% confidence interval (CI): 1.06, 1.67] and seasonal maximum NDVI (FR: 1.19; 95% CI: 1.00, 1.41) models, but little association in the seasonal mean NDVI models (FR: 0.98; 95% CI: 0.73, 1.30). Restricted cubic splines showed evidence of nonlinearity in this association. Results were similar across buffer distances. Perceived stress, depressive symptoms, and physical activity explained ≤ 5 : 0 % of mediation across all NDVI metrics. DISCUSSION In this cohort, greater residential green space was associated with a modest increase in fecundability. https://doi.org/10.1289/EHP10648.
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Affiliation(s)
- Mary D. Willis
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Amelia K. Wesselink
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Marcia Pescador Jimenez
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Chad M. Coleman
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Kipruto Kirwa
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Elizabeth E. Hatch
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Lauren A. Wise
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
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27
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Serrano N, Realmuto L, Graff KA, Hirsch JA, Andress L, Sami M, Rose K, Smith A, Irani K, McMahon J, Devlin HM. Healthy Community Design, Anti-displacement, and Equity Strategies in the USA: A Scoping Review. J Urban Health 2023; 100:151-180. [PMID: 36580236 PMCID: PMC9798938 DOI: 10.1007/s11524-022-00698-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 12/30/2022]
Abstract
Recent investments in built environment infrastructure to create healthy communities have highlighted the need for equity and environmental justice. Although the benefits of healthy community design (e.g., connecting transportation systems and land use changes) are well established, some reports suggest that these changes may increase property values. These increases can raise the risk of displacement for people with low incomes and/or who are from racial and ethnic minority groups, who would then miss out on benefits from changes in community design. This review scanned the literature for displacement mitigation and prevention measures, with the goal of providing a compilation of available strategies for a wide range of audiences including public health practitioners. A CDC librarian searched the Medline, EbscoHost, Scopus, and ProQuest Central databases, and we identified grey literature using Google and Google Scholar searches. The indexed literature search identified 6 articles, and the grey literature scan added 18 articles. From these 24 total articles, we identified 141 mitigation and prevention strategies for displacement and thematically characterized each by domain using an adapted existing typology. This work provides a well-categorized inventory for practitioners and sets the stage for future evaluation research on the implementation of strategies and practices to reduce displacement.
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Affiliation(s)
- Natalicio Serrano
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL USA
| | - Lindsey Realmuto
- College of Urban Planning and Public Affairs, University of Illinois at Chicago, Chicago, IL USA
| | - Kaitlin A. Graff
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
- McKing Consulting Corporation, Atlanta, GA USA
| | - Jana A. Hirsch
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Lauri Andress
- Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, PA USA
| | - Mojgan Sami
- Department of Public Health, California State University Fullerton, Fullerton, CA USA
| | - Ken Rose
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Akimi Smith
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Katherine Irani
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Jean McMahon
- Coordination Operations and Response Element, Administration for Strategic Preparedness and Response, U.S. Department of Health and Human Services, Washington D.C., USA
| | - Heather M. Devlin
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
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28
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Smith GS, Archibald P, Thorpe RJ. Race and obesity disparities among adults living in gentrifying neighborhoods. J Racial Ethn Health Disparities 2023; 10:93-99. [PMID: 35083727 DOI: 10.1007/s40615-021-01199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 02/03/2023]
Abstract
There is a paucity of research seeking to understand race disparities in obesity among individuals living in a gentrifying neighborhood. American Community Survey data were used to identify gentrifying neighborhoods. In a cross-sectional analysis, these data were then linked to the 2014 Medical Expenditure Panel Survey, yielding an analytic sample of 887 Black and White adults. Obesity was based on body mass index ≥ 30 kg/m2. After controlling for potential confounders, Black adults living in gentrifying neighborhoods had a higher prevalence of obesity (PR: 1.39; 95% CI: 1.03, 1.88) than White adults living in gentrifying neighborhoods. Gentrification may have no impact on reducing Black-White obesity disparities in the US.
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Affiliation(s)
- G S Smith
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - P Archibald
- Department of Social Work, College of Staten Island-City University of New York School of Health Science, Staten Island, NY, USA
| | - R J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Program for Research On Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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29
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Bhavsar NA, Yang LZ, Phelan M, Shepherd-Banigan M, Goldstein BA, Peskoe S, Palta P, Hirsch JA, Mitchell NS, Hirsch AG, Lunyera J, Mohottige D, Diamantidis CJ, Maciejewski ML, Boulware LE. Association between Gentrification and Health and Healthcare Utilization. J Urban Health 2022; 99:984-997. [PMID: 36367672 PMCID: PMC9727003 DOI: 10.1007/s11524-022-00692-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
There is tremendous interest in understanding how neighborhoods impact health by linking extant social and environmental drivers of health (SDOH) data with electronic health record (EHR) data. Studies quantifying such associations often use static neighborhood measures. Little research examines the impact of gentrification-a measure of neighborhood change-on the health of long-term neighborhood residents using EHR data, which may have a more generalizable population than traditional approaches. We quantified associations between gentrification and health and healthcare utilization by linking longitudinal socioeconomic data from the American Community Survey with EHR data across two health systems accessed by long-term residents of Durham County, NC, from 2007 to 2017. Census block group-level neighborhoods were eligible to be gentrified if they had low socioeconomic status relative to the county average. Gentrification was defined using socioeconomic data from 2006 to 2010 and 2011-2015, with the Steinmetz-Wood definition. Multivariable logistic and Poisson regression models estimated associations between gentrification and development of health indicators (cardiovascular disease, hypertension, diabetes, obesity, asthma, depression) or healthcare encounters (emergency department [ED], inpatient, or outpatient). Sensitivity analyses examined two alternative gentrification measures. Of the 99 block groups within the city of Durham, 28 were eligible (N = 10,807; median age = 42; 83% Black; 55% female) and 5 gentrified. Individuals in gentrifying neighborhoods had lower odds of obesity (odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.81-0.99), higher odds of an ED encounter (OR = 1.10; 95% CI: 1.01-1.20), and lower risk for outpatient encounters (incidence rate ratio = 0.93; 95% CI: 0.87-1.00) compared with non-gentrifying neighborhoods. The association between gentrification and health and healthcare utilization was sensitive to gentrification definition.
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Affiliation(s)
- Nrupen A Bhavsar
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
| | | | | | - Megan Shepherd-Banigan
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Benjamin A Goldstein
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Sarah Peskoe
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Priya Palta
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Jana A Hirsch
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Nia S Mitchell
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Annemarie G Hirsch
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Joseph Lunyera
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Clarissa J Diamantidis
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Matthew L Maciejewski
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - L Ebony Boulware
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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30
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Forrester SN, Whitfield KE, Kiefe CI, Thorpe RJ. Navigating Black Aging: The Biological Consequences of Stress and Depression. J Gerontol B Psychol Sci Soc Sci 2022; 77:2101-2112. [PMID: 34875069 PMCID: PMC9683493 DOI: 10.1093/geronb/gbab224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Black persons in the United States are more likely to suffer from social inequality. Chronic stress caused by social inequality and racial discrimination results in weathering of the body that causes physiological dysregulation and biological age being higher than chronological age (accelerated aging). Depression has been linked to both racial discrimination and accelerated aging and accelerated aging has been demonstrated to be higher in Black than White persons, on average. However, we know little about accelerated aging across the life course in Black Americans. METHODS We used mixed-effects growth models to measure biological age acceleration, measured with cardiometabolic markers, over a 20-year period in Black participants of the Coronary Artery Risk Development in Young Adults Study who were aged 27-42 years at analytic baseline. We included an interaction between depressive symptoms and time to determine whether risk of depression was associated with a faster rate of biological aging. RESULTS We found that the rate of biological aging increased over a 20-year span and that those at risk for depression had a faster rate of biological aging than those not at risk. We also found that various social factors were associated with biological age acceleration over time. DISCUSSION Given the known association between perceived racial discrimination and depressive symptoms, we provide a novel instance of the long-term effects of social inequality. Specifically, biological age acceleration, a marker of physiological dysregulation, is associated with time among Black persons and more strongly associated among those with depressive symptoms.
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Affiliation(s)
- Sarah N Forrester
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Catarina I Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Mui Y, Headrick G, Chien J, Pollack C, Saleem HT. Revisiting revitalization: exploring how structural determinants moderate pathways between neighborhood change and health. Int J Equity Health 2022; 21:165. [DOI: 10.1186/s12939-022-01771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/16/2022] [Accepted: 09/27/2022] [Indexed: 11/19/2022] Open
Abstract
AbstractVacant housing can produce many issues that affect residents’ quality of life, especially in historically segregated communities of color. To address these challenges, local governments invest in strategic, place-based revitalization initiatives focused on the regeneration of vacant housing. Yet, the outcomes of these efforts remain contested. To maximize health benefits of revitalization investments, a more nuanced understanding of pathways between neighborhood changes and residents’ responses, adaptations, and ability to thrive is necessary, though, remains largely absent in the literature. Using the Vacants to Value initiative in Baltimore, MD as a case study, we explore (1) how health manifests among certain groups in the context of vacant housing revitalization; (2) how vacant housing and its regeneration engender social and cultural environmental change i.e., gentrification; and (3) what structural determinants (cultural norms, policies, institutions, and practices) contribute to the distribution of material resources and benefits of revitalization. Results suggest that vacant housing revitalization requires more than just physical remedies to maximize health. Our findings demonstrate how vacant housing revitalization influences the physical environment, social environment, and structural determinants of material resources and community engagement that can ultimately impact residents’ physical, mental, and social health. This study recommends that because housing disparities are rooted in structural inequalities, how policies, practices, and processes moderate pathways for residents to adapt and benefit from neighborhood changes is consequential for health and health equity. Establishing shared governance structures is a promising approach to foster equitable decision-making and outcomes. Going forward in urban regeneration, pathways to retain and strengthen the social environment while revitalizing the physical environment may be promising to achieve healthy communities.
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Xiao Q, Myott E, Schlundt DG, Stancil W. Association of Neighborhood Economic Trajectories With Changes in Weight Status Among Black and White Adults in the Southeastern US. JAMA Netw Open 2022; 5:e2230697. [PMID: 36074463 PMCID: PMC9459659 DOI: 10.1001/jamanetworkopen.2022.30697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE Neighborhood environment is an important factor associated with population disparities in obesity. However, few studies have examined whether and in what ways long-term trajectories of neighborhood conditions may be associated with weight outcomes. Moreover, there is a lack of research focusing on multidimensional and nuanced measures that make distinctions between multiple types of neighborhood change (eg, gentrification vs overall growth). OBJECTIVE To examine the association between long-term neighborhood economic trajectories and changes in weight status among Black and White adults residing in predominantly low-income communities in the southeastern US. DESIGN, SETTING, AND PARTICIPANTS This study was a longitudinal analysis of participants in the Southern Community Cohort Study. Five types of neighborhood economic trajectories (stability, growth, displacement, abandonment, and poverty concentration) were measured using data from the US Census and the American Community Survey from 2000 to 2016. Data were analyzed from December 12, 2021, to July 16, 2022. A total of 33 621 Black and White adults in the southeastern US were included in the analytic sample. EXPOSURE Neighborhood economic trajectory. MAIN OUTCOMES AND MEASURES Substantial weight gain and substantial weight loss (ie, gaining or losing ≥10% of baseline weight) between baseline (March 2002 to September 2009) and follow-up (November 2008 to January 2013) periods were assessed using self-reported information. RESULTS Among 33 621 participants, the mean (SD) age was 53.4 (8.8) years; 22 116 participants (65.8%) were women, 21 782 (64.8%) were Black, and 11 839 (35.2%) were White. Compared with residents in neighborhoods with stable trajectories, those in neighborhoods with growth trajectories that did not displace original residents were less likely to experience substantial weight gain (odds ratio [OR], 0.75; 95% CI, 0.58-0.97), whereas those in neighborhoods with poverty concentration trajectories were more likely to experience substantial weight gain (OR, 1.08; 95% CI, 1.00-1.17). These patterns appeared stronger among Black participants (eg, substantial weight gain in poverty concentration group: OR, 1.10 [95% CI, 1.00-1.22]; in growth group: OR, 0.76 [95% CI, 0.56-1.02]) compared with White participants (eg, substantial weight gain in poverty concentration group: OR, 1.03 [95% CI, 0.90-1.18]; in growth group: OR, 0.84 [95% CI, 0.52-1.36]). Differences in patterns were also observed among men (eg, substantial weight gain in poverty concentration group: OR, 1.02 [95% CI, 0.88-1.17]; in growth group: OR, 0.58 [95% CI, 0.35-0.96]) compared with women (eg, substantial weight gain in poverty concentration group: OR, 1.12 [95% CI, 1.02-1.23]; in growth group: OR, 0.83 [95% CI, 0.62-1.12]). However, none of the interaction terms between Black vs White participants and men vs women were statistically significant. Neighborhood trajectory was not associated with substantial weight loss (poverty concentration group: OR, 1.00 [95% CI, 0.93-1.09]; abandonment group: OR, 1.01 [95% CI, 0.84-1.15]; displacement group: OR, 1.04 [95% CI, 0.83-1.23]; growth group: OR, 0.88 [95% CI, 0.69-1.12]). CONCLUSIONS AND RELEVANCE In this cohort study, neighborhood economic trajectories were associated with weight gain. These findings highlight the importance of using more nuanced and multidimensional measures of neighborhood change in public health research.
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Affiliation(s)
- Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston
| | - Eric Myott
- Institute on Metropolitan Opportunity, University of Minnesota, Minneapolis
| | - David G. Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - William Stancil
- Institute on Metropolitan Opportunity, University of Minnesota, Minneapolis
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Acolin A, Crowder K, Decter-Frain A, Hajat A, Hall M. Gentrification, Mobility, and Exposure to Contextual Social Determinants of Health. HOUSING POLICY DEBATE 2022; 33:194-223. [PMID: 37200539 PMCID: PMC10187766 DOI: 10.1080/10511482.2022.2099937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/17/2022] [Accepted: 07/06/2022] [Indexed: 05/20/2023]
Abstract
This study uses individual level consumer trace data for 2006 residents of low- and moderate-income neighborhoods for the principal cities of the 100 largest metropolitan regions in the US using their location in 2006 and 2019 to examine exposure to the following four cSDOH: healthcare access (Medically Underserved Areas), socioeconomic condition (Area Deprivation Index), air pollution (NO2, PM 2.5 and PM10), and walkability (National Walkability Index). The results control for individual characteristics and initial neighborhood conditions. Residents of neighborhoods classified as gentrifying were exposed to more favorable cSDOH as of 2006 relative to residents of low- and moderate-income neighborhoods that were not gentrifying in terms of likelihood to be in a MUA, and level of local deprivation and walkability while experiencing similar level of air pollution. As a result of changes in neighborhood characteristics and differential mobility pattern, between 2006 and 2019, individuals who originally lived in gentrifying neighborhoods experienced worse changes in MUAs, ADI, and Walkability Index but a greater improvement in exposure to air pollutants. The negative changes are driven by movers, while stayers actually experience a relative improvement in MUAs and ADI and larger improvements in exposure to air pollutants. The findings indicate that gentrification may contribute to health disparities through changes in exposure to cSDOH through mobility to communities with worse cSDOH among residents of gentrifying neighborhoods although results in terms of exposure to health pollutants are mixed.
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Fuster M, Kodali H, Ray K, Elbel B, Handley MA, Huang TTK, Johnson G. Area Characteristics and Consumer Nutrition Environments in Restaurants: an Examination of Hispanic Caribbean Restaurants in New York City. J Racial Ethn Health Disparities 2022; 9:1454-1463. [PMID: 34152587 PMCID: PMC8216094 DOI: 10.1007/s40615-021-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
Hispanics in the USA, particularly those of Caribbean descent, experience high levels of diet-related diseases and dietary risk factors. Restaurants are an increasingly important yet understudied source of food and may present opportunities to positively influence urban food environments. We sought to explore food environments further, by examining the association between neighborhood characteristics and restaurant consumer nutrition environments within New York City's Hispanic Caribbean (HC) restaurant environments. We applied an adapted version of the Nutrition Environment Measurements Survey for Restaurants (NEMS-R) to evaluate a random sample of HC restaurants (n=89). NEMS-HCR scores (continuous and categorized as low, medium, and high based on data distribution) were examined against area sociodemographic characteristics using bivariate and logistic regression analysis. HC restaurants located in Hispanic geographic enclaves had a higher proportion of fried menu items (p<0.01) but presented fewer environmental barriers to healthy eating, compared with those in areas with lower Hispanic concentrations. No significant differences in NEMS-R scores were found by other neighborhood characteristics. Size was the only significant factor predicting high NEMS-HCR scores, where small restaurants were less likely to have scores in the high category (NEMS-HCR score>6), compared with their medium (aOR: 6.6, 95% CI: 1.8-24.6) and large counterparts (aOR: 5.6, 95% CI: 1.5-21.4). This research is the first to examine the association between restaurant location and consumer nutrition environments, providing information to contribute to future interventions and policies seeking to improve urban food environments in communities disproportionately affected by diet-related conditions, as in the case of HC communities in New York City.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY, USA.
| | - Hanish Kodali
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Brian Elbel
- Department of Population Health, Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Terry T-K Huang
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, City University of New York, New York, NY, USA
| | - Glen Johnson
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
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Greening, Revitalization, and Health in South Wilmington, Delaware. Dela J Public Health 2022; 8:78-84. [PMID: 36177162 PMCID: PMC9495474 DOI: 10.32481/djph.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We highlight the potential for paradoxical impacts of green infrastructure integrated with urban redevelopment. Absent directly addressing social inequalities in parallel efforts, green infrastructure may lead to negative health outcomes of disadvantaged residents, including eventual displacement. We present the research literature and reviews on this topic. We next highlight the case of recent in-migration of higher-income Whites and others in South Wilmington, Delaware, spurred on by high-end Riverfront redevelopment at Christina Landing. This migration may obscure how greening efforts—such as a new wetlands park to control area flooding—influence health outcomes in Southbridge, a low-income, African American neighborhood also within South Wilmington. The area’s Census tract boundary, often used in both health and equity assessments, is shared by these distinctive communities. When viewed through the lens of inequality, greening can have multi-faceted impacts that structure health outcomes. We underscore the importance of the mitigation of its potentially harmful effects.
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Candipan J, Riley AR, Easley JA. While Some Things Change, Do Others Stay the Same? The Heterogeneity of Neighborhood Health Returns to Gentrification. HOUSING POLICY DEBATE 2022; 33:129-163. [PMID: 39130778 PMCID: PMC11315458 DOI: 10.1080/10511482.2022.2076715] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/13/2022] [Accepted: 05/06/2022] [Indexed: 08/13/2024]
Abstract
Gentrification is associated with decreases in neighborhood poverty and crime, increases in amenities and services, among other benefits-all identified as structural determinants of health. However, gentrification is also associated with population-level replacement of the existing community, or threats thereof. Combining census data from the ten largest MSAs in the U.S. with tract-level estimates from the CDC-PLACES Project from 2013-14 to 2017-18, we explore how the changing socioeconomic conditions in gentrifying neighborhoods correlate with changes in neighborhood health. We find significant differences between gentrifying and non-gentrifying neighborhoods in their associations with neighborhood health. The sociodemographic changes occurring in gentrifying neighborhoods generally correspond with simultaneous decreases in aggregate health risk behaviors and negative health outcomes. However, these changes are heterogeneous and complex. Whether and how neighborhood health changes alongside other components of neighborhood change depends on whether gentrification occurs in majority Black, Hispanic, or White neighborhoods. Our findings provide preliminary evidence that the changes accompanying gentrification extend to neighborhood health, but the direction of influence varies by neighborhood composition, type of sociodemographic change, specific health outcome, and spatial spillover. We discuss theoretical implications for future work addressing the mechanisms driving changes in neighborhood health, and potential approaches that differentiate policy responses.
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Willis MD, Orta OR, Ncube C, Wesselink AK, Ðoàn LN, Kirwa K, Boynton-Jarrett R, Hatch EE, Wise LA. Association Between Neighborhood Disadvantage and Fertility Among Pregnancy Planners in the US. JAMA Netw Open 2022; 5:e2218738. [PMID: 35771576 PMCID: PMC9247730 DOI: 10.1001/jamanetworkopen.2022.18738] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IMPORTANCE Decades of inequitable policies in the US have yielded disparities in neighborhood quality, and some studies show that living in a socioeconomically disadvantaged neighborhood is associated with worse health outcomes, including reproductive health outcomes. However, no US studies to date have directly examined the association between residence in disadvantaged neighborhoods and fertility. OBJECTIVE To examine the association between residence in disadvantaged neighborhoods and fecundability, a sensitive marker of fertility with many health implications. DESIGN, SETTING, AND PARTICIPANTS This prospective preconception cohort study used the Pregnancy Study Online, for which baseline data were collected from June 19, 2013, through April 12, 2019. The study included 6356 participants who identified as female, were 21 to 45 years of age, were attempting conception without fertility treatment, and provided a valid residential address in the contiguous US at enrollment. EXPOSURES A standardized area deprivation index (ADI) derived at the census block group level applied to each residential address. MAIN OUTCOMES AND MEASURES Fecundability, the per-cycle probability of conception, via questionnaires that were completed every 8 weeks for 12 months, until conception or a censoring event. Proportional probabilities models were used to estimate fecundability ratios and 95% CIs for associations between ADI and fecundability. Restricted cubic splines were also implemented to examine nonlinearity. Models were adjusted for demographic characteristics and factors associated with fertility. The study's a priori hypothesis was that higher levels of neighborhood disadvantage would be associated with decreased fecundability. RESULTS Among 6356 participants, 3725 pregnancies were observed for 27 427 menstrual cycles of follow-up. The mean (SD) baseline age was 30.0 (4.1) years, and most participants were non-Hispanic White (5297 [83.3%]) and nulliparous (4179 [65.7%]). Comparing the top and bottom deciles of disadvantaged neighborhood status, adjusted fecundability ratios were 0.79 (95% CI, 0.66-0.96) for national-level ADI rankings and 0.77 (95% CI, 0.65-0.92) for within-state ADI rankings. Restricted cubic splines showed some evidence of nonlinearity in the association. Associations were slightly stronger among participants with lower annual incomes (<$50 000). CONCLUSIONS AND RELEVANCE In this cohort study, residence in a socioeconomically disadvantaged neighborhood was associated with moderately decreased fecundability. If confirmed in other studies, these results suggest that investments to reduce disadvantaged neighborhood status may yield positive cobenefits for fertility.
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Affiliation(s)
- Mary D Willis
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
| | - Olivia R Orta
- John Jay College of Criminal Justice, City University of New York, New York, New York
| | - Collette Ncube
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
| | - Amelia K Wesselink
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
| | - Lan N Ðoàn
- Department of Population Health, Section for Health Equity, Grossman School of Medicine, New York University, New York
| | - Kipruto Kirwa
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts
| | - Renée Boynton-Jarrett
- Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts
| | - Elizabeth E Hatch
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
| | - Lauren A Wise
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
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Selected Research Issues of Urban Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095553. [PMID: 35564947 PMCID: PMC9105718 DOI: 10.3390/ijerph19095553] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/17/2023]
Abstract
Health is created within the urban settings of people’s everyday lives. In this paper we define Urban Public Health and compile existing evidence regarding the spatial component of health and disease in urban environments. Although there is already a substantial body of single evidence on the links between urban environments and human health, focus is mostly on individual health behaviors. We look at Urban Public Health through a structural lens that addresses health conditions beyond individual health behaviors and identify not only health risks but also health resources associated with urban structures. Based on existing conceptual frameworks, we structured evidence in the following categories: (i) build and natural environment, (ii) social environment, (iii) governance and urban development. We focused our search to review articles and reviews of reviews for each of the keywords via database PubMed, Cochrane, and Google Scholar in order to cover the range of issues in urban environments. Our results show that linking findings from different disciplines and developing spatial thinking can overcome existing single evidence and make other correlations visible. Further research should use interdisciplinary approaches and focus on health resources and the transformation of urban structures rather than merely on health risks and behavior.
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Sangaramoorthy M, Yang J, Guan A, DeRouen MC, Tana MM, Somsouk M, Thompson CA, Gibbons J, Ho C, Chu JN, Cheng I, Gomez SL, Shariff-Marco S. Asian American/Pacific Islander and Hispanic Ethnic Enclaves, Neighborhood Socioeconomic Status, and Hepatocellular Carcinoma Incidence in California: An Update. Cancer Epidemiol Biomarkers Prev 2022; 31:382-392. [PMID: 34853019 PMCID: PMC8825691 DOI: 10.1158/1055-9965.epi-21-1035] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Using more recent cancer registry data, we analyzed disparities in hepatocellular carcinoma (HCC) incidence by ethnic enclave and neighborhood socioeconomic status (nSES) among Asian American/Pacific Islander (AAPI) and Hispanic populations in California. METHODS Primary, invasive HCC cases were identified from the California Cancer Registry during 1988-1992, 1998-2002, and 2008-2012. Age-adjusted incidence rates (per 100,000 population), incidence rate ratios, and corresponding 95% confidence intervals were calculated for AAPI or Hispanic enclave, nSES, and the joint effects of ethnic enclave and nSES by time period (and the combination of the three periods), sex, and race/ethnicity. RESULTS In the combined time period, HCC risk increased 25% for highest versus lowest quintile of AAPI enclave among AAPI males. HCC risk increased 22% and 56% for lowest versus highest quintile of nSES among AAPI females and males, respectively. In joint analysis, AAPI males living in low nSES areas irrespective of enclave status were at 17% to 43% increased HCC risk compared with AAPI males living in areas of nonenclave/high nSES. HCC risk increased by 22% for Hispanic females living in areas of low nSES irrespective of enclave status and by 19% for Hispanic males living in areas of nonenclave/low nSES compared with their counterparts living in areas of nonenclave/high nSES. CONCLUSIONS We found significant variation in HCC incidence by ethnic enclave and nSES among AAPI and Hispanic populations in California by sex and time period. IMPACT Future studies should explore how specific attributes of enclaves and nSES impact HCC risk for AAPI and Hispanic populations.
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Affiliation(s)
- Meera Sangaramoorthy
- Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
| | - Juan Yang
- Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
| | - Alice Guan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
| | - Mindy C DeRouen
- Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Michele M Tana
- Division of Gastroenterology at Zuckerberg San Francisco General, University of California San Francisco, San Francisco, California
| | - Ma Somsouk
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
- Division of Gastroenterology at Zuckerberg San Francisco General, University of California San Francisco, San Francisco, California
| | - Caroline A Thompson
- School of Public Health, San Diego State University, San Diego, California
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
| | - Joseph Gibbons
- Department of Sociology, College of Arts and Letters, San Diego State University, San Diego, California
| | - Chanda Ho
- Department of Transplantation, California Pacific Medical Center, San Francisco, California
| | - Janet N Chu
- Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Iona Cheng
- Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Scarlett Lin Gomez
- Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Salma Shariff-Marco
- Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California.
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
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The Impacts of Tourism Stays on Residents’ Self-Reported Health: A Pan-European Analysis on the Role of Age and Urbanization Level. SUSTAINABILITY 2022. [DOI: 10.3390/su14031157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Understanding the impacts of tourism on the quality of life of residents is a priority for the sustainable tourism agenda, and is especially relevant to the COVID-19 recovery period. However, the evidence is poor, and it is not clear whether the outcomes vary among sociodemographic groups. This study fills this gap by proposing a pan-European analysis of the effects of tourism stays per 1000 residents (as a measure of tourism pressure) on self-perceived health at a regional level, based on data from Eurostat, the EU-SILC (European Union Statistics on Income and Living Conditions survey), and the LFS (Labor Force Survey). Multilevel models with random effects were used, including three levels: region, time, and region–time. Results show that tourism pressure may benefit self-reported health but only among residents aged over 50 years old living in rural contexts, or over 65 living in low density urban areas. As for younger groups (under 50) living in high density cities, tourism is longitudinally associated with worsened self-reported health. These results, which are supported by instrumental-variable estimations, suggest that urban residents and younger groups do not benefit from tourism. This might be due to a number of side effects related to increased living costs, precarious labour, and conflicts related to public space. Therefore, our findings challenge the narrative that urban tourism universally improves residents’ quality of life. Considering the global urgency of creating healthier and more equitable post-COVID-19 cities and societies, tourism should be considered together with health and equity dimensions.
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Iyanda AE, Lu Y. 'Gentrification is not improving my health': a mixed-method investigation of chronic health conditions in rapidly changing urban neighborhoods in Austin, Texas. JOURNAL OF HOUSING AND THE BUILT ENVIRONMENT : HBE 2022; 37:77-100. [PMID: 33994893 PMCID: PMC8107018 DOI: 10.1007/s10901-021-09847-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/19/2021] [Indexed: 05/14/2023]
Abstract
UNLABELLED Though there are extensive studies on neighborhood effects on health, this relationship remains elusive and requires continuous empirical evidence to support existing findings. Gentrification is a process of neighborhood change that affects most longtime residents. This study examined the health impact of the rapidly changing physical and cultural environment using oral history interviews, electronic interviews, and a quantitative structured survey. The study draws on the social determinants of health framework to explain the self-reported chronic health conditions (SR-CHCs) among 331 residents in Austin, Texas. The study employed non-linear techniques suitable for Poisson distribution to estimate the association between gentrification and SR-CHCs and complemented by direct quotes from in-depth interviews (IDIs). Perceived gentrification score significantly vary by marital status (p < 0.001), educational attainment (p < 0.001), and gender (p < 0.01), while SR-CHCs only significantly varies by educational attainment, p = 0.015). Multivariate results show that gentrification was positively associated with SR-CHCs, after adjusting for socioeconomic variables. Compared to the Hispanics, blacks were 97% more likely to report multiple counts of SR-CHCs (IRR = 1.969, 95% CI 1.074-3.608), and participants with high household income were 8% less likely to report multiple CHCs (IRR = 0.920, 95% CI 0.870-0.973). Drawing from the empirical findings, this study recommends both area-based and individual-level policies to mitigate neighborhood change's impact on residents' health. Finally, this study further adds to the understanding of social determinants of health in understanding chronic health within the changing urban physical and socio-ecology systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10901-021-09847-8.
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Affiliation(s)
- Ayodeji Emmanuel Iyanda
- Department of Geography, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Yongmei Lu
- Department of Geography, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
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Russo RG, Li Y, Ðoàn LN, Ali SH, Siscovick D, Kwon SC, Yi SS. COVID-19, Social Determinants of Health, and Opportunities for Preventing Cardiovascular Disease: A Conceptual Framework. J Am Heart Assoc 2021; 10:e022721. [PMID: 34889110 PMCID: PMC9075236 DOI: 10.1161/jaha.121.022721] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The COVID‐19 pandemic has disrupted the social, economic, and health care systems in the United States and shined a spotlight on the burden of disease associated with social determinants of health (SDOH). Addressing SDOH, while a challenge, provides important opportunities to mitigate cardiovascular disease incidence, morbidity, and mortality. We present a conceptual framework to examine the differential effects of the COVID‐19 pandemic on SDOH across demographically diverse populations, focusing on the short‐ and long‐term development of cardiovascular disease, as well as future research opportunities for cardiovascular disease prevention. The COVID‐19 pandemic exerted negative shifts in SDOH and cardiovascular risk factors (ie, smoking, body mass index, physical activity, dietary behavior, cholesterol, blood pressure, and blood sugar). For example, evidence suggests that unemployment and food insecurity have increased, whereas health care access and income have decreased; changes to SDOH have resulted in increases in loneliness and processed food consumption, as well as decreases in physical activity and hypertension management. We found that policy measures enacted to mitigate economic, social, and health issues inadequately protected populations. Low‐income and racial and ethnic minority communities, historically underserved populations, were not only disproportionately adversely affected by the pandemic but also less likely to receive assistance, likely attributable in part to the deep structural inequities pervasive in our society. Effective and culturally appropriate interventions are needed to mitigate the negative health impacts of historical systems, policies, and programs that created and maintain structural racism, especially for immigrants, racial and ethnic minorities, and populations experiencing social disadvantage.
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Affiliation(s)
- Rienna G Russo
- Department of Population Health NYU Grossman School of Medicine New York NY
| | - Yan Li
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY.,Department of Obstetrics, Gynecology, and Reproductive Science Icahn School of Medicine at Mount Sinai New York NY
| | - Lan N Ðoàn
- Department of Population Health NYU Grossman School of Medicine New York NY
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences NYU School of Global Public Health New York NY
| | | | - Simona C Kwon
- Department of Population Health NYU Grossman School of Medicine New York NY
| | - Stella S Yi
- Department of Population Health NYU Grossman School of Medicine New York NY
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Joyce BT, Gao T, Koss K, Zheng Y, Cardenas A, Heiss J, Just A, Zhang K, van Horn L, Allen NB, Greenland P, Cohen S, Gordon-Larsen P, Mitchell C, McLanahan S, Schneper L, Notterman D, Rifas-Shiman SL, Oken E, Hivert MF, Wright R, Baccarelli A, Lloyd-Jones D, Hou L. Impact of paternal education on epigenetic ageing in adolescence and mid-adulthood: a multi-cohort study in the USA and Mexico. Int J Epidemiol 2021; 51:870-884. [PMID: 34534313 DOI: 10.1093/ije/dyab196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Both parental and neighbourhood socio-economic status (SES) are linked to poorer health independently of personal SES measures, but the biological mechanisms are unclear. Our objective was to examine these influences via epigenetic age acceleration (EAA)-the discrepancy between chronological and epigenetic ages. METHODS We examined three USA-based [Coronary Artery Risk Disease in Adults (CARDIA) study, Fragile Families and Child Wellbeing Study (FFCWS) and Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS)] and one Mexico-based (Project Viva) cohort. DNA methylation was measured using Illumina arrays, personal/parental SES by questionnaire and neighbourhood disadvantage from geocoded address. In CARDIA, we examined the most strongly associated personal, parental and neighbourhood SES measures with EAA (Hannum's method) at study years 15 and 20 separately and combined using a generalized estimating equation (GEE) and compared with other EAA measures (Horvath's EAA, PhenoAge and GrimAge calculators, and DunedinPoAm). RESULTS EAA was associated with paternal education in CARDIA [GEEs: βsome college = -1.01 years (-1.91, -0.11) and β<high school = 1.05 (0.09, 2.01) vs college graduates] and FFCWS [GEEs: β<high school = 0.62 (0.00, 1.24)]. We found stronger associations for some paternal education categories among White adults (for GEE, βsome college = -1.39 (-2.41, -0.38)], men (βsome college = -1.76 (-3.16, -0.35)] and women [β<high school = 1.77 (0.42, 3.11)]. CONCLUSIONS These findings suggest that EAA captures epigenetic impacts of paternal education independently of personal SES later in life. Longitudinal studies should explore these associations at different life stages and link them to health outcomes. EAA could be a useful biomarker of SES-associated health and provide important insight into the pathogenesis and prevention of chronic disease.
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Affiliation(s)
- Brian T Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tao Gao
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kalsea Koss
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Jonathan Heiss
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Kai Zhang
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Linda van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Norrina Bai Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Colter Mitchell
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Sara McLanahan
- Department of Sociology, Princeton University, Princeton, NJ, USA
| | - Lisa Schneper
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
| | - Daniel Notterman
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Department of Endocrinology, Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Hirsch JA, Grunwald HE, Miles KL, Michael YL. Development of an instrument to measure perceived gentrification for health research: Perceptions about changes in environments and residents (PACER). SSM Popul Health 2021; 15:100900. [PMID: 34485674 PMCID: PMC8399084 DOI: 10.1016/j.ssmph.2021.100900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 01/22/2023] Open
Abstract
Despite a myriad of potential pathways linking neighborhood change and gentrification to health, existing quantitative measures failed to capture individual-level, self-reported perceptions of these processes. We developed the Perceptions About Change in Environment and Residents (PACER) survey to measure the gentrification-related neighborhood change experienced by individuals relevant to health. We employed a multi-stage process to develop PACER including a scoping review, question refinement, content validity, and cognitive interviews. Content validity and cognitive interviews were assessed within the National Neighborhood Indicators Partnership (NNIP) and for residents of different tenure in both gentrifying and non-gentrifying neighborhoods to ensure PACER considers the complex nature of neighborhood change for different people within different urban contexts. We piloted the instrument to a sample from the resident panel BeHeardPhilly to assess acceptability and data quality. Finally, we assessed internal consistency, dimensionality, and criterion-related validity using Principal Components Analysis (PCA), descriptive statistics, and correlation coefficients. Testing showed good internal consistency for PACER questions, as well as for each of four resulting factors (Feelings, Built Environment, Social Environment, and Affordability). Correlations between factors and other context measures demonstrated strong criterion-related validity. PACER offers an unprecedented tool for measuring and understanding resident perceptions about gentrification-related neighborhood change relevant to health. Rigorously tested and tailored for health, PACER holds utility for application across different settings to examine changes from events that may impact and shift neighborhoods.
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Affiliation(s)
- Jana A. Hirsch
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
| | - Heidi E. Grunwald
- Institute for Survey Research, Temple University, Philadelphia, PA, USA
| | - Keisha L. Miles
- Institute for Survey Research, Temple University, Philadelphia, PA, USA
| | - Yvonne L. Michael
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
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Croff R, Hedmann M, Barnes LL. Whitest City in America: A Smaller Black Community's Experience of Gentrification, Displacement, and Aging in Place. THE GERONTOLOGIST 2021; 61:1254-1265. [PMID: 33772304 DOI: 10.1093/geront/gnab041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The influx of people with higher socioeconomic status into large Black communities is well documented; less is known regarding smaller, aging Black communities. Older Black adults in Portland, Oregon, among America's fastest gentrifying cities with the smallest metropolitan Black population, discussed barriers to healthy aging. Perspectives centered on the experience of gentrification, displacement, and its impact on social microsystems, place security, and aging in place. RESEARCH DESIGN AND METHODS One-time focus groups engaged 41 Black adults aged ≥45. A demographic survey included residence area/duration. Discussions were thematically coded. Ecological Systems Theory guided interpretation. RESULTS The majority of participants resided within gentrifying historically Black neighborhoods (89.2%), were aged ≥65 (54.6%), and lived in their neighborhood ≥21 years (24.3%). Emergent discussion themes were: Rise and fall of Black ownership; Displacement; Race-related stress; and Financial burden. Gentrification contributed to the dismantling of Black property ownership curated over generations, increased financial burden, and threatened place security. Physical displacement strained social networks, diminishing intergenerational neighborhood ties that supported aging in place. Cultural and physical displacement weakened sense of social cohesion and belonging, and induced race-related stressful interactions with new residents within original and relocation neighborhoods. DISCUSSION AND IMPLICATIONS Gentrification in the Pacific Northwest echoes national trends, uprooting critical close-proximity social networks and deteriorating motivation to engage in neighborhood-based social activity. Smaller, aging Black communities may be particularly vulnerable to these effects which critically impact aging in place. Data inform researchers and policymakers to better understand how gentrification affects smaller, aging Black communities.
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Affiliation(s)
- Raina Croff
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Monique Hedmann
- Department of Family Medicine, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
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46
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Breaking Down and Building Up: Gentrification, Its drivers, and Urban Health Inequality. Curr Environ Health Rep 2021; 8:157-166. [PMID: 33713334 PMCID: PMC7955692 DOI: 10.1007/s40572-021-00309-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 12/27/2022]
Abstract
Purpose of Review Many neighborhoods which have been unjustly impacted by histories of uneven urban development, resulting in socioeconomic and racial segregation, are now at risk for gentrification. As urban renewal projects lead to improvements in the long-neglected built environments of such neighborhoods, accompanying gentrification processes may lead to the displacement of or exclusion of underprivileged residents from benefiting from new amenities and improvements. In addition, gentrification processes may be instigated by various drivers. We aimed to discuss the implications of specific types of gentrification, by driver, for health equity. Recent Findings Several recent articles find differential effects of gentrification on the health of underprivileged residents of gentrifying neighborhoods compared to those with greater privilege (where sociodemographic dimensions such as race or socioeconomic status are used as a proxy for privilege). Generally, studies show that gentrification may be beneficial for the health of more privileged residents while harming or not benefiting the health of underprivileged residents. Very recent articles have begun to test hypothesized pathways by which urban renewal indicators, gentrification, and health equity are linked. Few public health articles to date are designed to detect distinct impacts of specific drivers of gentrification. Summary Using a case example, we hypothesize how distinct drivers of gentrification—specifically, retail gentrification, environmental gentrification, climate gentrification, studentification, tourism gentrification, and health care gentrification—may imply specific pathways toward reduced health equity. Finally, we discuss the challenges faced by researchers in assessing the health impacts of gentrification.
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Green Gentrification and Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030907. [PMID: 33494268 PMCID: PMC7908481 DOI: 10.3390/ijerph18030907] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 12/25/2022]
Abstract
Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on how greening initiatives in gentrifying neighborhoods impact health, well-being, and health pathways (e.g., physical activity, affordable housing). Using a multi-step approach to scoping the literature (including searches in PubMed, JSTOR, and Google Scholar), we identified 15 empirical studies that met our inclusion criteria. We found studies focusing on green space use, physical activity, sense of community, safety, and self-reported health. Overall, longtime, marginalized residents are negatively impacted by green gentrification as they experience a lower sense of community, feel that they do not belong in green space, and, in many studies, use green space less often than newcomers. Overall, the research in this area is limited, and more studies on mental health and cardiovascular health markers could advance this literature. Based on the limited available evidence, we suggest that public health, urban planning, and parks professionals could collaborate to enhance the use of green space for marginalized residents and their feelings of inclusion in gentrifying areas.
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Smith GS, McCleary RR, Thorpe RJ. Racial Disparities in Hypertension Prevalence within US Gentrifying Neighborhoods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217889. [PMID: 33126467 PMCID: PMC7662342 DOI: 10.3390/ijerph17217889] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 01/14/2023]
Abstract
Racial disparities in hypertension remain a persistent public health concern in the US. While several studies report Black–White differences in the health impacts of gentrification, little is known concerning the impact of living in a gentrifying neighborhood on hypertension disparities. Data from the American Community Survey were used to identify gentrifying neighborhoods across the US from 2006 to 2017. Health and demographic data were obtained for non-Hispanic Black and White respondents of the 2014 Medical Expenditure Panel Survey (MEPS) residing in gentrifying neighborhoods. Modified Poisson models were used to determine whether there is a difference in the prevalence of hypertension of individuals by their race/ethnicity for those that live in gentrifying neighborhoods across the US. When compared to Whites living within gentrifying neighborhoods, Blacks living within gentrifying neighborhoods had a similar prevalence of hypertension. The non-existence of Black–White hypertension disparities within US gentrifying neighborhoods underscores the impact of neighborhood environment on race differences in hypertension.
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Affiliation(s)
- Genee S. Smith
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.R.M.); (R.J.T.J.)
- Correspondence: ; Tel.: +1-443-287-6735
| | - Rachael R. McCleary
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.R.M.); (R.J.T.J.)
| | - Roland J. Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.R.M.); (R.J.T.J.)
- Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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