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Lindauer A, Croff R, Duff K, Mattek N, Fuller P, Pierce A, Bonds K, Kaye J. The African American Dementia and Aging Project (AADAPt): An Oregon-based Longitudinal Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.06.24306831. [PMID: 38766213 PMCID: PMC11100851 DOI: 10.1101/2024.05.06.24306831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Objectives The vast majority of studies on aging, cognition, and dementia focus on non-Hispanic white subjects. This paper adds to the extant literature by providing insight into the African American aging experience. Here we describe the study design and baseline characteristics of the African American Dementia and Aging Project (AADAPt) study, which is exploring aging and cognition in African American older adults in Oregon. Methods African American older adults (n=177) participated in AADAPt, a longitudinal study that collected data on cognitive, physical, and social functioning in annual visits since 2000. Results AADAPt participants had risk factors for developing dementia in future, such as hypertension and hyperlipidemia, but also reported protective factors such as high social engagement. Conclusions The AADAPt project offers new insights into aging in older African Americans that includes data on cognition, social engagement, and physical health, which are crucial for understanding the experience of under-represented groups and making future studies more inclusive. These findings reflect a window of time for a geographically-focused cohort, and the lessons learned from this study likely have broader implications for shaping the health of these older African American adults. Keywords: African American, Dementia, Observational Study.
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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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Zhan S, Ye J. Disrupted ageing in place: Urbanisation and displaced older villagers in Suzhou, China. Australas J Ageing 2024; 43:256-263. [PMID: 38497227 DOI: 10.1111/ajag.13299] [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: 09/02/2023] [Revised: 01/20/2024] [Accepted: 02/09/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE This study examines the impacts of urbanisation-induced displacement on rural older villagers and the issues of rebuilding ageing in place in Suzhou Municipality in China's Jiangsu Province. METHODS The study employed a qualitative research method involving three measures of data collection, including 20 older-adult interviews, 14 key informant interviews (with street and community administrators, managers of service companies, managers of nursing homes and community doctor) and participant observation of older villagers' daily life in urban resettlement communities. RESULTS The displacement and resettlement of villagers for urbanisation had serious negative impacts on older villagers, including financial insecurity, relative deprivation and radical changes to the living environment. The community services were limited and insufficient, but the resettlement of the whole village in the same place enabled the village community to maintain social and cultural continuities, which facilitated older villagers' adaptation to the new urban place. Filial piety, though weakened and transformed, continued to play an important role in regulating old-age support, but descending familism reduced family resources for old-age support. CONCLUSIONS This study highlights the importance of examining the impacts of external social and economic forces, such urbanisation in China, on ageing in place. We draw three conclusions based on empirical research in Suzhou: (1) the resettlement of older villagers in urban areas did not significantly narrow the rural-urban gap in old-age support in Suzhou; (2) urbanisation-induced displacement in China affected older residents differently from gentrification in Western countries, due to different processes of compensation and resettlement as well as China's rural-urban welfare gap; and (3) community services for displaced older villagers are limited, but social and cultural continuities before and after resettlement have helped older villagers adapt to the new urban place.
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Affiliation(s)
- Shaohua Zhan
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Jihong Ye
- School of Politics and Public Administration, Governance Modernization Research Base of Southern Jiangsu Province, Soochow University, Suzhou, China
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Pan Z, Liu Y, Liu Y, Huo Z, Han W. Age-friendly neighbourhood environment, functional abilities and life satisfaction: A longitudinal analysis of older adults in urban China. Soc Sci Med 2024; 340:116403. [PMID: 37989046 DOI: 10.1016/j.socscimed.2023.116403] [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: 04/17/2023] [Revised: 10/02/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
The construction of age-friendly neighbourhoods is a priority for practice and policy to promote active ageing and increase life satisfaction for older adults. However, there has been a paucity of longitudinal evidence on the interaction effects of age-friendly neighbourhood environment and functional abilities on life satisfaction among older adults in urban China. This study makes the first attempt to examine the effect of person-environment fit on life satisfaction by the accumulative effects of age-friendliness of the baseline neighbourhood environment (measured within the WHO Age-Friendly City framework) on functional abilities and life satisfaction trajectories and the long-term effects of functioning changes on life satisfaction, drawing from four waves of longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) and latent growth curve modelling. Results indicated that the age-friendliness of transportation was positively associated with functional abilities, and housing was the primary factor that shaped life satisfaction at the baseline. Better maintenance of functional abilities could promote life satisfaction over time. For older adults living in recently built neighbourhoods, social environment factors such as associations and facilities for social participation were more important in functional abilities, and communication and information were more important in life satisfaction. For those living in neighbourhoods built before 2000, physical environment factors such as transportation were essential in functional abilities, and housing was more essential in life satisfaction; health-related facilities and services at baseline exerted a cumulative effect on maintaining functional abilities in the long run. Our findings inform policymakers about how to effectively allocate public resources to enhance older adults' life satisfaction in the Chinese urban context.
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Affiliation(s)
- Zhuolin Pan
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Engineering Research Center for Public Security and Disaster, Guangzhou, China.
| | - Yuqi Liu
- Department of Urban Planning, School of Architecture, South China University of Technology, Guangzhou, China.
| | - Ye Liu
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou, China; Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Engineering Research Center for Public Security and Disaster, Guangzhou, China.
| | - Ziwen Huo
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou, China.
| | - Wenchao Han
- Guangzhou Urban Planning & Design Survey Research Institute, Guangzhou, China.
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Pichardo CM, Chambers EC, Sanchez-Johnsen LAP, Pichardo MS, Gallo L, Talavera GA, Pirzada A, Roy A, Castañeda SF, Durazo-Arvizu RA, Perreira KM, Teng Y, Rodriguez CB, Allison M, Carlson JA, Daviglus ML, Plascak JJ. Association of census-tract level gentrification and income inequality with 6-year incidence of metabolic syndrome in the Hispanic Community Health Study/Study of Latinos, an epidemiologic cohort study. Soc Sci Med 2023; 336:116222. [PMID: 37776783 PMCID: PMC11185427 DOI: 10.1016/j.socscimed.2023.116222] [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] [Received: 02/02/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Metabolic syndrome varies by socio-demographic characteristics, with younger (18-29 years) and older (50-69 years) Hispanic/Latino having higher prevalence compared to other groups. While there is substantial research on neighborhood influences on cardiometabolic health, there are mixed findings regarding the effects of gentrification and few studies have included Hispanic/Latinos. The role of neighborhood income inequality on metabolic health remains poorly understood. OBJECTIVES Examined associations of neighborhood gentrification and income inequality with metabolic syndrome (MetSyn) using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). DESIGN, SETTING AND PARTICIPANTS The HCHS/SOL is a community-based cohort of adults of Hispanic/Latinos (aged 18-74). Analyses included 6710 adults who did not meet criteria for MetsS at baseline (2008-2011) and completed the visit 2 examination (2014-2017). Poisson regressions estimated odds ratios (IRR) and 95% confidence intervals (CI) for neighborhood gentrification and change in income inequality with MetSyn incidence. MAIN OUTCOME AND EXPOSURE MEASURES Gentrification was measured with an index that included changes (2000 to 2006-2010) in education, poverty, and income. Change in neighborhood income inequality (2005-2009 to 2012-2016) was measured using the Gini coefficient of income distribution. MetSyn was defined using National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS Among 6647 Hispanic/Latino adults, 23% (N = 1530) had incident MetSyn. In models adjusted for socio-demographic, health insurance status, and neighborhood characteristics, gentrification (IRR, 1.00, 95%CI, 0.96-1.03) and income inequality change (IRR, 1.00, 95%CI, 0.99-1.00) were not associated with MetSyn at visit 2. There was no association between cross-sectional income inequality (2005-2009) and MetSyn at visit 2 (IRR, 0.97, 95%CI, 0.82-1.15). CONCLUSION Neighborhood gentrification and income inequality change were not associated with incidence of MetSyn over 6 years among Hispanic/Latino adults. This study demonstrated that income-based residential changes alone may not be sufficient to explain neighborhood influences on health outcomes among this population.
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Affiliation(s)
- Catherine M Pichardo
- National Cancer Institute, National Institute of Health, 9609 Medical Center Drive, Rockville, MD 20815, USA; University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA.
| | - Earle C Chambers
- Albert Einstein College of Medicine, 1300 Morris Park Ave, The Bronx, NY, 1046, USA
| | - Lisa A P Sanchez-Johnsen
- University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA; Medical College of Wisconsin (MCW), Institute for Health and Equity, Department of Psychiatry and Behavioral Medicine, and MCW Cancer Center, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Margaret S Pichardo
- Hospital of the University of Pennsylvania, Department of Surgery, 3400 Spruce St # 4, Philadelphia, PA, 19104, USA
| | - Linda Gallo
- San Diego State University, Department of Psychology, 5500 Campanile Drive; San Diego, CA, 92182-4611, USA
| | - Gregory A Talavera
- San Diego State University, Department of Psychology, 5500 Campanile Drive; San Diego, CA, 92182-4611, USA
| | - Amber Pirzada
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine West (MC 764) 1819 West Polk Street, Suite 246, Chicago, IL, 60612, USA
| | - Amanda Roy
- University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA
| | - Sheila F Castañeda
- San Diego State University, Department of Psychology, 5500 Campanile Drive; San Diego, CA, 92182-4611, USA
| | - Ramon A Durazo-Arvizu
- Children's Hospital Los Angeles, Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA
| | - Krista M Perreira
- University of North Carolina at Chapel Hill School of Medicine, 321 S Columbia St, Chapel Hill, NC, 27599, USA
| | - Yanping Teng
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, 123 W. Franklin Street, Suite 450 CB #8030 Chapel Hill, NC, 27516, USA
| | - Carmen B Rodriguez
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Matthew Allison
- University of California San Diego, School of Health Sciences, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Jordan A Carlson
- Children's Mercy Kansas City Hospital, 2401 Gillham Rd, Kansas City, MO, 64108, USA
| | - Martha L Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine West (MC 764) 1819 West Polk Street, Suite 246, Chicago, IL, 60612, USA
| | - Jesse J Plascak
- Ohio State University Comprehensive Cancer Center, Starling-Loving Hall, 320 W 10th Ave b302, Columbus, OH, 43210, USA
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Mendoza-Graf A, MacCarthy S, Collins R, Wagner L, Dubowitz T. Exploring differences in perceptions of gentrification, neighborhood satisfaction, social cohesion, and health among residents of two predominantly African American Pittsburgh neighborhoods (n = 60). BMC Public Health 2023; 23:2137. [PMID: 37915015 PMCID: PMC10621185 DOI: 10.1186/s12889-023-16970-4] [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: 05/31/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Gentrification often leads to changes in the social and physical environment of neighborhoods, which social capital theory has found are connected to aspects of resident health and wellbeing. A growing body of literature has explored the impact of gentrification on health and wellbeing of residents. The goal of this study is to qualitatively explore the ways in which gentrification may have impacted perceptions of neighborhood satisfaction, social cohesion, and health of neighborhood residents (n = 60) from two predominantly Black neighborhoods in Pittsburgh, Pennsylvania, one of which experienced Black gentrification during the study's time period. This analysis is unique in its ability to capture experiences of residents who remained in their neighborhood throughout the course of the study, as well as those who moved away from their neighborhood. METHODS Participants were randomly selected from a larger cohort enrolled in a quasi-experimental study and categorized by whether they lived in a census tract that gentrified, whether they owned or rented their home, and whether they moved from the neighborhood or remained in the same place of residence between 2011 and 2018. Phone interviews lasting approximately 30 min were conducted with participants and were audio recorded and transcribed verbatim. Participants were provided a $40 gift card for their time. Interview data were analyzed using a directed content approach, and Cohen's Kappa was obtained (k = 0.924) to signal good inter-rater reliability. RESULTS Results showed renters in gentrified census tracts overwhelmingly viewed gentrification trends as a negative change compared to homeowners. Overall, participants from gentrified census tracts reported being relatively satisfied with their neighborhood, though some suggested there were fewer resources in the neighborhood over time; felt their social cohesion had deteriorated over time; and more commonly reflected negative health changes over time. CONCLUSIONS These findings suggest that while gentrification can bring much needed improvements to neighborhoods, it can also bring other disruptive changes that affect the health and wellbeing of existing residents.
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Affiliation(s)
| | - Sarah MacCarthy
- Department of Health Behavior, University of Alabama School of Public Health, 227 Ryals Public Health Building, 1665 University Boulevard, Birmingham, Alabama, 35233, England
| | - Rebecca Collins
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - La'Vette Wagner
- RAND Corporation, Pittsburgh Office, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Tamara Dubowitz
- RAND Corporation, Pittsburgh Office, 1776 Main Street, Santa Monica, CA, 90407, USA
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Sims KD, Willis MD, Hystad PW, Batty GD, Bibbins-Domingo K, Smit E, Odden MC. Neighborhood Characteristics and Elevated Blood Pressure in Older Adults. JAMA Netw Open 2023; 6:e2335534. [PMID: 37747730 PMCID: PMC10520741 DOI: 10.1001/jamanetworkopen.2023.35534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Importance The local environment remains an understudied contributor to elevated blood pressure among older adults. Untargeted approaches can identify neighborhood conditions interrelated with racial segregation that drive hypertension disparities. Objective To evaluate independent associations of sociodemographic, economic, and housing neighborhood factors with elevated blood pressure. Design, Setting, and Participants In this cohort study, the sample included Health and Retirement Study participants who had between 1 and 3 sets of biennial sphygmomanometer readings from 2006 to 2014 or 2008 to 2016. Statistical analyses were conducted from February 5 to November 30, 2021. Exposures Fifty-one standardized American Community Survey census tract variables (2005-2009). Main Outcomes and Measures Elevated sphygmomanometer readings over the study period (6-year period prevalence): a value of at least 140 mm Hg for systolic blood pressure and/or at least 90 mm Hg for diastolic blood pressure. Participants were divided 50:50 into training and test data sets. Generalized estimating equations were used to summarize multivariable associations between each neighborhood variable and the period prevalence of elevated blood pressure, adjusting for individual-level covariates. Any neighborhood factor associated (Simes-adjusted for multiple comparisons P ≤ .05) with elevated blood pressure in the training data set was rerun in the test data set to gauge model performance. Lastly, in the full cohort, race- and ethnicity-stratified associations were evaluated for each identified neighborhood factor on the likelihood of elevated blood pressure. Results Of 12 946 participants, 4565 (35%) had elevated sphygmomanometer readings (median [IQR] age, 68 [63-73] years; 2283 [50%] male; 228 [5%] Hispanic or Latino, 502 [11%] non-Hispanic Black, and 3761 [82%] non-Hispanic White). Between 2006 and 2016, a lower likelihood of elevated blood pressure was observed (relative risk for highest vs lowest tertile, 0.91; 95% CI, 0.86-0.96) among participants residing in a neighborhood with recent (post-1999) in-migration of homeowners. This association was precise among participants with non-Hispanic White and other race and ethnicity (relative risk, 0.91; 95% CI, 0.85-0.97) but not non-Hispanic Black participants (relative risk, 0.97; 95% CI, 0.85-1.11; P = .48 for interaction) or Hispanic or Latino participants (relative risk, 0.84; 95% CI, 0.65-1.09; P = .78 for interaction). Conclusions and Relevance In this cohort study of older adults, recent relocation of homeowners to a neighborhood was robustly associated with reduced likelihood of elevated blood pressure among White participants but not their racially and ethnically marginalized counterparts. Our findings indicate that gentrification may influence later-life blood pressure control.
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Affiliation(s)
- Kendra D. Sims
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Mary D. Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Perry W. Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - G. David Batty
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Editor in Chief, JAMA
| | - Ellen Smit
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Michelle C. Odden
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
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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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Thurber A. Older Adults in Action: Using Action Research to Address Neighborhood Change. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:763-779. [PMID: 36721360 DOI: 10.1080/01634372.2023.2173347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Older adults face distinct challenges amidst changing neighborhood conditions, yet also bring distinct resources to aid their communities. After considering the literature related to well-being in older adulthood, the effects of neighborhood change on older adults, and older adults and social action, this paper explores the experiences of older adults in the Neighborhood Story Project. This action research project engages a group of neighbors to identify a set of research questions about their community, conduct place-based inquiry, and take action based on their learning. This study considers the degree to which the Neighborhood Story Project constitutes a macro therapeutic intervention. Drawing on observational and interview data with participants in seven Neighborhood Story Projects, this study explores the resources older adults brought to the project, what they personally gained from participating, and how their work benefited the broader community. The paper concludes with implications for macro-therapeutic interventions with older adults living through neighborhood change.
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Affiliation(s)
- Amie Thurber
- School of Social Work, Portland State University, Portland, USA
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10
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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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11
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Lee CC, Huang RY, Wu YL, Yeh WC, Chang HC. The Impact of Living Arrangements and Social Capital on the Well-Being of the Elderly. Healthcare (Basel) 2023; 11:2050. [PMID: 37510491 PMCID: PMC10379188 DOI: 10.3390/healthcare11142050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
This study examines the impact of living arrangements and social capital on the subjective well-being of the elderly, as well as the mutual effects and relationships between the well-being and self-rated health status of the elderly. A total of 369 questionnaires were administered, and the effective recovery rate was 98.10%. The results indicate three key findings: (1) the current location for aging in place, social support, social activities, house ownership, and self-rated health status are indispensable factors affecting the well-being of the elderly. The best location for aging in place was the community, where the elderly's sense of well-being was highest-the next best options were aging at home and institutional care. (2) Elderly people with sole ownership of their homes were more likely to have higher levels of well-being than those owning jointly or who were tenants. (3) There was significant interaction between subjective well-being and self-rated health status.
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Affiliation(s)
- Chun-Chang Lee
- Department of Real Estate Management, National Pingtung University, Pingtung City 912301, Taiwan
| | - Ruo-Yu Huang
- Department of Real Estate Management, National Pingtung University, Pingtung City 912301, Taiwan
| | - Yun-Ling Wu
- Department of Real Estate Management, National Pingtung University, Pingtung City 912301, Taiwan
| | - Wen-Chih Yeh
- Department of Real Estate Management, HungKuo Delin University of Technology, New Taipei City 236354, Taiwan
| | - Hung-Chung Chang
- Department of Business Administration, Chihlee University of Technology, New Taipei City 220305, Taiwan
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12
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Carr D. Ageism and late-life mortality: How community matters. Soc Sci Med 2023; 320:115501. [PMID: 36424283 PMCID: PMC9678335 DOI: 10.1016/j.socscimed.2022.115501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/30/2022] [Indexed: 11/23/2022]
Abstract
AGEISM: the deeply entrenched biases that people hold about old age-is a persistent social problem that intensified during the COVID-19 pandemic. The harmful physical, emotional, and cognitive health consequences of individual-level age bias are well-documented, with most studies operationalizing ageism as an older adult's personal encounters with age discrimination, self-perceptions of their own aging, and internalized negative beliefs about old age. However, the impacts of community-level age bias on older adults' well-being have received less attention. This commentary reviews recent evidence (Kellogg et al.,) showing that county-level explicit age bias is associated with lower mortality rates among older adults, with effects limited to older adults residing in counties with relatively younger populations. Effects were not detected in counties with relatively older populations, or for implicit age bias. These counterintuitive findings require further exploration, including the use of more fine-grained measures of community-level ageism, attention to the role of gentrification in communities, and the development of new measures of structural ageism, drawing on approaches used to study the impacts of structural racism. Data science approaches, including the use of social media data in tandem with mortality data, may reveal how age bias affects older adults. Communities are especially important to older adults, who spend much of their time in areas immediately proximate to their homes. As more individuals age in place, and as federal funding for home-based and community services (HCBS) increases, researchers should identify which community-level characteristics, including age bias, undermine or enhance late-life well-being.
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Affiliation(s)
- Deborah Carr
- Department of Sociology and Center for Innovation in Social Science, Boston University, 704 Commonwealth Ave, Boston, MA, 02215, USA.
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13
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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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14
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Ahmadi M, Nopour R. Clinical decision support system for quality of life among the elderly: an approach using artificial neural network. BMC Med Inform Decis Mak 2022; 22:293. [DOI: 10.1186/s12911-022-02044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Due to advancements in medicine and the elderly population’s growth with various disabilities, attention to QoL among this age group is crucial. Early prediction of the QoL among the elderly by multiple care providers leads to decreased physical and mental disorders and increased social and environmental participation among them by considering all factors affecting it. So far, it is not designed the prediction system for QoL in this regard. Therefore, this study aimed to develop the CDSS based on ANN as an ML technique by considering the physical, psychiatric, and social factors.
Methods
In this developmental and applied study, we investigated the 980 cases associated with pleasant and unpleasant elderlies QoL cases. We used the BLR and simple correlation coefficient methods to attain the essential factors affecting the QoL among the elderly. Then three BP configurations, including CF-BP, FF-BP, and E-BP, were compared to get the best model for predicting the QoL.
Results
Based on the BLR, the 13 factors were considered the best factors affecting the elderly’s QoL at P < 0.05. Comparing all ANN configurations showed that the CF-BP with the 13-16-1 structure with sensitivity = 0.95, specificity = 0.97, accuracy = 0.96, F-Score = 0.96, PPV = 0.95, and NPV = 0.97 gained the best performance for QoL among the elderly.
Conclusion
The results of this study showed that the designed CDSS based on the CFBP could be considered an efficient tool for increasing the QoL among the elderly.
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15
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Sadler RC, Felton JW, Rabinowitz JA, Powell TW, Latimore A, Tandon D. Inequitable Housing Practices and Youth Internalizing Symptoms: Mediation Via Perceptions of Neighborhood Cohesion. URBAN PLANNING 2022; 7:153-166. [PMID: 37033410 PMCID: PMC10081151 DOI: 10.17645/up.v7i4.5410] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Disordered urban environments negatively impact mental health symptoms and disorders. While many aspects of the built environment have been studied, one influence may come from inequitable, discriminatory housing practices such as redlining, blockbusting, and gentrification. The patterns of disinvestment and reinvestment that follow may be an underlying mechanism predicting poor mental health. In this study, we examine pathways between such practices and internalizing symptoms (i.e., anxiety and depression) among a sample of African American youth in Baltimore, Maryland, considering moderation and mediation pathways including neighborhood social cohesion and sex. In our direct models, the inequitable housing practices were not significant predictors of social cohesion. In our sex moderation model, however, we find negative influences on social cohesion: for girls from gentrification, and for boys from blockbusting. Our moderated mediation model shows that girls in gentrifying neighborhoods who experience lower social cohesion have higher levels of internalizing symptoms. Likewise for boys, living in a formerly blockbusted neighborhood generates poorer social cohesion, which in turn drives higher rates of internalizing symptoms. A key implication of this work is that, in addition to standard measures of the contemporary built environment, considering other invisible patterns related to discriminatory and inequitable housing practices is important in understanding the types of neighborhoods where anxiety and depression are more prevalent. And while some recent work has discussed the importance of considering phenomena like redlining in considering long-term trajectories of neighborhoods, other patterns such as blockbusting and gentrification may be equally important.
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Affiliation(s)
- Richard C. Sadler
- Division of Public Health, Michigan State University, USA
- Department of Family Medicine, Michigan State University, USA
| | - Julia W. Felton
- Center for Health Policy & Health Services Research, Henry Ford Health System, USA
| | - Jill A. Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Terrinieka W. Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Amanda Latimore
- Johns Hopkins Bloomberg School of Public Health, USA
- Center for Addiction Research and Effective Solutions, USA
| | - Darius Tandon
- Center for Community Health, Northwestern University Feinberg School of Medicine, USA
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16
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Beck AN, Thomas K, Finch BK, Gibbons J. Determining Gentrification's Relationship to Birth Outcomes in Metropolitan California. HOUSING POLICY DEBATE 2022; 33:107-128. [PMID: 37275319 PMCID: PMC10237677 DOI: 10.1080/10511482.2022.2125334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 06/07/2023]
Abstract
There is inconsistent evidence as to whether gentrification, the increase of affluent residents into low-income neighborhoods, is detrimental to health. To date, there is no systematic evidence on how gentrification may matter for a range of birth outcomes across cities with varying characteristics. We utilize California's Birth Cohort File (2009-2012), Decennial Census data, and the American Community Survey (2008-2012) to investigate the relationship of gentrification to: preterm birth, low birthweight, and small-for-gestational-age across California. We find that socioeconomic gentrification is uniformly associated with better birth outcomes. Notably, however, we find that only places specifically experiencing increases in non-White gentrification had this positive impact. These associations vary somewhat by maternal characteristics and by type of gentrification measure utilized; discrepancies between alternative measurement strategies are explored. This study provides evidence that socioeconomic gentrification is positively related to birth outcomes and the race-ethnic character of gentrification matters, emphasizing the continued need to examine how gentrification may impact a range of health and social outcomes.
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Affiliation(s)
- Audrey N. Beck
- Department of Sociology, San Diego State University, San Diego, United States
| | - Kyla Thomas
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles,United States
| | - Brian K. Finch
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles,United States
| | - Joseph Gibbons
- Department of Sociology, San Diego State University, San Diego, United States
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17
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Ruiz MS, Williams A, O’Rourke A, MacIntosh E, Moné S, Clay C. The Impact of Housing Insecurity on Access to Care and Services among People Who Use Drugs in Washington, DC. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137561. [PMID: 35805220 PMCID: PMC9265701 DOI: 10.3390/ijerph19137561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/07/2022] [Accepted: 06/17/2022] [Indexed: 12/05/2022]
Abstract
People who use drugs are highly marginalized communities and are disproportionately affected by environmental changes—e.g., neighborhood gentrification—that affect housing availability and stability, particularly in urban locations. These changes could negatively affect individuals’ access to and utilization of health care and social services, resulting in poorer health outcomes. This study examined the impact of gentrification and housing instability on drug users’ access to harm reduction and other health services. Data were collected from 139 clients of a large harm reduction organization. Results showed that 67% of the participants were either unstably housed or homeless, and about one-third of participants indicated that their current housing situations negatively affected their access to primary care (33.9%), behavioral health services (36.7%) and basic services (38.3%). While homeless individuals were still able to access services generally, a greater percentage—compared to those unstably or stably housed—reported difficulty accessing care. As these data were collected prior to the COVID pandemic, it is likely that many of our participants faced greater struggles with housing insecurity and health care access issues due to shutdowns and increased need for social isolation and quarantine. More work is needed to address housing instability and homelessness among already marginalized populations.
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Affiliation(s)
- Monica S. Ruiz
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW, Suite 300, Washington, DC 20052, USA;
- Correspondence: ; Tel.: +1-202-994-3676
| | - Allison Williams
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW, Suite 300, Washington, DC 20052, USA;
| | - Allison O’Rourke
- DC Center for AIDS Research, Department of Psychological and Brain Sciences, 2125 G St. NW, Washington, DC 20052, USA;
| | - Elizabeth MacIntosh
- Honoring Individual Power and Strength (HIPS), 906 H St. NE, Washington, DC 20002, USA; (E.M.); (S.M.); (C.C.)
| | - Shareese Moné
- Honoring Individual Power and Strength (HIPS), 906 H St. NE, Washington, DC 20002, USA; (E.M.); (S.M.); (C.C.)
| | - Cyndee Clay
- Honoring Individual Power and Strength (HIPS), 906 H St. NE, Washington, DC 20002, USA; (E.M.); (S.M.); (C.C.)
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18
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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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19
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Smith RJ, Baik S, Lehning AJ, Mattocks N, Cheon JH, Kim K. Residential Segregation, Social Cohesion, and Aging in Place: Health and Mental Health Inequities. THE GERONTOLOGIST 2022; 62:1289-1298. [PMID: 35666206 DOI: 10.1093/geront/gnac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Research shows that living in segregated neighborhoods may have deleterious health outcomes via social, physical, and socioeconomic contexts that deepen existing inequities. However, there has been limited scholarship examining the effects of segregation on older adults, despite an increasing focus on aging in place. Guided by the Ecological Model of Aging, we examined the effects of segregation on older adults' self-rated health and mental health, accounting for both individual characteristics and neighborhood opportunities and risks (e.g., social cohesion) and the potential moderating role of race and economic vulnerability. RESEARCH DESIGN AND METHODS We used data from the first four rounds of the National Health & Aging Trends Study (2011-2014) merged with tract-level census data for a final sample size of 3084 community-dwelling older adults in urban areas. We conducted multivariate regression analyses after conditioning on residential location selection variables. RESULTS There was no significant association between neighborhood segregation and self-rated health or between segregation and anxiety and depression symptoms. Consistent with the literature, perceived social cohesion was protective of health in each model. DISCUSSION AND IMPLICATIONS Our findings highlight the need for more rigorous research on segregation and older residents that utilize longitudinal and spatial data. Our findings also have implications for policies and programs that aim to support the ability to age in place for older adults who have different racial identities and live in different neighborhood contexts. Since social cohesion can be a protective factor for older adults' health and mental health, policymakers and practitioners should support initiatives to increase social cohesion.
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Affiliation(s)
- Richard J Smith
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Sol Baik
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Amanda J Lehning
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Nicole Mattocks
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Ji Hyang Cheon
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Kyeongmo Kim
- School of Social Work, Virginia Commonwealth University, Richmond, Virginia, USA
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20
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The Role of Urban Environments in Promoting Active and Healthy Aging: A Systematic Scoping Review of Citizen Science Approaches. J Urban Health 2022; 99:427-456. [PMID: 35587850 PMCID: PMC9187804 DOI: 10.1007/s11524-022-00622-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
Promoting active and healthy aging in urban spaces requires environments with diverse, age-friendly characteristics. This scoping review investigated the associations between urban characteristics and active and healthy aging as identified by citizen science (CS) and other participatory approaches. Using a systematic scoping review procedure, 23 articles employing a CS or participatory approach (participant age range: 54-98 years) were reviewed. An inductive and deductive thematic analysis was completed to (a) identify local urban barriers and facilitators and (b) map them against the World Health Organization (WHO) Checklist of Essential Features of Age-Friendly Cities. A new Citizen Science Appraisal Tool (CSAT) was developed to evaluate the quality of CS and other participatory approaches included in the reviewed articles. A range of interconnected urban barriers and facilitators was generated by residents across the personal (e.g. perceived safety), environmental (e.g. unmaintained infrastructure), socio-cultural (e.g. cross-cultural activities), economic (e.g. affordable housing) and political (e.g. governmental support to migrant communities) domains. Mapping the barriers and facilitators to the WHO age-friendly checklist underscored the checklist's relevance and elucidated the need to explore barriers for migrant and cross-cultural communities and neighborhood development and alterations. The CSAT demonstrated strengths related to active engagement of residents and study outcomes leading to real-world implications. To advance the potential of CS to enrich our understanding of age-friendly environments, employing co-production to enhance relevance and sustainability of outcomes is an important strategy. Overall, employing CS highlighted the value of systematically capturing the experiences of older adults within studies aimed at promoting active and healthy aging.
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21
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The racial and cultural ecology of home and community-based services for diverse older adults. J Aging Stud 2022; 61:101023. [DOI: 10.1016/j.jaging.2022.101023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/19/2022]
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22
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Santos CJ, Paciência I, Ribeiro AI. Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116745. [PMID: 35682327 PMCID: PMC9180257 DOI: 10.3390/ijerph19116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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Affiliation(s)
- Cláudia Jardim Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90570 Oulu, Finland;
- Biocenter Oulu, University of Oulu, P.O. Box 5000, 90570 Oulu, Finland
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
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23
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Lee YJ, Braun KL, Wu YY, Hong S, Gonzales E, Wang Y, Hossain MD, Terada TM, Browne CV. Neighborhood Social Cohesion and the Health of Native Hawaiian and Other Pacific Islander Older Adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:3-23. [PMID: 33974515 DOI: 10.1080/01634372.2021.1917033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
Native Hawaiian and other Pacific Islander (NHPI) older adults experience various social and health challenges. There is a growing literature linking neighborhood conditions with health, yet few have focused on NHPI older adults. This study examines associations between neighborhood social cohesion and health outcomes (i.e., self-rated health, psychological distress, and memory) in this population. Data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n=1,045 with respondents aged 50+) were analyzed with logistic regression models. The level of neighborhood social cohesion was determined by responses to items on perceptions of mutual help, dependability, trust, and close relationships within the neighborhood. Higher perceived neighborhood social cohesion was associated with lower odds of having serious psychological distress or memory problems. There was no statistical association of social cohesion with self-rated health. Socially cohesive neighborhoods are important to the health of NHPI. We discuss methods to improve neighborhood social cohesion as a way to promote health equity for NHPI older adults in the United States (U.S.).
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Affiliation(s)
- Yeonjung Jane Lee
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Kathryn L Braun
- Thompson School of Social Work & Public Health, HI Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Yan Yan Wu
- Thompson School of Social Work & Public Health, HI Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Seunghye Hong
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Ernest Gonzales
- Silver School of Social Work, New York University, New York, New York, USA
| | - Yi Wang
- School of Social Work, The University of Iowa, Iowa City, Iowa, USA
| | - Mohammad Didar Hossain
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Tyran M Terada
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Colette V Browne
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
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Anguelovski I, Cole HVS, O'Neill E, Baró F, Kotsila P, Sekulova F, Pérez Del Pulgar C, Shokry G, García-Lamarca M, Argüelles L, Connolly JJ, Honey-Rosés J, López-Gay A, Fontán-Vela M, Matheney A, Oscilowicz E, Binet A, Triguero-Mas M. Gentrification pathways and their health impacts on historically marginalized residents in Europe and North America: Global qualitative evidence from 14 cities. Health Place 2021; 72:102698. [PMID: 34717079 DOI: 10.1016/j.healthplace.2021.102698] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/04/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022]
Abstract
As global cities grapple with the increasing challenge of gentrification and displacement, research in public health and urban geography has presented growing evidence about the negative impacts of those unequal urban changes on the health of historically marginalized groups. Yet, to date comprehensive research about the variety of health impacts and their pathways beyond single case sites and through an international comparative approach of different gentrification drivers and manifestations remains scarce. In this paper, we analyze qualitative data on the pathways by which gentrification impacts the health of historically marginalized residents in 14 cities in Europe and North America. We build on 77 interviews with key neighborhood stakeholders. Data analysis indicates four main concurrent processes: Threats to housing and financial security; Socio-cultural displacement; Loss of services and amenities through institutional gentrification; and Increased risks of criminal behavior and compromised public safety. Gentrification is experienced as a chain of physical and emotional community and individual traumas - an overall shock for historically marginalized groups - because of permanent pressures of insecurity, loss, state of displaceability, and the associated exacerbation of socio-environmental disadvantages.
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Affiliation(s)
- Isabelle Anguelovski
- Catalan Institution for Research and Advanced Studies (ICREA), Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain.
| | - Helen V S Cole
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Ella O'Neill
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Francesc Baró
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; Vrije Universiteit Brussel (VUB), Geography and Sociology Departments, Brussels, Belgium
| | - Panagiota Kotsila
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Filka Sekulova
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Carmen Pérez Del Pulgar
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; Department Environmental Politics, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany
| | - Galia Shokry
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Melissa García-Lamarca
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Spain
| | - Lucia Argüelles
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; Universitat Oberta de Catalunya (UOC), Estudis d'Economia i Empresa and Internet Interdisciplinary Institute (IN3), Spain
| | - James Jt Connolly
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; University of British Columbia (UBC), School of Community and Regional Planning (SCARP), Vancouver, Canada
| | - Jordi Honey-Rosés
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Spain
| | - Antonio López-Gay
- Universitat Autònoma de Barcelona (UAB), Department of Geography, Spain; Center for Demographic Studies (CED-CERCA), Spain
| | - Mario Fontán-Vela
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá; Preventive Medicine Department, Infanta Leonor University Hospital, Madrid, Spain
| | - Austin Matheney
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Emilia Oscilowicz
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain
| | - Andrew Binet
- Massachusetts Institute of Technology (MIT), Department of Urban Studies and Planning, USA
| | - Margarita Triguero-Mas
- Universitat Autònoma de Barcelona (UAB), Institute for Environmental Science and Technology (ICTA), Hospital del Mar Medical Research Institute (IMIM), Barcelona Laboratory for Urban Environmental Justice and Sustainability (BCNUEJ), Spain; Massachusetts Institute of Technology (MIT), Department of Urban Studies and Planning, USA
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Mental Health Outcomes in Barcelona: The Interplay between Gentrification and Greenspace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179314. [PMID: 34501901 PMCID: PMC8430678 DOI: 10.3390/ijerph18179314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/16/2022]
Abstract
Greenspace is widely related to mental health benefits, but this relationship may vary by social group. Gentrification, as linked to processes of unequal urban development and conflict, potentially impacts health outcomes. This study explores the relationships between greenspace and mental health and between gentrification and mental health associations. It also further examines gentrification as an effect modifier in the greenspace-mental health association and SES as an effect modifier in the gentrification-mental health association. We used cross-sectional Barcelona (Spain) data from 2006, which included perceived mental health status and self-reported depression/anxiety from the Barcelona Health Survey. Greenspace exposure was measured as residential access to (1) all greenspace, (2) greenways and (3) parks in 2006. Census-tract level gentrification was measured using an index including changes in sociodemographic indicators between 1991 and 2006. Logistic regression models revealed that only greenways were associated with better mental health outcomes, with no significant relationship between mental health and parks or all greenspace. Living in gentrifying neighborhoods was protective for depression/anxiety compared to living in non-gentrifying neighborhoods. However, only residents of gentrifiable census tracts benefited from the exposure to greenways. SES was not found to be an effect modifier in the association between gentrification and mental health. Future research should tackle this study's limitations by incorporating a direct measure of displacement in the gentrification status indicator, accounting for qualitative aspects of greenspace and user's perceptions. Gentrification may undermine the health benefits provided by greenspace interventions.
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Yeh J. Age-friendly for whom? An aperture to the lived experiences of older San Franciscans. THE GERONTOLOGIST 2021; 62:100-109. [PMID: 34378780 DOI: 10.1093/geront/gnab119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Spatial practices and changing urban environments affecting identity, experiences, and everyday life were examined among a diverse sample of older adults as they negotiated and navigated an age-friendly city. RESEARCH DESIGN AND METHODS Ethnographic interviews, observations, and visual methods were used to understand spatial practices and lived experiences of four older adults, who chronicled their lives using disposable cameras. RESULTS Informant identities emerged in their everyday practices, reflecting varied positionalities that fundamentally shaped their notions of "age-friendly." Informants sought to sustain or improve their lives while attempting to negotiate socio-environmental forms and forces that often threatened their identity and increased their precarity. DISCUSSION AND IMPLICATIONS Contrast exists between "invariant" macro/meso issues all older adults face as they age and "multivariant" ways in which age is accomplished based on place, biography, and intersectionality. Age-friendly environments may simultaneously maintain the status quo and exacerbate inequalities. Gerontology must take seriously how stratified life chances can undermine seemingly universal potential benefits of age-friendly environments.
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Affiliation(s)
- Jarmin Yeh
- Department of Social and Behavioral Sciences, Institute for Health & Aging, University of California, San Francisco, San Francisco, California, USA
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Brown H, Reid K. Navigating Infodemics, Unlocking Social Capital and Maintaining Food Security during the COVID-19 First Wave in the UK: Older Adults' Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147220. [PMID: 34299671 PMCID: PMC8306598 DOI: 10.3390/ijerph18147220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022]
Abstract
In March 2020, a national UK lockdown was implemented in response to rapidly rising COVID-19 infections. Those experiencing the most severe public health restrictions were ‘shielding’ groups as well as those over 70 years of age. Older age adults, many of whom were active, independent, and socially connected were immediately instructed to stay at home, to limit all external social contact and consider contingency for maintaining personal food security and social contact. The purpose of this qualitative study was to explore the experiences of older adults during the first UK lockdown (March–June 2020), specifically how our sample reacted to public health messaging, staying food secure and drawing on available social capital within their community. Semi-structured telephone interviews were conducted with eight participants. In addition, twenty-five participants completed a qualitative ‘open-ended’ survey. The data was collated and analysed, adopting a Thematic Analysis informed approach. Three themes were identified: (1) Too Much Information, (2) The Importance of Neighbours and Connections and (3) Not Wishing to be a Burden. These findings offer a rich insight into how early lockdown measures, never witnessed since World War 2, exposed existing pre-pandemic inequalities and concerns relating to loneliness, isolation and wellbeing. The findings are of relevance to researchers, older adult advocate groups and policy makers to inform post COVID-recovery within communities to ensure healthy ageing.
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Experiences of place attachment and mental wellbeing in the context of urban regeneration. Health Place 2021; 70:102604. [PMID: 34157505 DOI: 10.1016/j.healthplace.2021.102604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/16/2021] [Accepted: 06/05/2021] [Indexed: 11/20/2022]
Abstract
Urban regeneration is an important policy focus across the European Union, with initiatives seeking to address inequalities in public health. Although theoretically such initiatives should produce benefits for mental wellbeing, this lacks strong supporting evidence. The current research addressed a prior overreliance on quantitative methods and underappreciation of the psychological significance of place, through the adoption of qualitative interviews with residents, as part of an independent review of a £650m regeneration project. Interpretative phenomenological analysis was utilised to explore the processes involved in residents' mental wellbeing and place attachment. Analysis developed three super-ordinate themes: 'feelings of control', 'social and community relations', and 'understandings and definitions of place'. These highlight issues relating to physical health, social isolation, community cohesion, as well as the potential for regeneration activities to undermine various elements of the people-place relationship.
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Lehning AJ, Mattocks N, Smith RJ, Kim K, Cheon JH. Neighborhood Age Composition and Self-Rated Health: Findings from a Nationally Representative Study. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:257-273. [PMID: 33375913 DOI: 10.1080/01634372.2020.1866731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
Neighborhood age composition is an understudied area. Furthermore, existing empirical and conceptual work is conflicting, with some scholarship-indicating neighborhoods with older adults are beneficial and other scholarship suggesting it can be detrimental. Combining data from 7,197 older adults from the first wave (2011) of the National Health & Aging Trends Study and census tract data from the National Neighborhood Change Database, the purposes of our study were to: 1) identify the characteristics of neighborhoods experiencing different types of changes in age composition, and 2) examine the association between neighborhood age composition and self-rated health. Findings indicate that neighborhoods experiencing Concentration (where the number of older adults are declining but their percentage of the total population are increasing), the majority of which are in urban areas, have less aggregate economic resources, more indicators of neighborhood disorder, and less access to services and supports. Regression models also suggest older adults living in Concentration neighborhoods reported lower self-rated health compared to those living in the other three neighborhood types. Findings point to the importance of considering neighborhood age composition when targeting interventions and resources, and the potential consequences of being stuck in place in a neighborhood that does not meet elders' needs.
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Affiliation(s)
- Amanda J Lehning
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Nicole Mattocks
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Richard J Smith
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Kyeongmo Kim
- Virginia Commonwealth University School of Social Work, Richmond, VA, USA
| | - Ji Hyang Cheon
- University of Maryland School of Social Work, Baltimore, MD, 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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In Pursuit of Happiness: Changes in Living Arrangement and Subjective Well-Being among Older Adults in India. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09327-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Bigonnesse C, Chaudhury H. Ageing in place processes in the neighbourhood environment: a proposed conceptual framework from a capability approach. Eur J Ageing 2021; 19:63-74. [PMID: 35250420 PMCID: PMC8881541 DOI: 10.1007/s10433-020-00599-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 11/28/2022] Open
Abstract
The concept of "ageing in place" has become increasingly significant in the environmental gerontology literature. Despite its predominance, there have been limited efforts to offer a more comprehensive and nuanced conceptualization of this topic. Definitions found in the literature are often too simplistic and only partially capture the various aspects of older adults' experience while ageing in place. This paper presents a conceptual framework on ageing in place in the context of neighbourhood environment which aims to address this gap by proposing a multi-faceted understanding of ageing in place processes through the lenses of a capability approach, a more comprehensive definition of the concept, and related overarching principles. Building on predominant theories in environmental gerontology, this conceptual framework offers new insights into the interactions between "place" and the "ageing individual". It is meant to offer opportunities for discussion, to suggest new paths of inquiry, and to explore implications for policy and practice.
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Affiliation(s)
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
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Covid-19 and inequality: developing an age-friendly strategy for recovery in low income communities. QUALITY IN AGEING AND OLDER ADULTS 2020. [DOI: 10.1108/qaoa-09-2020-0044] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to explore the social impact of the COVID-19 pandemic, focusing on issues facing older people living in urban areas characterised by multiple deprivation.
Design/methodology/approach
The paper first reviews the role of place and neighbourhood in later life; second, it examines the relationship between neighbourhood deprivation and the impact of COVID-19; and, third, it outlines the basis for an “age-friendly” recovery strategy.
Findings
The paper argues that COVID-19 is having a disproportionate impact on low-income communities, which have already been affected by cuts to public services, the loss of social infrastructure and pressures on the voluntary sector. It highlights the need for community-based interventions to be developed as an essential part of future policies designed to tackle the effects of COVID-19.
Originality/value
The paper contributes to debates about developing COVID-19 recovery strategies in the context of growing inequalities affecting urban neighbourhoods.
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Abstract
Gentrification in the largest 50 US cities has more than doubled since the 1990s. The process of gentrification can bring about improved neighborhood conditions, reduced rates of crime, and property value increases. At the same time, it can equally foster negative conditions associated with poorer health outcomes, such as disrupted social networks from residential displacement and increases in stress. While neighborhood environment is consistently implicated in health outcomes research, gentrification is rarely conceptualized as a public health issue. Though research on gentrification is growing, empirical studies evaluating the health impacts of gentrification in the US are poorly understood. Here we systematically review US population-based empirical studies examining relationships between gentrification and health. Electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science, and Academic Search Complete) were searched using a combination of terms to identify peer-reviewed studies published on or before July 9, 2018, reporting associations between gentrification and health. Study title and abstract screenings were followed by full-text review of all studies meeting the following inclusion criteria of: ≥ 1 quantitative measure of association for a health outcome, within the context of gentrification; peer-reviewed research; located in the US; and English language. Of 8937 studies identified, 6152 underwent title and abstract screening, and 50 studies underwent full-text screening, yielding six studies for review. Gentrification exposure measures and health outcomes examined varied widely. Most studies reported little to no overall association between gentrification and health outcomes; however, gentrification was repeatedly associated with undesirable health effects among Black and economically vulnerable residents. Despite seemingly overall null associations between gentrification and health, evidence suggests that gentrification may negatively impact the health of certain populations, particularly Black and low-income individuals. Complexities inherent in operationalizing gentrification point toward the need for validated measures. Additionally, understanding how gentrification-health associations differ across health endpoints, race/ethnicities, socioeconomic status, and life course can provide insight into whether this process contributes to urban inequality and health disparities. As gentrification occurs across the US, it is important to understand how this process impacts health. While aging cities reinvest in the revitalization of communities, empirical research examining relationships between gentrification and health can help inform policy decisions.
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Weil J. Developing the Person-Place Fit Measure for Older Adults: Broadening Place Domains. THE GERONTOLOGIST 2020; 60:548-558. [PMID: 31433829 DOI: 10.1093/geront/gnz112] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Literature calls for larger studies with empirically tested instruments about the meaning of place for older adults-studies that include a broader range of domains and neighborhood characteristics. Although rich narrative and qualitative data for small groups of older individuals exist, a measure with valid and reliable scores that includes the new, multiple domains about aging in place does not. RESEARCH DESIGN AND METHODS Findings are reported from a two-phase, nine-step, exploratory sequential mixed-methods process of measurement development for the Person-Place Fit Measure for Older Adults (PPFM-OA). In Phase I, a focus group (n = 8) and qualitative interviews (n = 77) with persons 65 and older were used to develop emerging domains of aging in place. Qualitative data about concepts and language informed the development of a quantitative item pool for the Mechanical Turk-distributed survey. Phase II included a Delphi process reducing the number of items in the PPFM-OA. Exploratory factor analysis (EFA) and reliability analysis further reduced the number of potential measure items. RESULTS Five factors emerged from the EFA. They were primary or basic needs/necessities (α = .84), neighborhood changes and moving (α = .88), identity and place attachment (α = .86), community value (α = .89), and services and resources (α = .78). DISCUSSION AND IMPLICATIONS The development of a measure, such as the PPFM-OA, is crucial as more programs and services are created to address aging in place but uniform data for planning and evaluation are lacking. These initial quantitative analyses are informative for the next step, a larger-scale, quantitative evaluation.
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Affiliation(s)
- Joyce Weil
- Gerontology Program, University of Northern Colorado, Greeley
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Fritz H, Cutchin MP, Gharib J, Haryadi N, Patel M, Patel N. Neighborhood Characteristics and Frailty: A Scoping Review. THE GERONTOLOGIST 2020; 60:e270-e285. [PMID: 31276582 DOI: 10.1093/geront/gnz072] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Frailty is highly prevalent in later life and associated with early mortality and adverse health outcomes. The neighborhood has been identified as an important contributor to individual health, and neighborhood characteristics may contribute to frailty development. A scoping review was conducted of the peer-reviewed literature to better understand how physical and social neighborhood characteristics contribute to frailty. RESEARCH DESIGN AND METHODS Following an established scoping review methodology, we searched four peer-reviewed databases for relevant studies published from January 1, 2008, to December 31, 2018. Data extracted from studies included study characteristics, operationalization of neighborhood, the conceptual model of the neighborhood-frailty relationship, operationalization of frailty, and study findings for associations among neighborhood variables and frailty indicators. RESULTS A total of 522 articles were identified and 13 articles were included in the final data charting. Existing studies suggest that neighborhood characteristics are associated with frailty in later life. Few studies articulated a conceptual model identifying exact mechanisms through which neighborhood factors affected frailty. Studies designs were mostly cross-sectional. Longitudinal studies did not measure neighborhood characteristics over time. Studies varied considerably in how they operationalized the neighborhood. Frailty was most commonly assessed using a 5-point phenotype or a frailty index approach. DISCUSSION AND IMPLICATIONS Findings indicate that research on the relationship between neighborhood characteristics and frailty is an emerging area of inquiry. Additional studies are needed to more definitely explicate mechanisms through which neighborhoods contribute to, or protect older adults from, frailty.
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Affiliation(s)
- Heather Fritz
- Institute of Gerontology, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan.,Department of Health Care Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan
| | - Malcolm P Cutchin
- Institute of Gerontology, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan.,Department of Health Care Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan
| | - Jamil Gharib
- Department of Health Care Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan
| | - Neehar Haryadi
- Department of Emergency Medicine School of Medicine, Wayne State University, Detroit, Michigan
| | - Meet Patel
- Department of Emergency Medicine School of Medicine, Wayne State University, Detroit, Michigan
| | - Nandit Patel
- Department of Emergency Medicine School of Medicine, Wayne State University, Detroit, Michigan
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Sims M, Kershaw KN, Breathett K, Jackson EA, Lewis LM, Mujahid MS, Suglia SF. Importance of Housing and Cardiovascular Health and Well-Being: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2020; 13:e000089. [PMID: 32673512 DOI: 10.1161/hcq.0000000000000089] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cardiovascular disease disparities are shaped by differences in risk factors across racial and ethnic groups. Housing remains an important social determinant of health. The objective of this statement is to review and summarize research that has examined the associations of housing status with cardiovascular health and overall health. PubMed/Medline, Centers for Disease Control and Prevention data, US Census data, Cochrane Library reviews, and the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify empirical research studies that examined associations of housing with cardiovascular health and overall well-being. Health is affected by 4 prominent dimensions of housing: stability, quality and safety, affordability and accessibility, and neighborhood environment. Vulnerable and underserved populations are adversely affected by housing insecurity and homelessness, are at risk for lower-quality and unsafe housing conditions, confront structural barriers that limit access to affordable housing, and are at risk for living in areas with substandard built environment features that are linked to cardiovascular disease. Research linking select pathways to cardiovascular health is relatively strong, but research gaps in other housing pathways and cardiovascular health remain. Efforts to eliminate cardiovascular disease disparities have recently emphasized the importance of social determinants of health. Housing is a prominent social determinant of cardiovascular health and well-being and should be considered in the evaluation of prevention efforts to reduce and eliminate racial/ethnic and socioeconomic disparities.
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Greenfield EA, Black K, Buffel T, Yeh J. Community Gerontology: A Framework for Research, Policy, and Practice on Communities and Aging. THE GERONTOLOGIST 2020; 59:803-810. [PMID: 30124872 DOI: 10.1093/geront/gny089] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Indexed: 01/17/2023] Open
Abstract
We introduce "community gerontology" as an area of research, policy, and practice that aims to advance understanding of communities as fundamental contexts for aging and its diversity, and to leverage this understanding for change. We present a foundational framework for community gerontology in three parts. First, we discuss the mesolevel as the unifying construct for community gerontology. Second, we describe community gerontology's focus on pathways of mutual influence between the mesolevel with more micro and macro contexts over time. Third, we put forth community gerontology's emphasis on gerontologists' participation in community change processes to facilitate more optimal experiences of aging among diverse population subgroups. We conclude by describing the integrative nature of community gerontology and the ways that this framework can advance research on particular substantive areas, as well as gerontology as a whole.
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Affiliation(s)
- Emily A Greenfield
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick
| | - Kathy Black
- College of Liberal Arts and Social Sciences, University of South Florida, Sarasota-Manatee
| | - Tine Buffel
- School of Social Sciences, Manchester Institute for Collaborative Research on Ageing, The University of Manchester, UK
| | - Jarmin Yeh
- Department of Social and Behavioral Sciences, Institute for Health and Aging, University of California, San Francisco
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Firth CL, Fuller D, Wasfi R, Kestens Y, Winters M. Causally speaking: Challenges in measuring gentrification for population health research in the United States and Canada. Health Place 2020; 63:102350. [PMID: 32543436 DOI: 10.1016/j.healthplace.2020.102350] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/30/2022]
Abstract
The planet is rapidly urbanizing, the need for actionable evidence to guide the design of cities that help (not hinder) our health has never felt more urgent. One essential component of healthy city design is improving neighborhood conditions in previously disinvested areas. To ensure equitable city design, policy makers, city planners, health practitioners, and researchers are interested in understanding the complex relationship between urban change, gentrification, and population health. Yet, the causal link between gentrification and health outcomes remain unclear. Without clear and consistent gentrification measures, researchers struggle to identify populations who are exposed to gentrification, and to compare health outcomes between exposed and unexposed populations. To move the science forward, this paper summarizes the challenges related to gentrification measurement in the United States and Canada when aspiring to conduct studies to analyze causal relationships between gentrification and health. The paper concludes with a series of recommendations for studies aimed at examining both causes and consequences of gentrification and health.
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Affiliation(s)
- Caislin L Firth
- Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Daniel Fuller
- Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's Newfoundland, A1C 5S7, Canada.
| | - Rania Wasfi
- Université de Montréal/Centre de recherche du CHUM, Pavillon S, 850 rue St-Denis, Montréal, QC, H2X 0A9, Canada.
| | - Yan Kestens
- Université de Montréal/Centre de recherche du CHUM, Pavillon S, 850 rue St-Denis, Montréal, QC, H2X 0A9, Canada.
| | - Meghan Winters
- Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Bhavsar NA, Kumar M, Richman L. Defining gentrification for epidemiologic research: A systematic review. PLoS One 2020; 15:e0233361. [PMID: 32437388 PMCID: PMC7241805 DOI: 10.1371/journal.pone.0233361] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/03/2020] [Indexed: 02/04/2023] Open
Abstract
Neighborhoods have a profound impact on individual health. There is growing interest in the role of dynamic changes to neighborhoods-including gentrification-on the health of residents. However, research on the association between gentrification and health is limited, partly due to the numerous definitions used to define gentrification. This article presents a systematic review of the current state of literature describing the association between gentrification and health. In addition, it provides a novel framework for addressing important next steps in this research. A total of 1393 unique articles were identified, 122 abstracts were reviewed, and 36 articles published from 2007-2020 were included. Of the 36 articles, 9 were qualitative, 24 were quantitative, and 3 were review papers. There was no universally accepted definition of gentrification; definitions often used socioeconomic variables describing demographics, housing, education, and income. Health outcomes associated with gentrification included self-reported health, preterm birth, mental health conditions, alcohol use, psychosocial factors, and health care utilization, though the direction of this association varied. The results of this review also suggest that the impact of gentrification on health is not uniform across populations. For example, marginalized populations, such as Black residents and the elderly, were impacted more than White and younger residents. In addition, we identified multiples gaps in the research, including the need for a conceptual model, future mechanistic studies, and interventions.
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Affiliation(s)
- Nrupen A. Bhavsar
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Manish Kumar
- Trinity School of Arts and Sciences, Duke University, Durham, North Carolina, United States of America
| | - Laura Richman
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
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41
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Cole HVS. A call to engage: considering the role of gentrification in public health research. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/23748834.2020.1760075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Helen V. S. Cole
- Institut de Ciѐncia I Tecnologia Ambientals, Universitat Autonoma de Barcelona, Barcelona, Spain
- Healthy Cities Research Group, Institut Hospital Del Mar D’Investigacions Mèdiques (IMIM), Barcelona, Spain
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O’Neil K, Aubrecht K, Keefe J. Dimensions of Housing Insecurity for Older Women Living with a Low Income. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/26892618.2020.1744498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Kelly O’Neil
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Canada
| | - Katie Aubrecht
- Department of Sociology, St. Francis Xavier University, Antigonish, Canada
| | - Janice Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Canada
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Schnake-Mahl AS, Jahn JL, Subramanian SV, Waters MC, Arcaya M. Gentrification, Neighborhood Change, and Population Health: a Systematic Review. J Urban Health 2020; 97:1-25. [PMID: 31938975 PMCID: PMC7010901 DOI: 10.1007/s11524-019-00400-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite a proliferation of research on neighborhood effects on health, how neighborhood economic development, in the form of gentrification, affects health and well-being in the USA is poorly understood, and no systematic assessment of the potential health impacts has been conducted. Further, we know little about whether health impacts differ for residents of neighborhoods undergoing gentrification versus urban development, or other forms of neighborhood socioeconomic ascent. We followed current guidelines for systematic reviews and present data on the study characteristics of the 22 empirical articles that met our inclusion criteria and were published on associations between gentrification, and similar but differently termed processes (e.g., urban regeneration, urban development, neighborhood upgrading), and health published between 2000 and 2018. Our results show that impacts on health vary by outcome assessed, exposure measurement, the larger context-specific determinants of neighborhood change, and analysis decisions including which reference and treatment groups to examine. Studies of the health impacts of gentrification, urban development, and urban regeneration describe similar processes, and synthesis and comparison of their results helps bridge differing theoretical approaches to this emerging research. Our article helps to inform the debate on the impacts of gentrification and urban development for health and suggests that these neighborhood change processes likely have both detrimental and beneficial effects on health. Given the influence of place on health and the trend of increasing gentrification and urban development in many American cities, we discuss how future research can approach understanding and researching the impacts of these processes for population health.
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Affiliation(s)
- Alina S Schnake-Mahl
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jaquelyn L Jahn
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Mary C Waters
- Department of Sociology, Harvard University, Cambridge, MA, USA
| | - Mariana Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA
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Tran LD, Rice TH, Ong PM, Banerjee S, Liou J, Ponce NA. Impact of gentrification on adult mental health. Health Serv Res 2020; 55:432-444. [PMID: 31957022 DOI: 10.1111/1475-6773.13264] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To estimate the net effect of living in a gentrified neighborhood on probability of having serious psychological distress. DATA SOURCES We pooled 5 years of secondary data from the California Health Interview Survey (2011-2015) and focused on southern California residents. STUDY DESIGN We compared adults (n = 43 815) living in low-income and gentrified, low-income and not gentrified, middle- to high-income and upscaled, and middle- to high-income and not upscaled neighborhoods. We performed a probit regression to test whether living in a gentrified neighborhood increased residents' probabilities of having serious psychological distress in the past year and stratified analyses by neighborhood tenure, homeownership status, and low-income status. Instrumental variables estimation and propensity scores were applied to reduce bias arising from residential selection and simultaneity. An endogenous treatment effects model was also applied in sensitivity analyses. DATA COLLECTION/EXTRACTION METHODS Adults who completed the survey on their own and lived in urban neighborhoods with 500 or more residents were selected for analyses. Survey respondents who scored 13 and above on the Kessler 6 were categorized as having serious psychological distress in the past year. We used eight neighborhood change measures to classify respondents' neighborhoods. PRINCIPAL FINDINGS Living in a gentrified and upscaled neighborhood was associated with increased likelihood of serious psychological distress relative to living in a low-income and not gentrified neighborhood. The average treatment effect was 0.0141 (standard error = 0.007), which indicates that the prevalence of serious psychological distress would have been 1.4 percentage points less if none of the respondents lived in gentrified neighborhoods. Gentrification appears to have a negative impact on the mental health of renters, low-income residents, and long-term residents. This effect was not observed among homeowners, higher-income residents, and recent residents. CONCLUSIONS Gentrification levies mental health costs on financially vulnerable community members and can worsen mental health inequities.
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Affiliation(s)
- Linda Diem Tran
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Thomas H Rice
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Paul M Ong
- Department of Urban Planning, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Julia Liou
- Asian Health Services, Oakland, California
| | - Ninez A Ponce
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
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Engelberg Anderson JK, Jain P, Wade AJ, Morris AM, Slaboda JC, Norman GJ. Indicators of potential health-related social needs and the association with perceived health and well-being outcomes among community-dwelling medicare beneficiaries. Qual Life Res 2020; 29:1685-1696. [PMID: 31907869 DOI: 10.1007/s11136-019-02410-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Health-related social needs (HRSNs) can make older adults' more vulnerable and impact their health, well-being, and ability to age-in-place. The current study assessed the prevalence of potential HRSNs (pHRSNs) across several domains (e.g., transportation, social isolation) and explored the associations with health and well-being outcomes in a sample of Medicare beneficiaries. METHODS Cross-sectional analyses were conducted with a representative sample of community-dwelling Medicare beneficiaries (N = 5758) from the 2012 National Health and Aging Trends Study. Binary indicators of pHRSNs were created for five domains: medical and utility financial needs (MUFN), housing, nutrition, social isolation, and transportation. Outcomes were depression/anxiety, self-rated health, meaning/satisfaction, perceived control/adaptability. Variables were weighted, and multivariate regression models assessed associations between pHRSN variables and outcomes, controlling for sociodemographics and health conditions. RESULTS Of the estimated 32 million community-dwelling beneficiaries, approximately 13.3 million were positive for ≥ 1 pHRSN and 11.4 million for ≥ 2 pHRSNs. The prevalence by domain was 7% for housing, 8% for transportation, 12% for UMFN and nutrition, and 33% for social isolation. Each domain, except for housing, was significantly (p < .05) associated with at least two of the four outcomes, where being positive for a pHRSN was associated with greater depression/anxiety and poorer self-rated general health. CONCLUSIONS Over 40% of Medicare beneficiaries had ≥ 1 pHRSN indicators, which means they are more vulnerable and that may limit their ability to age-in-place. Given the growing aging population, better measures and methods are needed to identify, monitor, and address HRSNs. For example, leveraging existing community-based services through coordinated care may be an effective strategy to address older adults' HRSNs.
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Affiliation(s)
| | - Purva Jain
- West Health Institute, 10350 N Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Amy J Wade
- West Health Institute, 10350 N Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Andrea M Morris
- West Health Institute, 10350 N Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Jill C Slaboda
- West Health Institute, 10350 N Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Gregory J Norman
- University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
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Versey HS, Murad S, Willems P, Sanni M. Beyond Housing: Perceptions of Indirect Displacement, Displacement Risk, and Aging Precarity as Challenges to Aging in Place in Gentrifying Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4633. [PMID: 31766451 PMCID: PMC6927009 DOI: 10.3390/ijerph16234633] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 11/18/2022]
Abstract
Neighborhoods within age-friendly cities and communities are an important factor in shaping the everyday lives of older adults. Yet, less is known about how neighborhoods experiencing change influence the ability to age in place. One type of rapid neighborhood change occurring across major cities nationally and globally is gentrification, a process whereby the culture of an existing neighborhood changes through the influx of more affluent residents and businesses. Few studies have considered the impact of gentrification on older adults, who are among the most vulnerable to economic and social pressures that often accompany gentrification. The current study explores one consequence of gentrification, indirect displacement. While gentrification-induced displacement can refer to the physical (e.g., direct) displacement of residents moving out of a neighborhood due to rising housing costs, it also references the replacement of the unique character and social identity of a neighborhood (e.g., indirect displacement). We examine perceptions of the latter, characterized by perceived cultural shifts and housing concerns among adults aging in place in a gentrifying neighborhood in New York City. The implications of indirect displacement for displacement risk and aging precarity are discussed as potential threats to aging in place in age-friendly cities.
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Affiliation(s)
- H. Shellae Versey
- Department of Psychology, Wesleyan University, Middletown, CT 06459, USA; (P.W.); (M.S.)
| | - Serene Murad
- Physicians for Human Rights, New York, NY 10018, USA;
| | - Paul Willems
- Department of Psychology, Wesleyan University, Middletown, CT 06459, USA; (P.W.); (M.S.)
| | - Mubarak Sanni
- Department of Psychology, Wesleyan University, Middletown, CT 06459, USA; (P.W.); (M.S.)
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Reilly KH, Bartley K, Paone D, Tuazon E. Alcohol-related emergency department visits and income inequality in New York City, USA: an ecological study. Epidemiol Health 2019; 41:e2019041. [PMID: 31623424 PMCID: PMC6928467 DOI: 10.4178/epih.e2019041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/08/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Previous research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits. METHODS The study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model. RESULTS There were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate. CONCLUSIONS This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.
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Affiliation(s)
- Kathleen H Reilly
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Katherine Bartley
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Denise Paone
- Bureau of Alcohol and Drug Use Prevention, Care and Treatment, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Ellenie Tuazon
- Bureau of Alcohol and Drug Use Prevention, Care and Treatment, New York City Department of Health and Mental Hygiene, New York, NY, USA
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Tehrani SO, Wu SJ, Roberts JD. The Color of Health: Residential Segregation, Light Rail Transit Developments, and Gentrification in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3683. [PMID: 31574988 PMCID: PMC6801918 DOI: 10.3390/ijerph16193683] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 11/16/2022]
Abstract
As the modern urban-suburban context becomes increasingly problematic with traffic congestion, air pollution, and increased cost of living, city planners are turning their attention to transit-oriented development as a strategy to promote healthy communities. Transit-oriented developments bring valuable resources and improvements in infrastructure, but they also may be reinforcing decades-old processes of residential segregation, gentrification, and displacement of low-income residents and communities of color. Careful consideration of zoning, neighborhood design, and affordability is vital to mitigating the impacts of transit-induced gentrification, a socioeconomic by-product of transit-oriented development whereby the provision of transit service "upscales" nearby neighborhood(s) and displaces existing community members with more affluent and often White residents. To date, the available research and, thus, overall understanding of transit-induced gentrification and the related social determinants of health are limited and mixed. In this review, an overview of racial residential segregation, light rail transit developments, and gentrification in the United States has been provided. Implications for future transit-oriented developments are also presented along with a discussion of possible solutions.
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Affiliation(s)
- Shadi O Tehrani
- School of Architecture and Environmental Design, Iran University of Science and Technology, Tehran 16846-13114, Iran.
| | - Shuling J Wu
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742, USA.
| | - Jennifer D Roberts
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742, USA.
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Tulier ME, Reid C, Mujahid MS, Allen AM. "Clear action requires clear thinking": A systematic review of gentrification and health research in the United States. Health Place 2019; 59:102173. [PMID: 31357049 PMCID: PMC6868313 DOI: 10.1016/j.healthplace.2019.102173] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/13/2019] [Accepted: 07/18/2019] [Indexed: 12/28/2022]
Abstract
Gentrification is a process in which formerly declining, under-resourced, neighborhoods experience reinvestment and in-migration of increasingly affluent new residents, with understudied implications for individual health and health-protective community resources for low-income and minority residents. Increased attention on urban health inequities have propelled research on the relationship between gentrification and health. Yet, there are significant challenges inherent in the study of gentrification given its non-linear process occurring at multiple levels and via various mechanisms in a complex web of urban systems. How then have empirical studies addressed questions regarding the relationship between gentrification and health and wellness from a conceptual and methodological standpoint? Applying key search terms to PubMed and Web of Science, we identified 546 papers published in the United States. This review is guided by three foundational premises informing the inclusion and exclusion of articles. These include: 1. a clear definition of gentrification and explicit health outcome; 2. identification of a specific geographic context (United States) in which gentrification occurs, and 3. use of a social determinants of health framework to identify potential health outcomes of interest. 17 papers met our inclusion criteria. Through systematic content analysis using MaxQDA software, we evaluated the included studies using three critical frames: 1. conceptualization of gentrification; 2. mechanisms linking gentrification and health; and 3. spatio-temporal considerations. Based on this analysis, we identify the strengths and limitations of existing research, and offer three methodological approaches to strengthen the current literature on gentrification and health. We recommend that future studies: 1. explicitly identify the mechanisms and levels at which processes can occur and systems are organized; 2. incorporate space and time into the analytical strategy and 3. articulate an epistemological standpoint driven by their conceptualization of the exposure and identification of the relevant mechanism and outcome of interest.
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Affiliation(s)
- Melody Esther Tulier
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, 60 College St.New Haven, CT, 06520-8034, USA.
| | - Carolina Reid
- Department of City and Regional Planning, University of California, Berkeley, 312 Wurster Hall #1850, Berkeley, CA, 94720-1820, USA
| | - Mahasin S Mujahid
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, 2121 Berkeley Way, Berkeley, CA, 94720-7360, USA
| | - Amani M Allen
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, 2121 Berkeley Way, Berkeley, CA, 94720-7360, USA; University of California, Berkeley School of Public Health Division of Community Health Sciences, 2121 Berkeley Way, MC #5302, Berkeley, CA, 94720-7360, USA
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50
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Anguelovski I, Triguero-Mas M, Connolly JJT, Kotsila P, Shokry G, Pérez Del Pulgar C, Garcia-Lamarca M, Argüelles L, Mangione J, Dietz K, Cole H. Gentrification and health in two global cities: a call to identify impacts for socially-vulnerable residents. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/23748834.2019.1636507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Isabelle Anguelovski
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
- ICREA - Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Margarita Triguero-Mas
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - James JT Connolly
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Panagiota Kotsila
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Galia Shokry
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Carmen Pérez Del Pulgar
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Melissa Garcia-Lamarca
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Lucia Argüelles
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Julia Mangione
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Kaitlyn Dietz
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
| | - Helen Cole
- UAB - Universitat Autònoma de Barcelona, Barcelona, Spain
- ICTA - Institute for Environmental Science and Technology, Barcelona, Spain
- IMIM - Medical Research Institute, Hospital del Mar, Barcelona, Spain
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