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Au A, Murad-Kassam S, Mukanoheli V, Idrees S, Ben Mabrouk E, Abdi K, Kennedy M, Whitfield K, Salma J. Immigrant Older Adults' Experiences of Aging in Place and Their Neighborhoods: A Qualitative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:904. [PMID: 39063481 PMCID: PMC11277252 DOI: 10.3390/ijerph21070904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Engaging in one's neighborhood fosters independence, promotes social connectedness, improves quality of life, and increases life expectancy in older adults. There is a lack of evidence synthesis on immigrant older adults' neighborhood perceptions and experiences, essential for addressing neighborhood-level influences on aging in place. This study systematically synthesizes qualitative evidence on immigrant older adults' perceptions and experiences of their neighborhoods. A comprehensive search was conducted from inception to 5 April 2023, in multiple databases. This review considered studies including immigrant older adults aged ≥60 years, included studies from any country where the neighborhood was the focus, and only considered qualitative data while excluding review studies, theoretical publications, and protocols. Eligible studies were appraised using the JBI critical appraisal checklist for qualitative research. The Joanna Briggs Institute meta-aggregation approach was used to synthesize findings, and the ConQual approach established confidence in the synthesis. A total of 30 studies were included. Most studies were conducted in North America and explored phenomena such as aging in place, social capital, social cohesion, sense of community, and life satisfaction. Key contextual factors were walkable safe access to social spaces, accessible transportation to amenities, social cohesion with neighbors, and pre-migration neighborhood experiences. Immigrant older adults have varied experiences related to their sense of belonging and social cohesion. Factors such as racial discrimination, feeling unsafe, and social isolation contributed to negative perceptions. This review highlights the need for inclusive neighborhoods that align with the needs and values of immigrant older adults aging in place.
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Affiliation(s)
- Alesia Au
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Sadaf Murad-Kassam
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Vestine Mukanoheli
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Sobia Idrees
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Esra Ben Mabrouk
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Khadija Abdi
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Megan Kennedy
- Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Kyle Whitfield
- Faculty of Science, School of Urban and Regional Planning, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Jordana Salma
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
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Cheung ESL. Neighborhood Gentrification and Food Insecurity Among Urban Older Adults: Evidence From New York City. THE GERONTOLOGIST 2024; 64:gnae048. [PMID: 38761043 DOI: 10.1093/geront/gnae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Gentrification is a prevalent neighborhood development process in urban areas across the United States. Prior studies have identified the influence of gentrification on late-life health and quality of life, yet little is known about its relationship with food insecurity, an important public health issue for older adult populations. Using New York City as a case study, this study investigated associations between living in a gentrifying neighborhood and food insecurity, as well as the mediating roles of neighborhood environment factors-social cohesion, public transportation, and food environment. RESEARCH DESIGN AND METHODS This study adopted 2 waves of annual data from the Poverty Tracker Study (2015-2016; N = 703) merged with American Community Survey and spatial data sets to measure gentrification and neighborhood factors. Adjusted logistic regressions were used to examine the associations between gentrification and food insecurity. Further mediation analyses were conducted to test the mechanisms of such associations. RESULTS Older adults in gentrifying neighborhoods were more likely to have food insecurity than those in moderate- to high-income neighborhoods. Compared to low-income neighborhoods, older adults in gentrifying neighborhoods had a lower likelihood of reporting food insecurity. Two significant mediators were found when comparing gentrification with moderate- to high-income neighborhoods: social cohesion and healthy food outlets. DISCUSSION AND IMPLICATIONS This study highlights the importance of gentrification in determining late-life food insecurity and identifies possible mechanisms with policy and social service implications to reduce the risk of food insecurity in urban areas.
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Affiliation(s)
- Ethan Siu Leung Cheung
- Department of Family and Consumer Studies, The University of Utah, Salt Lake City, Utah, USA
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Zhang Z, Barr A. Gentrification and crime in Buffalo, New York. PLoS One 2024; 19:e0302832. [PMID: 38900783 PMCID: PMC11189242 DOI: 10.1371/journal.pone.0302832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/14/2024] [Indexed: 06/22/2024] Open
Abstract
Since the 1990s, gentrification has significantly changed American urban landscapes. Its implications for crime are under recent scrutiny, particularly in large cities like New York City, Los Angeles, and Chicago. We extend this literature by focusing on the gentrification-crime link in the midsize city of Buffalo, New York using nine years of data from the American Community Survey and the Buffalo Police Department. Examining changes both within tracts over time and changes between gentrified and never-gentrified tracts, we find that gentrification is associated with reduced property crime and is not associated with changes in violent crime. More specifically, in comparing crime trends across tracts, we find that gentrified tracts show a trajectory of declining property crime that mirrors more advantaged tracts, while vulnerable-but-never-gentrified tracts show a U-shaped trajectory of property crime. Looking at within-tract changes, we find that years following gentrification of a given tract have lower property crime rates than years preceding gentrification, independent of the general reduction in crime over time. We discuss the implications of these findings for understanding the intersections between urban processes and crime.
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Affiliation(s)
- Zhe Zhang
- Department of Sociology, University at Buffalo, SUNY, Buffalo, New York, United States of America
| | - Ashley Barr
- Department of Sociology, University at Buffalo, SUNY, Buffalo, New York, United States of America
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Baeker Bispo JA, Goo I, Ashad-Bishop K, Kobetz E, Bailey Z. Does Neighborhood Social Cohesion Influence Participation in Routine Cancer Screening? Findings From a Representative Sample of Adults in South Florida. FAMILY & COMMUNITY HEALTH 2024; 47:130-140. [PMID: 38372330 DOI: 10.1097/fch.0000000000000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Neighborhood social cohesion (NSC) has been associated with a variety of health outcomes, but limited research has examined its impact on behaviors that support cancer control. The purpose of this study was to examine associations between NSC and guideline-concordant breast, cervical and colorectal cancer screening. METHODS Data are from a cross-sectional survey administered to 716 adults in South Florida from 2019 to 2020. The analytic samples included adults eligible for breast (n = 134), cervical (n = 195), and colorectal cancer (n = 265) screening. NSC was measured using a validated 5-item instrument. Associations between NSC and guideline-concordant screening were examined using multivariable logistic regression. RESULTS In fully adjusted analyses, the odds of guideline-concordant breast cancer screening increased by 86% for every unit increase in NSC (aOR = 1.86; 95% CI, 1.03-3.36). NSC was not statistically significantly associated with guideline-concordant cervical cancer screening (aOR = 0.86; 95% CI, 0.54-1.38) or colorectal cancer screening (aOR = 1.29; 95% CI, 0.81-2.04). CONCLUSIONS These findings suggest that NSC supports some screening behaviors, namely, mammography use. To better understand heterogeneous relationships between NSC and utilization of preventive care services such as cancer screening, more research is needed that disaggregates effects by sex, age, race/ethnicity, and socioeconomic status.
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Affiliation(s)
- Jordan A Baeker Bispo
- American Cancer Society, Surveillance and Health Equity Science, Atlanta, Georgia (Drs Baeker Bispo and Ashad-Bishop); Miller School of Medicine, University of Miami, Miami, Florida (Drs Goo and Kobetz); Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida (Dr Kobetz); Keck School of Medicine, University of Southern California, Los Angeles, California (Dr Goo); and University of Minnesota School of Public Health, Minneapolis, Minnesota (Dr Bailey)
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Pichardo CM, Ezeani A, Pichardo MS, Agurs‐Collins T, Powell‐Wiley TM, Ryan B, Minas TZ, Bailey‐Whyte M, Tang W, Dorsey TH, Wooten W, Loffredo CA, Ambs S. Association of neighborhood gentrification with prostate cancer and immune markers in African American and European American men. Cancer Med 2024; 13:e6828. [PMID: 38151903 PMCID: PMC10807554 DOI: 10.1002/cam4.6828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Prior studies showed that neighborhood deprivation increases the risk of lethal prostate cancer. However, the role of neighborhood gentrification in prostate cancer development and outcome remains poorly understood. We examined the relationships of gentrification with prostate cancer and serum proteome-defined inflammation and immune function in a diverse cohort. METHODS The case-control study included 769 cases [405 African American (AA), 364 European American (EA) men] and 1023 controls (479 AA and 544 EA), with 219 all-cause and 59 prostate cancer-specific deaths among cases. Geocodes were linked to a neighborhood gentrification index (NGI) derived from US Census data. Cox and logistic regression, and MANOVA, were used to determine associations between NGI, as continuous or quintiles (Q), and outcomes. RESULTS Adjusting for individual socioeconomic status (SES), continuous NGI was positively associated with prostate cancer among all men (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14). AA and low-income men experienced the highest odds of prostate cancer when residing in tracts with moderate gentrification, whereas EA men experienced reduced odds of regional/metastatic cancer with increased gentrification in SES-adjusted analyses. Continuous NGI also associated with mortality among men presenting with localized disease and low-income men in SES-adjusted Cox regression analyses. NGI was not associated with serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression. CONCLUSIONS Findings show that neighborhood gentrification associates with prostate cancer and mortality in this diverse population albeit associations were heterogenous within subgroups. The observations suggest that changing neighborhood socioeconomic environments may affect prostate cancer risk and outcome, likely through multifactorial mechanisms.
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Affiliation(s)
| | - Adaora Ezeani
- Division of Cancer Control and Population Sciences, NCINIHRockvilleMarylandUSA
| | - Margaret S. Pichardo
- Department of Surgery, Hospital of the University of PennsylvaniaPenn MedicinePhiladelphiaPennsylvaniaUSA
| | - Tanya Agurs‐Collins
- Division of Cancer Control and Population Sciences, NCINIHRockvilleMarylandUSA
| | - Tiffany M. Powell‐Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute (NHLBI)National Institutes of HealthBethesdaMarylandUSA
- Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD)National Institutes of HealthBethesdaMarylandUSA
| | - Brid Ryan
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - Tsion Zewdu Minas
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - Maeve Bailey‐Whyte
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
- School of MedicineUniversity of LimerickLimerickIreland
| | - Wei Tang
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
- Data Science & Artificial Intelligence, R&DAstraZenecaGaithersburgMarylandUSA
| | - Tiffany H. Dorsey
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
| | - William Wooten
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center Biostatistics Shared ServiceBaltimoreMarylandUSA
| | - Christopher A. Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer CenterGeorgetown University Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI)National Institutes of Health (NIH)BethesdaMarylandUSA
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Wind K, Poland B, HakemZadeh F, Jackson S, Tomlinson G, Jadad A. Using self-reported health as a social determinants of health outcome: a scoping review of reviews. Health Promot Int 2023; 38:daad165. [PMID: 38041807 DOI: 10.1093/heapro/daad165] [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] [Indexed: 12/04/2023] Open
Abstract
Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure.
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Affiliation(s)
- Keiwan Wind
- DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Farimah HakemZadeh
- Faculty of Liberal Arts and Professional Studies, School of Human Resources Management, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada
| | - Suzanne Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - George Tomlinson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Alejandro Jadad
- Centre for Digital Therapeutics, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
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Spitzer SA, Vail DG, Heindel P, Dey T, Cooper Z, Salim A, Jarman MP. Gentrification as a Factor in the Incidence of Firearm Injuries. JAMA Surg 2023; 158:1152-1158. [PMID: 37728889 PMCID: PMC10512160 DOI: 10.1001/jamasurg.2023.3939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/29/2023] [Indexed: 09/22/2023]
Abstract
Importance Firearm injuries are an epidemic in the US; more than 45 000 fatal injuries were recorded in 2020 alone. Gaining a deeper understanding of socioeconomic factors that may contribute to increasing firearm injury rates is critical to prevent future injuries. Objective To explore whether neighborhood gentrification is associated with firearm injury incidence rates over time. Design, Setting, and Participants This cross-sectional study used nationwide, urban US Census tract-level data on gentrification between 2010 and 2019 and firearm injuries data collected between 2014 and 2019. All urban Census tracts, as defined by Rural Urban Commuting Area codes 1 to 3, were included in the analysis, for a total of 59 379 tracts examined from 2014 through 2019. Data were analyzed from January 2022 through April 2023. Exposure Gentrification, defined to be an area in a central city neighborhood with median housing prices appreciating over the median regional value and a median household income at or below the 40th percentile of the median regional household income and continuing for at least 2 consecutive years. Main Outcomes and Measures The number of firearm injuries, controlling for Census tract population characteristics. Results A total of 59 379 urban Census tracts were evaluated for gentrification; of these tracts, 14 125 (23.8%) were identified as gentrifying, involving approximately 57 million residents annually. The firearm injury incidence rate for gentrifying neighborhoods was 62% higher than the incidence rate in nongentrifying neighborhoods with similar sociodemographic characteristics (incidence rate ratio [IRR], 1.62; 95% CI, 1.56-1.69). In a multivariable analysis, firearm injury incidence rates increased by 57% per year for low-income Census tracts that did not gentrify (IRR, 1.57; 95% CI, 1.56-1.58), 42% per year for high-income tracts that did not gentrify (IRR, 1.42; 95% CI, 1.41-1.43), and 49% per year for gentrifying tracts (IRR, 1.49; 95% CI, 1.48-1.50). Neighborhoods undergoing the gentrification process experienced an additional 26% increase in firearm injury incidence above baseline increase experienced in neighborhoods not undergoing gentrification (IRR, 1.26; 95% CI, 1.23-1.30). Conclusions and Relevance Results of this study suggest that gentrification is associated with an increase in the incidence of firearm injuries within gentrifying neighborhoods. Social disruption and residential displacement associated with gentrification may help explain this finding, although future research is needed to evaluate the underlying mechanisms. These findings support use of targeted firearm prevention interventions in communities experiencing gentrification.
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Affiliation(s)
- Sarabeth A. Spitzer
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Gillian Reny Stepping Strong Center for Trauma Innovation, Brigham and Women’s Hospital, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Patrick Heindel
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Tanujit Dey
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Zara Cooper
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Ali Salim
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Gillian Reny Stepping Strong Center for Trauma Innovation, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Molly P. Jarman
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- The Gillian Reny Stepping Strong Center for Trauma Innovation, Brigham and Women’s Hospital, Boston, Massachusetts
- The Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
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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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Pichardo MS, Pichardo CM, Talavera GA, Gallo LC, Kuo CC, Castañeda SF, Chambers EC, Daviglus ML, Pirzada A, Perreira KM, Sotres-Alvarez D, Peña Ortiz TY, Plascak JJ. Change in Neighborhood Socioeconomic Status and Adherence to the Cancer Prevention Lifestyle Guidelines in Hispanic/Latino Adults: Results from the HCHS/SOL Study. CANCER RESEARCH COMMUNICATIONS 2023; 3:1981-1991. [PMID: 37783658 PMCID: PMC10542571 DOI: 10.1158/2767-9764.crc-23-0187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/03/2023] [Accepted: 09/05/2023] [Indexed: 10/04/2023]
Abstract
Neighborhood conditions are dynamic; the association of changing neighborhood socioeconomic factors with cancer preventive behaviors remains unclear. We examined associations of neighborhood socioeconomic deprivation, gentrification, and change in income inequality with adherence to the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention in The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The HCHS/SOL enrolled 16,415 adults, ages 18–74 years, at baseline (2008–2011), from communities in the Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA. Geocoded baseline addresses were linked to the 2000 decennial Census and 5-year American Community Survey (2005–2009 and 2012–2016) tracts to operationalize neighborhood deprivation index (NDI), gentrification, and income inequality. Complex survey multinominal logistic regression models estimated the relative risk ratio (RRR) with overall guideline adherence level (low, moderate, high) and by components—diet, physical activity, body mass index (BMI), and alcohol intake. Overall, 14%, 60%, and 26% of the population had low, moderate, and high ACS guideline adherence, respectively. NDI was negatively associated with risk of high (vs. low) guideline adherence [RRR = 0.87, 95% confidence interval (CI) = 0.78–0.98], although attenuated after controlling for individual socioeconomic status (SES; RRR = 0.89, 95% CI = 0.80–1.00), and associated with lower adherence to BMI recommendations (low vs. moderate RRR = 0.90, 95% CI = 0.84–0.97; high RRR = 0.86, 95% CI = 0.77–0.97). Gentrification was associated with higher likelihood of meeting the dietary recommendations (low vs. moderate RRR = 1.04, 95% CI = 1.01–1.07), but not with overall adherence or individual components. Change in income inequality was not associated with outcomes. Neighborhood deprivation may be negatively associated with ACS guideline adherence among Hispanic/Latino adults. SIGNIFICANCE This study provides new evidence on the link between neighborhood gentrification, changing income inequality and adoption and maintenance of cancer preventive behaviors in an understudied population in cancer research. We observed that while neighborhood deprivation may deter from healthy lifestyle behaviors, positive changes in neighborhood SES via the process of gentrification, may not influence lifestyle guideline adherence among Hispanic/Latino adults.
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Affiliation(s)
- Margaret S. Pichardo
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Catherine M. Pichardo
- South Bay Latino Research Center, Department of Psychology, San Diego State University, San Diego, California
| | | | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California
| | - Charlene C. Kuo
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland
| | | | - Earle C. Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, The Bronx, New York
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois
| | - Krista M. Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Jesse J. Plascak
- Division of Cancer Prevention and Control, Ohio State University College of Medicine, Columbus, Ohio
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11
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Gao X, Thomas TA, Morello-Frosch R, Allen AM, Snowden JM, Carmichael SL, Mujahid MS. Neighborhood gentrification, displacement, and severe maternal morbidity in California. Soc Sci Med 2023; 334:116196. [PMID: 37678111 PMCID: PMC10959124 DOI: 10.1016/j.socscimed.2023.116196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/29/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Gentrification, a racialized and profit-driven process in which historically disinvested neighborhoods experience an influx of development that contributes to the improvement of physical amenities, increasing housing costs, and the dispossession and displacement of existing communities, may influence the risk of severe maternal morbidity (SMM). Leveraging a racially diverse population-based sample of all live hospital births in California between 2006 and 2017, we examined associations between neighborhood-level gentrification and SMM. SMM was defined as having one of 21 procedures and diagnoses, as described in the SMM index developed by Centers for Disease Control and Prevention. We compared three gentrification measures to determine which operationalization best captures aspects of gentrification most salient to SMM: Freeman, Landis 3-D, and Urban Displacement Project Gentrification and Displacement Typology. Descriptive analysis assessed bivariate associations between gentrification and birthing people's characteristics. Overall and race and ethnicity-stratified mixed-effects logistic models assessed associations between gentrification and SMM, adjusting for individual sociodemographic and pregnancy factors while accounting for clustering by census tract. The study sample included 5,256,905 births, with 72,718 cases of SMM (1.4%). The percentage of individuals living in a gentrifying neighborhood ranged from 5.7% to 11.7% across exposure assessment methods. Net of individual and pregnancy-related factors, neighborhood-level gentrification, as measured by the Freeman method, was protective against SMM (OR = 0.89, 95% CI: 0.86-0.93); in comparison, gentrification, as measured by the Gentrification and Displacement Typology, was associated with greater risk of SMM (OR = 1.18, 95% CI: 1.14-1.23). These associations were significant among non-Hispanic White, non-Hispanic Black, and Hispanic individuals. Findings demonstrate that gentrification plays a role in shaping the risk of SMM among birthing people in California. Differences in how gentrification is conceptualized and measured, such as an emphasis on housing affordability compared to a broader characterization of gentrification's multiple aspects, may explain the heterogeneity in the directions of observed associations.
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Affiliation(s)
- Xing Gao
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Timothy A Thomas
- Urban Displacement Project, Institute of Governmental Studies, University of California Berkeley, Berkeley, CA, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management, University of California Berkeley, Berkeley, CA, USA; Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Amani M Allen
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Jonathan M Snowden
- School of Public Health, Oregon Health & Science University-Portland State University, OR, USA
| | - Suzan L Carmichael
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA; Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Stanford University, Stanford, CA, USA
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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12
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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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Casey JA, Daouda M, Babadi RS, Do V, Flores NM, Berzansky I, González DJ, Van Horne YO, James-Todd T. Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021. Curr Environ Health Rep 2023; 10:312-336. [PMID: 37581863 PMCID: PMC10504232 DOI: 10.1007/s40572-023-00406-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods. RECENT FINDINGS We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.
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Affiliation(s)
- Joan A. Casey
- University of Washington School of Public Health, Seattle, WA USA
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Misbath Daouda
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Ryan S. Babadi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Vivian Do
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Nina M. Flores
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Isa Berzansky
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - David J.X. González
- Department of Environmental Science, Policy & Management and School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | | | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
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14
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Auchincloss AH, Mucciaccio F, Fang CY, Ruggiero DA, Hirsch JA, Zhong J, Li M, Egleston BL, Tseng M. Neighborhood gentrification, wealth, and co-ethnic density associations with acculturation stressors among Chinese immigrants. SSM Popul Health 2023; 23:101476. [PMID: 37583620 PMCID: PMC10424118 DOI: 10.1016/j.ssmph.2023.101476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 07/25/2023] [Indexed: 08/17/2023] Open
Abstract
Objective This study examined the cross-sectional relationships between neighborhood social composition and gentrification, and acculturation stressors. Methods Person-level data came from first-generation Chinese immigrants enrolled in the Immigrant Enclaves Study (Philadelphia, Pennsylvania, baseline 2018-2020, N = 512). A validated scale was used to assess 22 stressors associated with migration or acculturation. Neighborhood characteristics from the American Community Survey 2015-2019 and 2008-2012 included: tract proportion of foreign born Chinese, neighborhood wealth, and past decade gentrification. Most neighborhood exposures were modeled as continuous as well as binary variables (intended to represent highest level of neighborhood exposure). Multivariable negative binomial regression adjusted for age, gender, income, education, employment, language, years in the U.S., and neighborhood variables (proportion co-ethnic, and neighborhood per capita income). Results The majority of participants spoke Mandarin (68% vs Cantonese 32%), mean participant age was 52.7 years old, years in the US was 18, and nearly one-half of the sample had less than 8 years of education. Mean number of stressors was 5.9 with nearly 20% of participants reporting 11 or more stressors. Multivariable results found the number of acculturation stressors was 18% lower for residents in the highest co-ethnic density neighborhoods and 13% lower for residents in the highest wealth areas, compared to other areas (expβ 0.82, 95% CI [CI] 0.69, 0.98; expβ 0.87, CI 0.75, 1.01, respectively). Stressors were no different whether participants lived in gentrified areas or not. Conclusions Among middle-aged Chinese immigrants, acculturation stress was lower for residents in neighborhoods with higher proportion of Chinese immigrants and for residents in neighborhoods with higher wealth, whereas gentrification had no influence on acculturation stress. More work on this topic is needed with vulnerable populations such as this one, informed by local context.
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Affiliation(s)
- Amy H. Auchincloss
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Francesca Mucciaccio
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Carolyn Y. Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Dominic A. Ruggiero
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jana A. Hirsch
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Julia Zhong
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Minzi Li
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Brian L. Egleston
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Marilyn Tseng
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, USA
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15
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McIntosh A, Anguelovski I, Cole H. "The trauma machine expands faster than our services": Health risks for unhoused people in an early-stage gentrifying area. Health Place 2023; 83:103035. [PMID: 37331113 DOI: 10.1016/j.healthplace.2023.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 06/20/2023]
Abstract
While homelessness continues to be a prevalent problem throughout the United States, many urban neighborhoods are also concurrently experiencing an influx of affluent neighbors through gentrification, exposing the stark inequalities in housing access nationwide. Gentrification-induced changes in neighborhood dynamics have also been shown to affect the health of low-income and non-white groups, with high risks of trauma from displacement and exposure to violent crime and criminalization. This study addresses risk factors for health among the most vulnerable, unhoused individuals, and provides a detailed case study on the potential exposures to emotional and physical traumas for unhoused people in early-stage gentrifying areas. By conducting 17 semi-structured interviews with people who work with the unhoused community - health providers, nonprofit employees, neighborhood representatives, and developers - in Kensington, Philadelphia, we analyze how early-stage gentrification impacts the risks for negative health consequences among unhoused groups. Results show that gentrification impacts the health of unhoused people in four main areas that, all together, create what we identify as a "trauma machine" - that is compounding traumas for unhoused residents by 1) reducing and compromising spaces of safety from violent crime, 2) decreasing public services, 3) threatening the quality of healthcare, and 4) increasing the likelihood of displacement and associated trauma.
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Affiliation(s)
- Andrea McIntosh
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain.
| | - Isabelle Anguelovski
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain; Institución Catalana de Investigación y Estudios Avanzados (ICREA), Passeig de Lluís Companys, 23, 08010, Barcelona, Spain.
| | - Helen Cole
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain.
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16
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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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17
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Linton S, Cruz AL, Arnold K. Public service providers' perspectives on and responses to the health and social consequences of gentrification in Atlanta, Georgia. JOURNAL OF SOCIAL SERVICE RESEARCH 2023; 49:494-509. [PMID: 37693303 PMCID: PMC10487345 DOI: 10.1080/01488376.2023.2237517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Service providers' perspectives on, and responses to the health and social impacts of gentrification have been underexplored. This study's objectives were to assess health and social service providers' perspectives on the causes and impacts of gentrification and their responses to gentrification's impacts. Qualitative in-depth interviews were conducted with 15 service providers sampled using maximum variation and snowball sampling, in Atlanta, Georgia, U.S.A. Inductive thematic analysis was used. Providers characterized gentrification as increases in community-level social and economic advantage and displacement of Black and Brown people. Neighborhood divestment and speculative development were reported determinants of gentrification. Revitalization and economic growth were reported positive effects of gentrification; negative ramifications included inflated housing costs, residential displacement, and reduced access to health and social services. Providers enacted multiple solutions to mitigate the negative consequences they observed, including educating residents on housing rights and collaborating with other organizations to expand outreach to displaced residents. Service providers are integral to contributing to knowledge on the causes and impacts of gentrification, and absolving problems resulting from gentrification. . Additional research documenting service provider's responses to the impacts of gentrification are needed to inform how future community development strategies are developed to create more benefits than harms.
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Affiliation(s)
- Sabriya Linton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health; 624 N. Broadway, Baltimore, MD 21205, Atlanta, USA
| | - Angie Lisbeth Cruz
- Department of Health Policy; Rollins School of Public Health at Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Kimberly Arnold
- Family Medicine and Community Health, Perelman School of Medicine, Philadelphia, PA 19104, USA
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18
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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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Stappers NEH, Bekker MPM, Jansen MWJ, Kremers SPJ, de Vries NK, Schipperijn J, Van Kann DHH. Effects of major urban redesign on sedentary behavior, physical activity, active transport and health-related quality of life in adults. BMC Public Health 2023; 23:1157. [PMID: 37322454 PMCID: PMC10267553 DOI: 10.1186/s12889-023-16035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The built environment is increasingly recognized as a determinant for health and health behaviors. Existing evidence regarding the relationship between environment and health (behaviors) is varying in significance and magnitude, and more high-quality longitudinal studies are needed. The aim of this study was to evaluate the effects of a major urban redesign project on physical activity (PA), sedentary behavior (SB), active transport (AT), health-related quality of life (HRQOL), social activities (SA) and meaningfulness, at 29-39 months after opening of the reconstructed area. METHODS PA and AT were measured using accelerometers and GPS loggers. HRQOL and sociodemographic characteristics were assessed using questionnaires. In total, 241 participants provided valid data at baseline and follow-up. We distinguished three groups, based on proximity to the intervention area: maximal exposure group, minimal exposure group and no exposure group. RESULTS Both the maximal and minimal exposure groups showed significantly different trends regarding transport-based PA levels compared to the no exposure group. In the exposure groups SB decreased, while it increased in the no exposure group. Also, transport-based light intensity PA remained stable in the exposure groups, while it significantly decreased in the no exposure group. No intervention effects were found for total daily PA levels. Scores on SA and meaningfulness increased in the maximal exposure group and decreased in the minimal and no exposure group, but changes were not statistically significant. CONCLUSION The results of this study emphasize the potential of the built environment in changing SB and highlights the relevance of longer-term follow-up measurements to explore the full potential of urban redesign projects. TRIAL REGISTRATION This research was retrospectively registered at the Netherlands Trial Register (NL8108).
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Affiliation(s)
- N E H Stappers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Debyeplein 1, Maastricht, 6229HA, The Netherlands.
| | - M P M Bekker
- Center for Space, Place and Society, Social Sciences Group, Wageningen University, Wageningen, The Netherlands
| | - M W J Jansen
- CAPHRI Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Academic Collaborative Center for Public Health, Public Health Service South-Limburg, Heerlen, The Netherlands
| | - S P J Kremers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Debyeplein 1, Maastricht, 6229HA, The Netherlands
| | - N K de Vries
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Debyeplein 1, Maastricht, 6229HA, The Netherlands
- CAPHRI Care and Public Health Research Institute, Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - J Schipperijn
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - D H H Van Kann
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Debyeplein 1, Maastricht, 6229HA, The Netherlands
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
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20
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Youngbloom AJ, Thierry B, Fuller D, Kestens Y, Winters M, Hirsch JA, Michael YL, Firth C. Gentrification, perceptions of neighborhood change, and mental health in Montréal, Québec. SSM Popul Health 2023; 22:101406. [PMID: 37114239 PMCID: PMC10127140 DOI: 10.1016/j.ssmph.2023.101406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
While census-defined measures of gentrification are often used in research on gentrification and health, surveys can be used to better understand how residents perceive neighborhood change, and the implications for mental health. Whether or not gentrification affects mental health may depend on the extent to which an individual perceives changes in their neighborhood. Using health and map-based survey data, collected from 2020 to 2021, from the Interventions, Research, and Action in Cities Team, we examined links between perceptions of neighborhood change, census-defined neighborhood gentrification at participant residential addresses, and mental health among 505 adults living in Montréal. After adjusting for age, gender, race, education, and duration at current residence, greater perceived affordability and more positive feelings about neighborhood changes were associated with better mental health, as measured by the mental health component of the short-form health survey. Residents who perceived more change to the social environment had lower mental health scores, after adjusting individual covariates. Census-defined gentrification was not significantly associated with mental health, and perceptions of neighborhood change did not significantly modify the effect of gentrification on mental health. Utilizing survey tools can help researchers understand the role that perceptions of neighborhood change play in the understanding how neighborhood change impacts mental health.
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Affiliation(s)
- Amy J. Youngbloom
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Benoit Thierry
- Université de Montréal/Centre de Recherche Du CHUM, Pavillon S, 850 Rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Daniel Fuller
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada
- Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's, Newfoundland, A1C 5S7, Canada
| | - Yan Kestens
- Université de Montréal/Centre de Recherche Du CHUM, Pavillon S, 850 Rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- Corresponding author.
| | - Jana A. Hirsch
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Yvonne L. Michael
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Caislin Firth
- Center for Studies in Demography & Ecology, University of Washington, Seattle, WA, USA
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21
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Alroy KA, Cavalier H, Crossa A, Wang SM, Liu SY, Norman C, Sanderson M, Gould LH, Lim SW. Can changing neighborhoods influence mental health? An ecological analysis of gentrification and neighborhood-level serious psychological distress-New York City, 2002-2015. PLoS One 2023; 18:e0283191. [PMID: 37018221 PMCID: PMC10075454 DOI: 10.1371/journal.pone.0283191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/03/2023] [Indexed: 04/06/2023] Open
Abstract
Neighborhood conditions influence people's health; sustaining healthy neighborhoods is a New York City (NYC) Health Department priority. Gentrification is characterized by rapid development in historically disinvested neighborhoods. The gentrification burden, including increased living expenses, and disrupted social networks, disproportionally impacts certain residents. To ultimately target health promotion interventions, we examined serious psychological distress time trends in gentrifying NYC neighborhoods to describe the association of gentrification and mental health overall and stratified by race and ethnicity. We categorized NYC neighborhoods as hypergentrifying, gentrifying, and not-gentrifying using a modified New York University Furman Center index. Neighborhoods with ≥100% rent growth were hypergentrifying; neighborhoods with greater than median and <100% rent growth were gentrifying; and neighborhoods with less than median rent growth were not-gentrifying. To temporally align neighborhood categorization closely with neighborhood-level measurement of serious psychological distress, data during 2000-2017 were used to classify neighborhood type. We calculated serious psychological distress prevalence among adult populations using data from 10 NYC Community Health Surveys during 2002-2015. Using joinpoint and survey-weighted logistic regression, we analyzed serious psychological distress prevalence time trends during 2002-2015 by gentrification level, stratified by race/ethnicity. Among 42 neighborhoods, 7 were hypergentrifying, 7 were gentrifying, and 28 were not gentrifying. In hypergentrifying neighborhoods, serious psychological distress prevalence decreased among White populations (8.1% to 2.3%, β = -0.77, P = 0.02) and was stable among Black (4.6% to 6.9%, β = -0.01, P = 0.95) and Latino populations (11.9% to 10.4%, β = -0.16, P = 0.31). As neighborhoods gentrified, different populations were affected differently. Serious psychological distress decreased among White populations in hypergentrifying neighborhoods, no similar reductions were observed among Black and Latino populations. This analysis highlights potential unequal mental health impacts that can be associated with gentrification-related neighborhood changes. Our findings will be used to target health promotion activities to strengthen community resilience and to ultimately guide urban development policies.
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Affiliation(s)
- Karen A. Alroy
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - Haleigh Cavalier
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - Aldo Crossa
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - Shu Meir Wang
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - Sze Yan Liu
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - Christina Norman
- Division of Mental Hygiene, New York City Department of Health and Mental Hygiene, Bureau of Mental Health, Queens, New York, United States of America
| | - Michael Sanderson
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - L. Hannah Gould
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
| | - Sung woo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Queens, New York, United States of America
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22
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Smith GS, Archibald P, Thorpe RJ. Race and obesity disparities among adults living in gentrifying neighborhoods. J Racial Ethn Health Disparities 2023; 10:93-99. [PMID: 35083727 DOI: 10.1007/s40615-021-01199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 02/03/2023]
Abstract
There is a paucity of research seeking to understand race disparities in obesity among individuals living in a gentrifying neighborhood. American Community Survey data were used to identify gentrifying neighborhoods. In a cross-sectional analysis, these data were then linked to the 2014 Medical Expenditure Panel Survey, yielding an analytic sample of 887 Black and White adults. Obesity was based on body mass index ≥ 30 kg/m2. After controlling for potential confounders, Black adults living in gentrifying neighborhoods had a higher prevalence of obesity (PR: 1.39; 95% CI: 1.03, 1.88) than White adults living in gentrifying neighborhoods. Gentrification may have no impact on reducing Black-White obesity disparities in the US.
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Affiliation(s)
- G S Smith
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - P Archibald
- Department of Social Work, College of Staten Island-City University of New York School of Health Science, Staten Island, NY, USA
| | - R J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Program for Research On Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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23
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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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24
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Mui Y, Headrick G, Chien J, Pollack C, Saleem HT. Revisiting revitalization: exploring how structural determinants moderate pathways between neighborhood change and health. Int J Equity Health 2022; 21:165. [DOI: 10.1186/s12939-022-01771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/16/2022] [Accepted: 09/27/2022] [Indexed: 11/19/2022] Open
Abstract
AbstractVacant housing can produce many issues that affect residents’ quality of life, especially in historically segregated communities of color. To address these challenges, local governments invest in strategic, place-based revitalization initiatives focused on the regeneration of vacant housing. Yet, the outcomes of these efforts remain contested. To maximize health benefits of revitalization investments, a more nuanced understanding of pathways between neighborhood changes and residents’ responses, adaptations, and ability to thrive is necessary, though, remains largely absent in the literature. Using the Vacants to Value initiative in Baltimore, MD as a case study, we explore (1) how health manifests among certain groups in the context of vacant housing revitalization; (2) how vacant housing and its regeneration engender social and cultural environmental change i.e., gentrification; and (3) what structural determinants (cultural norms, policies, institutions, and practices) contribute to the distribution of material resources and benefits of revitalization. Results suggest that vacant housing revitalization requires more than just physical remedies to maximize health. Our findings demonstrate how vacant housing revitalization influences the physical environment, social environment, and structural determinants of material resources and community engagement that can ultimately impact residents’ physical, mental, and social health. This study recommends that because housing disparities are rooted in structural inequalities, how policies, practices, and processes moderate pathways for residents to adapt and benefit from neighborhood changes is consequential for health and health equity. Establishing shared governance structures is a promising approach to foster equitable decision-making and outcomes. Going forward in urban regeneration, pathways to retain and strengthen the social environment while revitalizing the physical environment may be promising to achieve healthy communities.
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25
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Acolin A, Crowder K, Decter-Frain A, Hajat A, Hall M. Gentrification, Mobility, and Exposure to Contextual Social Determinants of Health. HOUSING POLICY DEBATE 2022; 33:194-223. [PMID: 37200539 PMCID: PMC10187766 DOI: 10.1080/10511482.2022.2099937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/17/2022] [Accepted: 07/06/2022] [Indexed: 05/20/2023]
Abstract
This study uses individual level consumer trace data for 2006 residents of low- and moderate-income neighborhoods for the principal cities of the 100 largest metropolitan regions in the US using their location in 2006 and 2019 to examine exposure to the following four cSDOH: healthcare access (Medically Underserved Areas), socioeconomic condition (Area Deprivation Index), air pollution (NO2, PM 2.5 and PM10), and walkability (National Walkability Index). The results control for individual characteristics and initial neighborhood conditions. Residents of neighborhoods classified as gentrifying were exposed to more favorable cSDOH as of 2006 relative to residents of low- and moderate-income neighborhoods that were not gentrifying in terms of likelihood to be in a MUA, and level of local deprivation and walkability while experiencing similar level of air pollution. As a result of changes in neighborhood characteristics and differential mobility pattern, between 2006 and 2019, individuals who originally lived in gentrifying neighborhoods experienced worse changes in MUAs, ADI, and Walkability Index but a greater improvement in exposure to air pollutants. The negative changes are driven by movers, while stayers actually experience a relative improvement in MUAs and ADI and larger improvements in exposure to air pollutants. The findings indicate that gentrification may contribute to health disparities through changes in exposure to cSDOH through mobility to communities with worse cSDOH among residents of gentrifying neighborhoods although results in terms of exposure to health pollutants are mixed.
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26
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Tempalski B, Williams LD, Kolak M, Ompad DC, Koschinsky J, McLafferty SL. Conceptualizing the Socio-Built Environment: An Expanded Theoretical Framework to Promote a Better Understanding of Risk for Nonmedical Opioid Overdose Outcomes in Urban and Non-Urban Settings. J Urban Health 2022; 99:701-716. [PMID: 35672547 PMCID: PMC9360264 DOI: 10.1007/s11524-022-00645-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 01/31/2023]
Abstract
Nonmedical opioid (NMO) use has been linked to significant increases in rates of NMO morbidity and mortality in non-urban areas. While there has been a great deal of empirical evidence suggesting that physical features of built environments represent strong predictors of drug use and mental health outcomes in urban settings, there is a dearth of research assessing the physical, built environment features of non-urban settings in order to predict risk for NMO overdose outcomes. Likewise, there is strong extant literature suggesting that social characteristics of environments also predict NMO overdoses and other NMO use outcomes, but limited research that considers the combined effects of both physical and social characteristics of environments on NMO outcomes. As a result, important gaps in the scientific literature currently limit our understanding of how both physical and social features of environments shape risk for NMO overdose in rural and suburban settings and therefore limit our ability to intervene effectively. In order to foster a more holistic understanding of environmental features predicting the emerging epidemic of NMO overdose, this article presents a novel, expanded theoretical framework that conceptualizes "socio-built environments" as comprised of (a) environmental characteristics that are applicable to both non-urban and urban settings and (b) not only traditional features of environments as conceptualized by the extant built environment framework, but also social features of environments. This novel framework can help improve our ability to identify settings at highest risk for high rates of NMO overdose, in order to improve resource allocation, targeting, and implementation for interventions such as opioid treatment services, mental health services, and care and harm reduction services for people who use drugs.
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Affiliation(s)
- Barbara Tempalski
- Center for Community-Based Population Health Research, NDRI-USA, Inc., 31 West 34th Street, New York, NY 10001 USA
| | - Leslie D. Williams
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, 1603 W. Taylor Street, Chicago, IL 60607 USA
| | - Marynia Kolak
- Center for Spatial Data Science, University of Chicago, 1155 East 60th Street, Chicago, IL 60637 USA
| | - Danielle C. Ompad
- Center for Drug Use and HIV/HCV Research, and the Department of Epidemiology, New York University School of Global Public Health, 708 Broadway, New York, NY 10003 USA
| | - Julia Koschinsky
- Center for Spatial Data Science, University of Chicago, 1155 East 60th Street, Chicago, IL 60637 USA
| | - Sara L. McLafferty
- Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, 1301 W Green Street, Urbana, IL 61801 USA
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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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28
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Cole HVS, Franzosa E. Title: advancing urban health equity in the United States in an age of health care gentrification: a framework and research agenda. Int J Equity Health 2022; 21:66. [PMID: 35546673 PMCID: PMC9092322 DOI: 10.1186/s12939-022-01669-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/20/2022] [Indexed: 11/22/2022] Open
Abstract
Background Access to health care has traditionally been conceptualized as a function of patient socio-demographic characteristics (i.e., age, race/ethnicity, education, health insurance status, etc.) and/or the system itself (i.e., payment structures, facility locations, etc.). However, these frameworks typically do not take into account the broader, dynamic context in which individuals live and in which health care systems function. Purpose The growth in market-driven health care in the U.S. alongside policies aimed at improving health care delivery and quality have spurred health system mergers and consolidations, a shift toward outpatient care, an increase in for-profit care, and the closure of less profitable facilities. These shifts in the type, location and delivery of health care services may provide increased access for some urban residents while excluding others, a phenomenon we term “health care gentrification.“ In this commentary, we frame access to health care in the United States in the context of neighborhood gentrification and a concurrent process of changes to the health care system itself. Conclusions We describe the concept of health care gentrification, and the complex ways in which both neighborhood gentrification and health care gentrification may lead to inequitable access to health care. We then present a framework for understanding health care gentrification as a function of dynamic and multi-level systems, and propose ways to build on existing models of health care access and social determinants of health to more effectively measure and address this phenomenon. Finally, we describe potential strategies applied researchers might investigate that could prevent or remediate the effects of health care gentrification in the United States.
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Affiliation(s)
- Helen V S Cole
- Barcelona Lab for Urban Environmental Justice and Sustainability, Institut de Ciencia i Tecnologia Ambientals (ICTA-UAB), Universitat Autonoma de Barcelona, Barcelona, Spain. .,Healthy Cities research group, Department of Epidemiology and Public Health, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - Emily Franzosa
- Research Health Science Specialist, Geriatric Research Education and Clinical Center (GRECC), James J. Peters VA Medical Center, Bronx, USA.,Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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29
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Selected Research Issues of Urban Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095553. [PMID: 35564947 PMCID: PMC9105718 DOI: 10.3390/ijerph19095553] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/17/2023]
Abstract
Health is created within the urban settings of people’s everyday lives. In this paper we define Urban Public Health and compile existing evidence regarding the spatial component of health and disease in urban environments. Although there is already a substantial body of single evidence on the links between urban environments and human health, focus is mostly on individual health behaviors. We look at Urban Public Health through a structural lens that addresses health conditions beyond individual health behaviors and identify not only health risks but also health resources associated with urban structures. Based on existing conceptual frameworks, we structured evidence in the following categories: (i) build and natural environment, (ii) social environment, (iii) governance and urban development. We focused our search to review articles and reviews of reviews for each of the keywords via database PubMed, Cochrane, and Google Scholar in order to cover the range of issues in urban environments. Our results show that linking findings from different disciplines and developing spatial thinking can overcome existing single evidence and make other correlations visible. Further research should use interdisciplinary approaches and focus on health resources and the transformation of urban structures rather than merely on health risks and behavior.
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Sanky C, Johnson H, Sanky D, Appel JM. Do Hospital Leaders Live in the Communities They Serve? A Comparative Analysis. Health Equity 2022; 6:313-321. [PMID: 35557549 PMCID: PMC9081031 DOI: 10.1089/heq.2021.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose: Many factors contribute to persistent intractable disparities in health care, but the geographic separation of health care executives and patient communities has not been explored. From Congresspeople to police officers, individuals engaged in public service often face criticism for not living in the neighborhoods where they work. These critiques stem from the belief that to engage meaningfully with a community, one has to understand its experiences and share its interests—and geographic proximity offers one opportunity to bridge such divides. This article seeks to determine whether the senior executive leadership of American hospitals live in the same communities as their patient populations. Methods: From August 2020 to January 2021, the research team identified the leadership of the “largest” and “best” hospitals in the United States (n=68). Public directories were used to locate residential addresses. Newly released U.S. Census data provided proportions of individuals identifying as black/African American and Hispanic/Latinx in each zip code. Respective demographic proportions of hospital communities and hospital leadership residence were compared. Results: Hospitals shared the same zip codes with only three health system leaders (4.41%), seven hospital leaders (10.45%), and six deans (10.91%) of respective institutions. Hospital leadership lived in zip codes with a significantly lower proportion of black/African American (p<0.0009) and Hispanic/Latinx (p<0.0036) residents than their hospital communities. Conclusion: This article reveals significant differences between where health care leaders live and where they work. Future research should investigate the impact of residential disparities and the consequences of potential remedies on health equity.
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Affiliation(s)
- Charles Sanky
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Graduate Program in Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hannah Johnson
- Graduate Program in Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel Sanky
- Graduate School of Medical Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Jacob M. Appel
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, 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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Hirsch JA, Grunwald HE, Miles KL, Michael YL. Development of an instrument to measure perceived gentrification for health research: Perceptions about changes in environments and residents (PACER). SSM Popul Health 2021; 15:100900. [PMID: 34485674 PMCID: PMC8399084 DOI: 10.1016/j.ssmph.2021.100900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 01/22/2023] Open
Abstract
Despite a myriad of potential pathways linking neighborhood change and gentrification to health, existing quantitative measures failed to capture individual-level, self-reported perceptions of these processes. We developed the Perceptions About Change in Environment and Residents (PACER) survey to measure the gentrification-related neighborhood change experienced by individuals relevant to health. We employed a multi-stage process to develop PACER including a scoping review, question refinement, content validity, and cognitive interviews. Content validity and cognitive interviews were assessed within the National Neighborhood Indicators Partnership (NNIP) and for residents of different tenure in both gentrifying and non-gentrifying neighborhoods to ensure PACER considers the complex nature of neighborhood change for different people within different urban contexts. We piloted the instrument to a sample from the resident panel BeHeardPhilly to assess acceptability and data quality. Finally, we assessed internal consistency, dimensionality, and criterion-related validity using Principal Components Analysis (PCA), descriptive statistics, and correlation coefficients. Testing showed good internal consistency for PACER questions, as well as for each of four resulting factors (Feelings, Built Environment, Social Environment, and Affordability). Correlations between factors and other context measures demonstrated strong criterion-related validity. PACER offers an unprecedented tool for measuring and understanding resident perceptions about gentrification-related neighborhood change relevant to health. Rigorously tested and tailored for health, PACER holds utility for application across different settings to examine changes from events that may impact and shift neighborhoods.
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Affiliation(s)
- Jana A. Hirsch
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
| | - Heidi E. Grunwald
- Institute for Survey Research, Temple University, Philadelphia, PA, USA
| | - Keisha L. Miles
- Institute for Survey Research, Temple University, Philadelphia, PA, USA
| | - Yvonne L. Michael
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
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Turcu C, Crane M, Hutchinson E, Lloyd S, Belesova K, Wilkinson P, Davies M. A multi-scalar perspective on health and urban housing: an umbrella review. BUILDINGS & CITIES 2021; 2:734-758. [PMID: 34738085 PMCID: PMC7611930 DOI: 10.5334/bc.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
With more than half the world's population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth's natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research.
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Affiliation(s)
- Catalina Turcu
- The Bartlett Faculty of the Built Environment, University College London, London, UK
| | - Melanie Crane
- The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Emma Hutchinson
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
| | - Simon Lloyd
- Climate and Health Programme (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Kristine Belesova
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, Faculty of the Built Environment, University College London, London, UK
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Gentrification in America - The Potential Deadly Consequences. Ann Surg 2021; 274:218-219. [PMID: 33990476 DOI: 10.1097/sla.0000000000004937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Breaking Down and Building Up: Gentrification, Its drivers, and Urban Health Inequality. Curr Environ Health Rep 2021; 8:157-166. [PMID: 33713334 PMCID: PMC7955692 DOI: 10.1007/s40572-021-00309-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 12/27/2022]
Abstract
Purpose of Review Many neighborhoods which have been unjustly impacted by histories of uneven urban development, resulting in socioeconomic and racial segregation, are now at risk for gentrification. As urban renewal projects lead to improvements in the long-neglected built environments of such neighborhoods, accompanying gentrification processes may lead to the displacement of or exclusion of underprivileged residents from benefiting from new amenities and improvements. In addition, gentrification processes may be instigated by various drivers. We aimed to discuss the implications of specific types of gentrification, by driver, for health equity. Recent Findings Several recent articles find differential effects of gentrification on the health of underprivileged residents of gentrifying neighborhoods compared to those with greater privilege (where sociodemographic dimensions such as race or socioeconomic status are used as a proxy for privilege). Generally, studies show that gentrification may be beneficial for the health of more privileged residents while harming or not benefiting the health of underprivileged residents. Very recent articles have begun to test hypothesized pathways by which urban renewal indicators, gentrification, and health equity are linked. Few public health articles to date are designed to detect distinct impacts of specific drivers of gentrification. Summary Using a case example, we hypothesize how distinct drivers of gentrification—specifically, retail gentrification, environmental gentrification, climate gentrification, studentification, tourism gentrification, and health care gentrification—may imply specific pathways toward reduced health equity. Finally, we discuss the challenges faced by researchers in assessing the health impacts of gentrification.
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Green Gentrification and Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030907. [PMID: 33494268 PMCID: PMC7908481 DOI: 10.3390/ijerph18030907] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 12/25/2022]
Abstract
Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on how greening initiatives in gentrifying neighborhoods impact health, well-being, and health pathways (e.g., physical activity, affordable housing). Using a multi-step approach to scoping the literature (including searches in PubMed, JSTOR, and Google Scholar), we identified 15 empirical studies that met our inclusion criteria. We found studies focusing on green space use, physical activity, sense of community, safety, and self-reported health. Overall, longtime, marginalized residents are negatively impacted by green gentrification as they experience a lower sense of community, feel that they do not belong in green space, and, in many studies, use green space less often than newcomers. Overall, the research in this area is limited, and more studies on mental health and cardiovascular health markers could advance this literature. Based on the limited available evidence, we suggest that public health, urban planning, and parks professionals could collaborate to enhance the use of green space for marginalized residents and their feelings of inclusion in gentrifying areas.
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