‘Gentrification is not improving my health’: a mixed-method investigation of chronic health conditions in rapidly changing urban neighborhoods in Austin, Texas

Abstract

Though there are extensive studies on neighborhood effects on health, this relationship remains elusive and requires continuous empirical evidence to support existing findings. Gentrification is a process of neighborhood change that affects most longtime residents. This study examined the health impact of the rapidly changing physical and cultural environment using oral history interviews, electronic interviews, and a quantitative structured survey. The study draws on the social determinants of health framework to explain the self-reported chronic health conditions (SR-CHCs) among 331 residents in Austin, Texas. The study employed non-linear techniques suitable for Poisson distribution to estimate the association between gentrification and SR-CHCs and complemented by direct quotes from in-depth interviews (IDIs). Perceived gentrification score significantly vary by marital status ( p < 0.001), educational attainment ( p < 0.001), and gender ( p < 0.01), while SR-CHCs only significantly varies by educational attainment, p = 0.015). Multivariate results show that gentrification was positively associated with SR-CHCs, after adjusting for socioeconomic variables. Compared to the Hispanics, blacks were 97% more likely to report multiple counts of SR-CHCs (IRR = 1.969, 95% CI 1.074–3.608), and participants with high household income were 8% less likely to report multiple CHCs (IRR = 0.920, 95% CI 0.870–0.973). Drawing from the empirical findings, this study recommends both area-based and individual-level policies to mitigate neighborhood change's impact on residents' health. Finally, this study further adds to the understanding of social determinants of health in understanding chronic health within the changing urban physical and socio-ecology systems. Supplementary Information The online version contains supplementary material available at 10.1007/s10901-021-09847-8.

Gentrification, perceptions of neighborhood change, and mental health in Montréal, Québec

“…Perceived change to the social environment was also significantly associated with mental health, with more perceived change to the social environment associated with worse mental health. This association is supported by prior research showing a negative effect of gentrification on mental health through the loss of community and through an increase in social tensions with neighbors ( Iyanda & Lu, 2021a , 2021b ; Shmool et al, 2015 ). This tension can increase psychosocial stress among residents and result in a decline in mental health, particularly for longer-term residents and residents of color ( Betancur, 2011 ; Mehdipanah et al, 2018 ).…”

“…Positive impacts may include increased transportation infrastructure, sidewalks, amenities, and jobs for college-educated workers ( Freeman, 2005 ; Hwang & Lin, 2016 ; Zuk et al, 2018 ). Negative effects of gentrification can include increased tensions between new and long-term residents, reduced levels of social cohesion, a loss of cultural establishments and small businesses, and an increase in cost of living and housing ( Anguelovski, 2015 ; Curran, 2004 ; Fullilove & Wallace, 2011 ; Iyanda & Lu, 2021a ; Oscilowicz et al, 2020 ; Sullivan, 2007 ). These negative consequences of gentrification are magnified for people facing housing instability, racialized communities, and people whose voices have been historically absent in urban planning processes ( Cole et al, 2017 ; Fullilove & Wallace, 2011 ; Gibbons, 2019 ; Tran et al, 2020 ).…”

“…Using measures of perceived neighborhood change and perceived gentrification may better capture individuals’ experiences of gentrification, and thus help explain how gentrification influences mental health. New survey tools on perceptions and feelings about neighborhood change in the context of gentrification have recently been developed, yet population health researchers have been slow to capitalize and apply these tools or to compare the influence of census-defined measures of gentrification to survey-based measures of gentrification-related change in studies on mental health ( Hirsch et al, 2021 ; Iyanda & Lu, 2021a ; Shmool et al, 2015 ). To address this gap, this paper explores the role of perceived changes to the neighborhood as an effect modifier of the relationships between census-defined gentrification and mental health.…”

Associations Between Residential Segregation and Incident Hypertension: The Multi‐Ethnic Study of Atherosclerosis

“…Given our finding that neighborhood social environment can buffer the associations between segregation and hypertension among Black participants, future studies should examine how structural processes such as gentrification may affect community‐level social support and cohesion to further exacerbate cardiovascular health inequities. 53 , 54 , 55 , 56 Although we did not document similar findings in other racial or ethnic groups, future studies with larger sample size may be necessary to detect these associations.…”

Urban health inequality in shifting environment: systematic review on the impact of gentrification on residents' health

“…Compared with other types of neighborhood environments, most studies have not found that gentrifying neighborhoods are positively correlated with the risk of chronic diseases, such as diabetes, hypertension, obesity, psychotic disorders, and asthma. Currently, there is only one study with 331 respondents, revealing that in gentrified neighborhoods, the self-rated chronic disease risk of black people is higher than that of other ethnic groups ( 77 ). Compared with gentrified neighborhoods, neighborhoods dominated by black people or poor neighborhoods have a higher probability of early detection of hypertension, and the prevalence of hypertension in gentrified neighborhoods is lower ( 69 ); however, there are no differences at the ethic level ( 78 ).…”