Iyanda Ayodeji Emmanuel, Lu Yongmei
Department of Geography, Texas State University, 601 University Drive, San Marcos, TX 78666 USA.
J Hous Built Environ. 2022;37(1):77-100. doi: 10.1007/s10901-021-09847-8. Epub 2021 May 10.
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 ( < 0.001), educational attainment ( < 0.001), and gender ( < 0.01), while SR-CHCs only significantly varies by educational attainment, = 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.
The online version contains supplementary material available at 10.1007/s10901-021-09847-8.
尽管关于邻里环境对健康的影响已有广泛研究，但这种关系仍难以捉摸，需要持续的实证证据来支持现有研究结果。绅士化是一种邻里环境变化的过程，会影响大多数长期居民。本研究通过口述历史访谈、电子访谈和定量结构化调查，考察了快速变化的物质和文化环境对健康的影响。该研究借鉴健康的社会决定因素框架，来解释德克萨斯州奥斯汀市331名居民的自我报告慢性健康状况（SR-CHCs）。该研究采用适合泊松分布的非线性技术，来估计绅士化与SR-CHCs之间的关联，并辅以深入访谈（IDI）的直接引语。感知到的绅士化得分在婚姻状况（<0.001）、教育程度（<0.001）和性别（<0.01）方面存在显著差异，而SR-CHCs仅在教育程度方面存在显著差异（=0.015）。多变量结果表明，在调整社会经济变量后，绅士化与SR-CHCs呈正相关。与西班牙裔相比，黑人报告多次SR-CHCs的可能性高97%（发病率比值比[IRR]=1.969，95%置信区间[CI]为1.074 - 3.608），而高家庭收入参与者报告多次慢性健康状况的可能性低8%（IRR=0.920，95%CI为0.870 - 0.973）。基于实证研究结果，本研究建议采取基于区域和个体层面的政策，以减轻邻里环境变化对居民健康的影响。最后，本研究进一步增进了对健康的社会决定因素的理解，有助于理解不断变化的城市物质和社会生态系统中的慢性健康问题。
在线版本包含可在10.1007/s10901-021-09847-8获取的补充材料。
