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绅士化、流动性与健康的情境性社会决定因素暴露

Gentrification, Mobility, and Exposure to Contextual Social Determinants of Health.

作者信息

Acolin Arthur, Crowder Kyle, Decter-Frain Ari, Hajat Anjum, Hall Matt

机构信息

University of Washington.

Cornell University.

出版信息

Hous Policy Debate. 2023;33(1):194-223. doi: 10.1080/10511482.2022.2099937. Epub 2022 Aug 18.

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.

摘要

本研究使用了美国100个最大都市区主要城市中低收入社区2006年居民的个人层面消费者追踪数据,利用他们在2006年和2019年的位置,来考察以下四种社区层面的社会决定因素健康因素(cSDOH)的暴露情况:医疗保健可及性(医疗服务不足地区)、社会经济状况(地区剥夺指数)、空气污染(二氧化氮、细颗粒物2.5和粗颗粒物10)以及步行便利性(国家步行便利性指数)。研究结果对个人特征和初始社区条件进行了控制。与2006年未经历绅士化的低收入和中等收入社区居民相比,经历绅士化社区的居民在处于医疗服务不足地区的可能性、当地剥夺水平和步行便利性方面,接触到更有利的社区层面的社会决定因素健康因素,同时经历的空气污染水平相似。由于社区特征的变化和不同的流动模式,在2006年至2019年期间,最初居住在经历绅士化社区的个人在医疗服务不足地区、地区剥夺指数和步行便利性指数方面经历了更糟糕的变化,但在空气污染物暴露方面有更大改善。负面变化是由迁移者推动的,而留守者实际上在医疗服务不足地区和地区剥夺指数方面经历了相对改善,在空气污染物暴露方面有更大改善。研究结果表明,绅士化可能通过社区层面的社会决定因素健康因素暴露的变化导致健康差异,即绅士化社区的居民迁移到社区层面的社会决定因素健康因素更差的社区,尽管在健康污染物暴露方面的结果好坏参半。

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本文引用的文献

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Defining gentrification for epidemiologic research: A systematic review.为流行病学研究定义绅士化:系统评价。
PLoS One. 2020 May 21;15(5):e0233361. doi: 10.1371/journal.pone.0233361. eCollection 2020.
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Gentrification And The Health Of Low-Income Children In New York City.绅士化与纽约市低收入儿童的健康
Health Aff (Millwood). 2019 Sep;38(9):1425-1432. doi: 10.1377/hlthaff.2018.05422.

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