Association between Gentrification and Health and Healthcare Utilization

Nrupen A Bhavsar; Lexie Zidanyue Yang; Matthew Phelan; Megan Shepherd-Banigan; Benjamin A Goldstein; Sarah Peskoe; Priya Palta; Jana A Hirsch; Nia S Mitchell; Annemarie G Hirsch; Joseph Lunyera; Dinushika Mohottige; Clarissa J Diamantidis; Matthew L Maciejewski; L Ebony Boulware

doi:10.1007/s11524-022-00692-w

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Association between Gentrification and Health and Healthcare Utilization

Journal article

Open access

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Association between Gentrification and Health and Healthcare Utilization

Nrupen A Bhavsar, Lexie Zidanyue Yang, Matthew Phelan, Megan Shepherd-Banigan, Benjamin A Goldstein, Sarah Peskoe, Priya Palta, Jana A Hirsch, Nia S Mitchell, Annemarie G Hirsch, …

Journal of urban health, v 99(6), pp 984-997

01 Dec 2022

DOI: https://doi.org/10.1007/s11524-022-00692-w

PMID: 36367672

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Abstract

Adult

Female

Humans

Male

Odds Ratio

Patient Acceptance of Health Care

Residence Characteristics

Residential Segregation

Obesity

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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Details

Title: Association between Gentrification and Health and Healthcare Utilization
Creators: Nrupen A Bhavsar - Duke University
Lexie Zidanyue Yang - Duke Clinical Research Institute, Durham, NC, USA
Matthew Phelan - Duke Clinical Research Institute, Durham, NC, USA
Megan Shepherd-Banigan - Durham VA Medical Center, Durham, NC, USA
Benjamin A Goldstein - Duke Clinical Research Institute, Durham, NC, USA
Sarah Peskoe - Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA
Priya Palta - Columbia University
Jana A Hirsch - Drexel University, Epidemiology and Biostatistics
Nia S Mitchell - Department of Medicine, Duke University School of Medicine, Durham, NC, USA
Annemarie G Hirsch - Geisinger Health System
Joseph Lunyera - Department of Medicine, Duke University School of Medicine, Durham, NC, USA
Dinushika Mohottige - Department of Medicine, Duke University School of Medicine, Durham, NC, USA
Clarissa J Diamantidis - Durham VA Medical Center, Durham, NC, USA
Matthew L Maciejewski - Durham VA Health Care System
L Ebony Boulware - Department of Medicine, Duke University School of Medicine, Durham, NC, USA
Publication Details: Journal of urban health, v 99(6), pp 984-997
Publisher: Springer Nature
Number of pages: 14
Grant note: RCS 10-391 / VA CIN 14-310 / VA K01HL140146 / NHLBI NIH HHS
Resource Type: Journal article
Language: English
Academic Unit: Urban Health Collaborative; Epidemiology and Biostatistics
Web of Science ID: WOS:000881885800001
Scopus ID: 2-s2.0-85141801516
Other Identifier: 991019288630504721

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Collaboration types: Domestic collaboration
Web of Science research areas: Public, Environmental & Occupational Health

Association between Gentrification and Health and Healthcare Utilization

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Abstract

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UN Sustainable Development Goals (SDGs)

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