Impact of gentrification on adult mental health

Abstract

Objective: To estimate the net effect of living in a gentrified neighborhood on probability of having serious psychological distress. Data Sources:We pooled 5 years of secondary data from the California Health Interview Survey (2011)(2012)(2013)(2014)(2015) and focused on southern California residents. Study Design:We compared adults (n = 43 815) living in low-income and gentrified, low-income and not gentrified, middle-to high-income and upscaled, and middle-to high-income and not upscaled neighborhoods. We performed a probit regression to test whether living in a gentrified neighborhood increased residents' probabilities of having serious psychological distress in the past year and stratified analyses by neighborhood tenure, homeownership status, and low-income status. Instrumental variables estimation and propensity scores were applied to reduce bias arising from residential selection and simultaneity. An endogenous treatment effects model was also applied in sensitivity analyses. Data Collection/Extraction Methods:Adults who completed the survey on their own and lived in urban neighborhoods with 500 or more residents were selected for analyses. Survey respondents who scored 13 and above on the Kessler 6 were categorized as having serious psychological distress in the past year. We used eight neighborhood change measures to classify respondents' neighborhoods.Principal Findings: Living in a gentrified and upscaled neighborhood was associated with increased likelihood of serious psychological distress relative to living in a lowincome and not gentrified neighborhood. The average treatment effect was 0.0141 (standard error = 0.007), which indicates that the prevalence of serious psychological distress would have been 1.4 percentage points less if none of the respondents lived in gentrified neighborhoods. Gentrification appears to have a negative impact on the mental health of renters, low-income residents, and long-term residents. This effect was not observed among homeowners, higher-income residents, and recent residents. Conclusions: Gentrification levies mental health costs on financially vulnerable community members and can worsen mental health inequities. K E Y W O R D S gentrification, mental health, psychological, residence characteristics, social determinants of health, stress | 433 Health Services Research TRAN eT Al.

Defining gentrification for epidemiologic research: A systematic review

“…One found that compared to their counterparts in high income areas, both economically vulnerable and higher income older adults in gentrifying areas experienced more depression and anxiety symptoms [32]. The other found that low-income and long-term adults of gentrifying neighborhoods had a higher likelihood of serious psychological distress than those in low-income and not gentrified neighborhoods [38]. However, gentrification was not associated with the likelihood of having psychotic experiences [37].…”

“…Multiple health outcomes were not associated with gentrification [19, 21, 23-25, 30, 36, 37, 48, 49]. Health outcomes that were associated with gentrification included: self-reported health [18,21,22,25,32,44], preterm birth [23], mental health conditions [19,32,38,44], alcohol and drug use [24,27,43,47], psychosocial factors [17,20,28,31,33,40,42,46,49], and health care utilization [26].…”

“…Investigators generally chose to conduct studies in geographic areas that were actively gentrifying or had already gentrified, including: Philadelphia [20,22], Chicago [17,29], New York City [18,19,23,26,30,31,33,37,40], Montreal [42,49], Vancouver [43,46], San Francisco [34], Baltimore [37], Melbourne [47], and Portland [39]. Several studies examined multiple geographic areas [21,24,25,27,37,38,48]. Studies conducted outside of the United States used different geographic areas, such as districts and census sections [41,44,45].…”

“…Physical and mental health diagnoses. Six studies quantified the association between gentrification and biomarkers or disease symptoms/diagnoses [5,19,29,32,37,38]. In one study, greater neighborhood affluence and gentrification was associated with a lower risk of hypertension [29].…”

“…The impact of gentrification on mental health was also assessed by three other studies [32,37,38]. One found that compared to their counterparts in high income areas, both economically vulnerable and higher income older adults in gentrifying areas experienced more depression and anxiety symptoms [32].…”