Henson, Laurence Cyril MPH; Law, Tyler MD; Mahasin, Mujahid PhD; Gao, Xing MPH; Khouderchah, Christy BS*
University of California, San Francisco
University of California, Berkeley
Background: Gentrification is associated with factors that negatively impact health outcomes among low-income households, but few studies have explored its correlation with disease incidence. In this study, we assess the relationship between increased levels of gentrification and the incidence of asthma exacerbations in nine counties within the San Francisco Bay Area.
Methods: We conducted an ecological study of gentrification levels and asthma exacerbations in nine San Francisco Bay Area counties. Measures of gentrification were calculated with the Freeman, et. al. method, using data from the 2006-2015 American Community Survey to classify median income and education levels per census tract. The census tract-level incidence of emergency department (ED) visits for asthma was obtained from the CalEnvironScreen 3.0. The association between gentrification levels and asthma exacerbations was modeled with log-linear regression.
Results: The unadjusted rate of ED visits for asthma when comparing gentrifying to stable neighborhoods was 1.29 (95% CI 1.27-1.31, p-value <0.001) for the aggregate of all nine San Francisco Bay Area counties. After adjustment, the incidence ratio was 1.15 (95% CI 1.13-1.17, p-value <0.001). Tests for interaction found higher percentages of blacks, hispanics, and asians in gentrifying census tracts had lower adjusted rates for asthma (Blacks: 0.83 - 1.13, Hispanics: 0.81 - 0.88, Asians: 0.81 - 0.9).
Interpretation: Living in a gentrifying neighborhood was associated with an increased risk of asthma exacerbation in the San Francisco Bay Area. Our results were consistent with prior studies suggesting a differential effect of gentrification on health outcomes by racial composition in the neighborhood.
Keywords: Population Health, Epidemiology, Health Disparities