Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City

ObjectivesAs gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City.MethodsWe used 2 data sources: 1) 2005–2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006–2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006–2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained.ResultsDuring 2006–2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006.ConclusionsThese findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations.研究目的 随着纽约市及其他城市地区绅士化进程持续推进，社会经济地位较低的居民面临居住流离失所的风险显著升高。然而，当前针对居住流离失所所产生的健康影响的量化评估研究仍较为匮乏。本研究旨在评估纽约市绅士化社区原住居民中，居住流离失所与医疗服务可及性及心理健康状况之间的关联。 研究方法 本研究采用两类核心数据源：其一为2005–2014年美国社区调查（American Community Surveys），用于识别纽约市的绅士化社区；其二为2006–2014年全州规划与研究合作系统（Statewide Planning and Research Cooperative System）。本研究的队列纳入了2006年居住在绅士化社区的12882名居民，这些受试者在2006–2014年间每两年至少完成1次急诊就诊或住院记录。研究对比了发生居住流离失所与未发生流离失所的受试者在基线随访期后的急诊就诊率与住院率差异。 研究结果 2006–2014年间，共计23%的受试者发生了居住流离失所。在校正了基线人口学特征、健康状况、医疗服务利用情况、居住迁移情况以及2006年居住社区等混杂因素后，与未发生流离失所的受试者相比，流离失所受试者的急诊就诊率与住院率显著更高，该差异主要源于心理健康相关不良事件（率比（Rate Ratio）=1.8，95%置信区间（confidence interval）=1.5, 2.2）。 研究结论 上述研究结果表明，居住流离失所会对医疗服务可及性与心理健康状况产生负面影响，这一效应在城市地区居住且既往有频繁急诊就诊或住院史的成年人群中尤为显著。