Improved housing stock, revamped parks and new bike lanes and grocery stores are some of the promised benefits of gentrification. But many of the same amenities that are touted as public health improvements can raise concerns from low-income communities vulnerable to gentrification. It's part of the reason why the $34 million renovation to Emancipation Park in Houston's Third Ward has been welcomed with a cautious optimism, seen as both needed investment in a community staple and a potential draw to hasten the spread of townhouses staking their claim along the edges of the neighborhood.
"Public health, over the last 20 years, has probably contributed to gentrification because a lot of our investment has been in those farmers markets and parks and sidewalks," said Vickie Boothe, senior evaluator with the Centers for Disease Control and Prevention at a panel discussion Friday at the Baker Institute.
Though those improvements are theoretically responsive to community needs - food deserts gain access to healthy foods, children are given spaces to play and gather, neighborhood walkability is improved - they are often hard to disentangle from processes of both public and private investment that drive up housing costs and fuel gentrification.
"The question came: is gentrification something in it of itself that can impact health," said Quianta Moore, a healthy policy scholar with the Baker Institute conducting a community needs assessments in Third Ward with the Sankofa Research Institute. "And who’s really getting the benefit," asked Moore.
"People renovate places that were in poor condition, they build new units, but again the issue is when that does happen, often you see increases in rent," said Ruby Mendenhall, the associate professor of sociology, African American studies, regional and national urban planning, gender and women's studies and social work at the University of Illinois at Urbana-Champagne. "Who can take advantage of these new units?"
Based on her research interviewing black mothers in Chicago neighborhoods with high-crime, she has been documenting the ways violence and the stress of violence impacts individual health. "There are a lot of these hidden processes associated with stress," said Mendenhall. "I think gentrification could help with that, but again I want to stress that those who do not benefit from the gentrification, their level of health and well being has probably decreased a lot."
Part of the issue in addressing the mixed outcomes of gentrification is that some view it is a mostly positive force. "Policymakers have been eager to promote gentrification because they oftentimes see it as a way to alleviate issues like declining tax bases, concentrated poverty," and other concerns, said Lance Freeman, a professor with Columbia University's urban planning program and the graduate school of architecture, planning and preservation.
Lauded as an example of investment without displacement, Atlanta's East Lake neighborhood was once the location of a 650-unit public housing complex known for crime and poverty. Transformed into a mixed-income development buttressed by job counseling services, school improvements and child care for residents, East Lake saw improved outcomes across the board.
"That's not the real story," said Boothe, repeating what one colleague from Atlanta told her. "Those aren’t the original East Lake residents," she added.
Once word of the proposed demolition got around, the tenant association of the original housing complex filed a lawsuit, calling for an injunction. "The tenants lost the litigation, their homes were demolished, and a majority of them never returned to the newly constructed mixed-income community," according to a report from Adam Goldstein with the University of St. Andrews. New screening policies from the housing authority explicitly banned roughly 13 percent of the old families from returning. "Of the 423 families who lived at the Meadows before the redevelopment," wrote Goldstein, "only [69] families eventually returned."
Looking at the research landscape, Moore said, "There really is not a lot of literature on the displaced and what their health outcomes look like."
But displacement isn't the only thing that keeps original residents from potentially reaping the benefits of more retail, improved transit access and other changes that can come with gentrification.
"We’ve done a number of projects looking at life expectancy and then also sort of looking at more of the local data on a social gradient," said Tram Nguyen, a local policy coordinator with the Alameda County Public Health Department in the Bay Area. In addition to the department's efforts to document rising rents and evictions in Oakland and other neighborhoods in the East Bay, Nguyen said they've also seen a connection between severe housing cost burdens and conditions like hypertension and increased mental health needs of local residents.
"Our thinking about this is very much a public health crisis approach," said Nguyen, "kind of stopping the bleeding...the community is calling for stabilization first."
In addition to the health burdens associated with rising rents and unstable housing that some may experience as a result of gentrification, there are other, more abstract impacts as well.
"Many of the long-term residents, whether or not they are homeowners or renters, may feel a sense of loss of community," said Freeman. Conflicts over decades-long community traditions highlight friction between newcomers and longtime residents. In Harlem, for example, some newcomers called the police to complain about the noise of a drum circle that had been a regular gathering for decades in the neighborhood. "That just inflames underlying tensions that are already there," said Freeman. And that often points back to not just a neighborhood's shifting economic fortunes but its shifting race and culture.
"I don’t see gentrification as necessarily having to involve race," said Freeman, citing the origins of the word in 1960s Great Britain. "They were talking about gentrification in terms of class," he said. But he acknowledged, in the United States, race and class are often impossibly intertwined, meaning race will likely be part of the conversation.
"There needs to be a forum or mechanism where people can come together and try to adjudicate these competing visions for what a neighborhood should look like," said Freeman.
But what are often viewed as local, neighborhood problems are part of regional shifts and require regional responses as well.
As populations move in and out of a neighborhood and even county, as Nguyen said they're finding in the East Bay, health departments and social services need to work to stay connected to the communities they serve. “We’re not reaching clients that need those services," she said. And it's a problem for surrounding counties as well. “What are the costs in the receiving counties that weren’t set up for this? We’re just starting to try to research that question more as a way to get to a broader regional solution.”