Gentrification may play an important role in influencing health outcomes, but few studies have examined these associations. One major barrier to producing empirical evidence to establish this link is that there is little consensus on how to measure gentrification. To address this barrier, we compared three gentrification classification methodologies in relation to their ability to identify neighborhood gentrification in nine San Francisco Bay Area counties: the Freeman method, the Landis method, and the Urban Displacement Project (UDP) Regional Early Warning System. In the 1580 census tracts, 43% of the population had a bachelor’s degree or higher. The average median household income was $79,671 in 2013. A comparison of gentrification methodologies revealed that the Landis and Freeman methodologies characterized the vast majority of census tracts as stable, and only 5.2% and 6.1% of tracts as gentrifying. UDP characterized 46.7% of tracts at risk, undergoing, or experiencing advanced stages of gentrification and displacement. There was substantial variation in the geographic location of tracts identified as gentrifying across methods. Given the variation in characterizations of gentrification across measures, studies evaluating associations between gentrification and health should consider using multiple measures of gentrification to examine the robustness of the study findings across measures.

Background: Low-income U.S. adults experiencing food insecurity have a disproportionately high prevalence of cigarette smoking, and quantitative studies suggest that food insecurity is a barrier to quitting. To guide effective tobacco control strategies, this study aimed to understand the experiences, perceptions, and context of tobacco use and cessation among low-income populations experiencing food insecurity. Methods: We conducted in-depth, semi-structured interviews with 23 adults who were currently smoking cigarettes and were experiencing food insecurity, mostly living in rural settings. Participants were recruited through food-pantry-based needs assessment surveys and study flyers in community-based organizations. The interview guide explored participants’ histories of smoking, the role and function of tobacco in their lives, their interest in and barriers to quitting, as well as lived experiences of food insecurity. We used reflexive thematic analysis to analyze transcribed interviews. Results: Within a broader context of structural challenges related to poverty and financial strain that shaped current smoking behavior and experiences with food insecurity, we identified the following five themes: smoking to ignore hunger or eat less; staying addicted to smoking in the midst of instability; smoking being prioritized in the midst of financial strain; life stressors and the difficulty of quitting smoking and staying quit; and childhood adversity at the intersection of food insecurity and tobacco use. Conclusion: The context of tobacco use among adults with food insecurity was highly complex. To effectively address tobacco-related disparities among those who are socially and economically disadvantaged, tobacco control efforts should consider relevant lived experiences and structural constraints intersecting smoking and food insecurity. Findings are applied to a conceptualization of clustering of conditions contributing to nicotine dependence, food insecurity, and stress.

The vast majority of studies investigating participation in, persistence through, and consequences of postsecondary education focus on educational attainment status among the so-called traditional population of collegegoers between the ages of 18 and 24. This narrow focus leaves largely invisible the role that an expanding set of educational trajectories throughout adulthood plays in shaping social stratification. Using 35-plus and 20 years of follow-up data from the US National Longitudinal Survey of Youth (NLSY)’s 1979 and 1997 cohorts, we find that a substantial share within each cohort is attaining education well into adulthood, and that these trajectories are patterned according to key social and demographic characteristics. In both cohorts, racial/ethnic differences in educational attainment grew over time and, for those attaining the same degree, members of historically disadvantaged groups did so at an older age. Cohort differences in trajectories emerged, however, when considering the intersection of race/ethnicity and socialized gender. Through careful descriptive analysis of two generational cohorts, our study makes clear the role of educational trajectories in the process of cumulative (dis)advantage across the life course, as well as across generations.

Higher educational attainment has been linked to better health and economic outcomes. However, little is known about how family caregiving responsibilities influence individuals’ educational trajectories in the United States (U.S.). Currently, 26% of U.S. undergraduates have at least one dependent child. While some literature describes the experiences of college-student parents, few studies examine the myriad ways family caregiving may singly or simultaneously present, including caregiving for children, relatives, household members, and older adults. The literature shows that caregiving for relatives, household members, and older adults is a common experience, with 20% of Americans providing care for an adult. Guided by social reproduction theory and reproductive labor, this paper examined qualitative interviews (n=31) from the Educational Trajectories & Health study to understand how caregiving responsibilities, broadly defined, influenced educational trajectories. Participants who identified as women discussed bearing disproportionate expectations to take on family caregiving responsibilities, including caregiving for siblings and aging parents. For most participants, family caregiving responsibilities substantially influenced educational decisions. Some experienced additional caregiving responsibilities but still attained their educational goals; others with family caregiving responsibilities discussed stretching and substituting resources in an effort to manage but ultimately having to step back from their stated educational pursuits. Situating these findings within broader social and structural contexts, this analysis examines educational disruption when family caregiving responsibilities arise. Findings have implications for policies that support students with family caregiving responsibilities at school, state, and federal levels.

The patient-centered medical home model intends to improve patient experience and primary care quality. Within an urban safety net setting in Northern California, United States, these desired outcomes are complicated by both the diversity of the patient community and the care continuity implications of a residency program. The objective of our study was to understand the patient experience beyond standardized satisfaction measures. We conducted a qualitative study, interviewing 19 patients from the clinic (English-, Spanish-, or Mien-speaking patients). Some themes, such as the desire to feel confident in their doctor, emerged across language groups, pointing to institutional challenges. Other themes, such as distrust in care being provided, were tied distinctly to speaking a language different from one’s provider. Still other themes, such as a sense of powerlessness, were related to cultural differences and to speaking a language (Mien) not spoken by staff. Findings illuminate the need to understand cultural behaviors and interactional styles in a diverse patient population to create a high-quality medical home.