Around the world, people’s life-sustaining capacities for caring for one another are overextended in unequal and unsustainable ways, with major implications for gender, racial, and health equity in...

The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.

One impediment to expanding the prevalence and quality of community-engaged research is a shortage of instructive resources for collaboratively designing research instruments and analyzing data with community members. This article describes how a consortium of community residents, grassroots community organizations, and academic and public institutions implemented collaborative research design and data analysis processes as part of a participatory action research (PAR) study investigating the relationship between neighborhoods and health in the greater Boston area. We report how nine different groups of community residents were engaged in developing a multi-dimensional survey instrument, generating and testing hypotheses, and interpreting descriptive statistics and preliminary findings. We conclude by reflecting on the importance of balancing planned strategies for building and sustaining resident engagement with improvisational facilitation that is responsive to residents’ characteristics, interests and needs in the design and execution of collaborative research design and data analysis processes.

Urban planning for health equity should be guided by an intersectional approach. Intersectionality is an essential framework for understanding the multiple overlapping factors, such as social and economic inequalities, that produce health disparities. We offer four strategies that planning researchers and practitioners can use to develop and integrate an intersectional approach into planning for health equity: challenging implicit and explicit assumptions, building cross-sectoral coalitions united by a shared vision for social and environmental justice, applying transdisciplinary and co-designing approaches throughout the planning process, and using existing tools to evaluate the impact of programs and policies on advancing health equity.

We explore whether housing displacement pressure could help explain place-based disparities in Massachusetts COVID-19 prevalence. We use qualitative data from the Healthy Neighborhoods Study to illustrate how rising and unaffordable housing costs are experienced by residents in municipalities disproportionately affected by COVID-19. We then predict municipal-level COVID-19 case rates as a function of home value increases and housing cost burden prevalence among low-income households, controlling for previously identified community-level risk factors. We find that housing value increase predicts higher COVID-19 case rates, but that associations are ameliorated in areas with higher home values. Qualitative data highlight crowding, “doubling up,” homelessness, and employment responses as mechanisms that might link housing displacement pressure to COVID-19 prevalence.

The health consequences of gentrification are little-understood, and researchers have called for qualitative studies to uncover potential causal pathways between gentrification and health. Resident Researchers in a Participatory Action Research study of community health in nine gentrifying neighborhoods across the Boston area hypothesized that financial insecurity is one pathway through which gentrification might harm health. We analyze qualitative data from semi-structured interviews with 40 financially vulnerable respondents to understand how the experience of living in a gentrifying neighborhood produces feelings of financial insecurity, and how such feelings may be harmful to health. Results indicate that experiencing gentrification exacerbates respondents’ sense of exposure to financial risk, while simultaneously reducing the perceived efficacy of available buffers against financial risks. The threats to an individual’s financial security introduced by gentrification-related changes in the neighborhood environment are stressful because they are appraised as taxing and exceeding the coping resources available to individuals. This gentrification-related financial insecurity is a meso-level phenomenon, produced by interactions between respondents and the contexts in which they live, with uncertain and uneven outcomes. Based on our findings, we argue that feelings of financial insecurity are one pathway through which the experience of living in a gentrifying neighborhood shapes health.