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Improvement of Geographic Disparities: Amelioration or Displacement?

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Abstract

Progression of geographic disparities in social determinants of health is a global concern. Using an Urban Health Index (UHI) approach, we proposed a framework of examining the change of geographic disparities in social determinants in small areas. Using the City of Atlanta in Georgia (USA) as a case study, we standardized six census-based social determinant indicators in 2000 and in 2010, respectively, and calculated their geometric mean to assign each census tract a UHI value for 2000 and for 2010. We then evaluated the temporal change of the UHIs in relation to the demographic changes using spatial and statistical methods. We found that Atlanta experienced an improvement in social determinant status and a reduction of disparities in the 10 years. The areas that experienced improvement, however, underwent demographic changes as well. This analysis provides support for displacement, rather than improvement, as the underlying factor for apparent change in geographic disparities. Findings suggest the importance of local evaluation for future policies to reduce disparities in cities.

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References

  1. United Nations Population Fund: State of world population 2007: Unleashing the potential of urban growth. 2007. Available at http://www.unfpa.org/sites/default/files/pub-pdf/695_filename_sowp2007_eng.pdf. Accessed 20 October 2016.

  2. Ostby G. Rural-urban migration, inequality and urban social disorder: evidence from African and Asian cities. Conflict Management and Peace Science. 2016;33(5):491–515.

    Article  Google Scholar 

  3. Oyvat C. Agrarian structures, urbanization, and inequality. World Dev. 2016;83:207–30.

    Article  Google Scholar 

  4. World Health Organization: Action on the social determinants of health: Learning from previous experiences. 2010. Available athttp://apps.who.int/iris/bitstream/10665/44488/1/9789241500876_eng.pdf?ua=1. Accessed 25 October 2016.

  5. Suglia SF, Shelton RC, Hsiao A, Wang YC, Rundle A, Link BG. Why the neighborhood social environment is critical in obesity prevention. Journal of Urban Health-Bulletin of the New York Academy of Medicine. 2016;93(1):206–12.

    PubMed  PubMed Central  Google Scholar 

  6. Walton E. Vital places: facilitators of behavioral and social health mechanisms in low-income neighborhoods. Soc Sci Med. 2014;122:1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hussein M, Roux AVD, Field RI. Neighborhood socioeconomic status and primary health care: usual points of access and temporal trends in a major US urban area. Journal of Urban Health-Bulletin of the New York Academy of Medicine. 2016;93(6):1046.

    PubMed  PubMed Central  Google Scholar 

  8. Ajlouni MT. Social determinants of health in selected slum areas in Jordan: challenges and policy directions. Int J Health Plann Manag. 2016;31(1):113–25.

    Article  Google Scholar 

  9. Laxy M, Malecki KC, Givens ML, Walsh MC, Nieto FJ. The association between neighborhood economic hardship, the retail food environment, fast food intake, and obesity: findings from the Survey of the Health of Wisconsin. BMC Public Health. 2015;15(1):1576.

    Article  Google Scholar 

  10. Lewis P, Fagnano M, Koehler A, Halterman JS. Racial disparities at the point of care for urban children with persistent asthma. J Community Health. 2014;39(4):706–11.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Wineman JD, Marans RW, Schulz AJ, van der Westhuizen DL, Mentz GB, Max P. Designing healthy neighborhoods contributions of the built environment to physical activity in Detroit. J Plan Educ Res. 2014;34(2):180–9.

    Article  Google Scholar 

  12. Bleich SN, Thorpe RJ, Sharif-Harris H, Fesahazion R, LaVeist TA. Social context explains race disparities in obesity among women. J Epidemiol Community Health. 2010;64(5):465–9.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Grady S, Darden J. Spatial methods to study local racial residential segregation and infant health in Detroit, Michigan. Ann Assoc Am Geogr. 2012;102(5):922–31.

    Article  Google Scholar 

  14. Johnson AM, Hines RB, Johnson JA, Bayakly AR. Treatment and survival disparities in lung cancer: the effect of social environment and place of residence. Lung Cancer. 2014;83(3):401–7.

    Article  PubMed  Google Scholar 

  15. Amey C, Miller M, Albrecht S. The role of race and residence in determining stage at diagnosis of breast cancer. J Rural Health. 1997;13:99–108.

    Article  CAS  PubMed  Google Scholar 

  16. Messer LC, Laraia BA, Kaufman JS, et al. The development of a standardized neighborhood deprivation index. Journal of Urban Health: Bulletin of the New York Academy of Medicine. 2006;83(6):1041–62.

    Article  Google Scholar 

  17. Grineski SE, Collins TW, McDonald YJ, et al. Double exposure and the climate gap: changing demographics and extreme heat in Ciudad Juarez, Mexico. Local Environ. 2015;20(2):180–201.

    Article  PubMed  Google Scholar 

  18. Weaver SR, Dai D, Stauber C, Luo R, Rothenberg R. The Urban Health Index: a handbook for its calculation and use. Kobe, Japan: World Health Organization; 2014.

    Google Scholar 

  19. Rothenberg R, Weaver SR, Dai D, Stauber C, Prasad A, Kano M. A flexible Urban Health Index for small area disparities. Journal of Urban Health: Bulletin of the New York Academy of Medicine. 2014;91(5):823–35.

    Article  Google Scholar 

  20. Shmool JLC, Kubzansky LD, Newman OD, Spengler J, Shepard P, Clougherty JE. Social stressors and air pollution across New York City communities: a spatial approach for assessing correlations among multiple exposures. Environ Health. 2014;13:15.

    Article  Google Scholar 

  21. Wen M, Zhang XY, Harris CD, Holt JB, Croft JB. Spatial disparities in the distribution of parks and green spaces in the USA. Ann Behav Med. 2013;45:S18–27.

    Article  PubMed  Google Scholar 

  22. World Health Organization CoSDoH. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva, Romandy: World Health Organization; 2013. Available at http://apps.who.int/iris/bitstream/10665/43943/1/9789241563703_eng.pdf. Accessed 1 March 2017

    Google Scholar 

  23. Immergluck D. Large redevelopment initiatives, housing values and gentrification: the case of the Atlanta Beltline. Urban Stud. 2009;46(8):1723–45.

    Article  Google Scholar 

  24. Peipins LA, Graham S, Young R, Lewis B, Flanagan B. Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area. Soc Sci Med. 2013;89:32–8.

    Article  PubMed  Google Scholar 

  25. Dai D. Racia/ethnic and socioeconomic disparities in urban green space accessibility: where to intervene? Landsc Urban Plan. 2011;102(4):234–44.

    Article  Google Scholar 

  26. Quinn SC, Kumar S. Health inequalities and infectious disease epidemics: a challenge for global health security. Biosecurity and Bioterrorism-Biodefense Strategy Practice and Science. 2014;12(5):263–73.

    Article  Google Scholar 

  27. Buckles K, Hagemann A, Malamud O, Morrill M, Wozniak A. The effect of college education on mortality. J Health Econ. 2016;50:99–114.

    Article  PubMed  Google Scholar 

  28. Environmental Systems Research Institute (ESRI): The American Community Survey: an Esri White Paper. 2014. Available at https://www.esri.com/library/whitepapers/pdfs/the-american-community-survey.pdf. Last Accessed 1 March 2017.

  29. Anselin L. Local indicators of spatial association—LISA. Geogr Anal. 1995;27:93–115.

    Article  Google Scholar 

  30. McLafferty S, Wang F. Rural Reversal? Rural-urban disparities in late-stage cancer risk in Illinois. Cancer. 2009;115:2755–64.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Anselin L, Syabri I, Kho Y. GeoDa: an introduction to spatial data analysis. Geogr Anal. 2006;38(1):5–22.

    Article  Google Scholar 

  32. Wang F, McLafferty S, Escamilla V, Luo L. Late-stage breast cancer diagnosis and health care access in Illinois. Prof Geogr. 2008;60(1):54–69.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Baller RD, Anselin L, Messner SF, Deane G, Hawkins DF. Structural covariates of US county homicide rates: incorporating spatial effects. Criminology. 2001;39(3):561–90.

    Article  Google Scholar 

  34. Fotheringham AS, Brunsdon C, Charlton M. Quantitative geography: perspectives on spatial data analysis. London, England: Sage; 2000.

    Google Scholar 

  35. Wang F. Quantitative methods and socio-economic applications in GIS. Boca Raton, Florida: CRC; 2015.

    Google Scholar 

  36. Fotheringham AS, Brunsdon C, Charlton M. Geographically weighted regression: the analysis of spatially varying relationships. West Sussex, England: Wiley; 2002.

    Google Scholar 

  37. Byrne G, Charlton M, Fotheringham AS Multiple dependent hypothesis tests in geographically weighted regression. 2009. Proceedings of the 10th International Conference on Geocomputation. University of New South Wales, Sydney, Australia. 2009. Available at http://www.geocomputation.org/2009/PDF/Byrne_et_al.pdf. Accessed 1 March 2017.

  38. da Silva AR, Fotheringham AS. The multiple testing issue in geographically weighted regression. Geogr Anal. 2016;48:233–47.

    Article  Google Scholar 

  39. Wheeler DC, Paez A. Geographically weighted regression. In: Fischer MM, Getis A, editors. Handbook of applied spatial analysis: software tools, methods and applications. Berlin and Heidelberg: Spinger; 2010. Available at http://www.csiss.org/gispopsci/workshops/2010/UCSB-SPA/docs/C5-Applied-Spatial-Analysis-Wheeler-Paez.pdf. Accessed 1 March 2017.

    Google Scholar 

  40. Environmental Systems Research Institute (ESRI): Geographically weighted regression (spatial statistics). Redlands, California. 2009. Available at http://resources.esri.com/help/9.3/arcgisengine/java/gp_toolref/spatial_statistics_tools/geographically_weighted_regression_spatial_statistics_.htm. Accessed 1 March 2017.

  41. Griffith DA, Amrhein CG. Multivariate statistical analysis for geographers. Upper Saddle River, NJ: Prentice Hall; 1997.

    Google Scholar 

  42. Tighe JR, Ganning JP. Do shrinking cities allow redevelopment without displacement? An analysis of affordability based on housing and transportation costs for redeveloping, declining, and stable neighborhoods. Housing Policy Debate. 2016;26(4–5):785–800.

    Article  Google Scholar 

  43. Kennedy M, Leonard P. Gentrification: practice and politics. 2001. Available at http://programs.lisc.org/files/901_file_asset_upload_file304_540.pdf. Accessed 1 March 2017.

  44. Knight JM, Gharipour M. Urban displacement and low-income communities: the case of the American city from the late twentieth century. Archnet-Ijar International Journal of Architectural Research. 2016;10(2):6–21.

    Google Scholar 

  45. Avey H, Fuller E, Branscomb J, et al. Using a health in all policies approach to address social determinants of sexually transmitted disease inequities in the context of community change and redevelopment. Public Health Rep. 2013;128:77–86.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Spielman SE, Folch D, Nagle N. Patterns and causes of uncertainty in the American Community Survey. Appl Geogr. 2014;46:147–57.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Van Hook J, Bachmeier JD. How well does the American Community Survey count naturalized citizens? Demogr Res. 2013;29:1–31.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This work was supported in part by the National Institute on Minority Health and Health Disparities of the National Institutes of Health in the USA under grant (1P20MD009572-01), the World Health Organization Centre for Health Development (the WHO Kobe Centre), and the National Natural Science Foundation of China (71673112). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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Authors and Affiliations

  1. Department of Geosciences, College of Arts and Sciences, Georgia State University, 24 Peachtree Center Ave NE, Atlanta, GA, 30303, USA

    Dajun Dai

  2. School of Public Health, Georgia State University, Atlanta, GA, 30302, USA

    Richard Rothenberg, Ruiyan Luo, Scott R. Weaver & Christine E. Stauber

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  1. Dajun Dai
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Correspondence to Dajun Dai.

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Dai, D., Rothenberg, R., Luo, R. et al. Improvement of Geographic Disparities: Amelioration or Displacement?. J Urban Health 94, 417–428 (2017). https://doi.org/10.1007/s11524-017-0151-4

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