| TYPE Original Research PUBLISHED 21 September 2023 DOI 10.3389/fenvh.2023.1202149 Gentrification and its association with health inequalities in EDITED BY Ayodeji E. Iyanda, Prairie View A&M University, United States Barcelona (2011–2017) REVIEWED BY Veronica Toffolutti, Patricia González-Marín1,2, Hugo Vásquez-Vera1*, Queen Mary University of London, Antonio López-Gay3,4, Andrés Peralta5,6, Miguel Solana-Solana3 United Kingdom Amanda Lehning, and Ana Fernández1,7 University of Maryland, United States 1 Housing and Health Research Group, Agència de Salut Pública de Barcelona, Barcelona, Spain, 2Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain, 3Department of Geography, *CORRESPONDENCE Universitat Autònoma de Barcelona, Bellaterra, Spain, 4Centre d’Estudis Demogràfics (CED-CERCA), Hugo Vásquez-Vera Bellaterra, Spain, 5Instituto de Salud Pública, Pontificia Universidad Católica del Ecuador, Quito, Ecuador, vasquezhug@paho.org 6 InPASS, Grupo de Investigación en Psicología, Ambiente, Salud y Sociedad, Pontificia Universidad RECEIVED 07 April 2023 Católica del Ecuador, Quito, Ecuador, 7Center for Biomedical Research and Public Health Network ACCEPTED 30 August 2023 (CIBERESP), Carlos III Health Institute, Madrid, Spain PUBLISHED 21 September 2023 CITATION Background: Prior studies have reported conflicting findings on the impact of González-Marín P, Vásquez-Vera H, López- gentrification of neighborhood residents. While some suggest it could worsen Gay A, Peralta A, Solana-Solana M and mental health, others indicate improved self-perceived health, although this Fernández A (2023) Gentrification and its effect may vary among social groups. This study aimed to determine health association with health inequalities in Barcelona (2011–2017). inequities, according to socioeconomic position, among residents of different Front. Environ. Health 2:1202149. neighborhoods of Barcelona between 2011 and 2017, considering the intensity doi: 10.3389/fenvh.2023.1202149 of the gentrification process. COPYRIGHT Methods: Observational study with two transversal cuts (2011 and 2017). © 2023 González-Marín, Vásquez-Vera, Neighborhoods were categorized into three groups based on the intensity of López-Gay, Peralta, Solana-Solana and gentrification: intensive, moderate-mild, and no gentrification processes. We fitted Fernández. This is an open-access article distributed under the terms of the Creative Poisson robust models to estimate the prevalence ratio (PR) of poor self-reported Commons Attribution License (CC BY). The use, and poor mental health according to socioeconomic position (social class III vs. distribution or reproduction in other forums is I). We then calculated relative differences between 2011 and 2017 through the permitted, provided the original author(s) and the copyright owner(s) are credited and that the interaction between the year and socioeconomic position (PRi). The calculations original publication in this journal is cited, in were adjusted for age and household disposable income in the neighborhood accordance with accepted academic practice. and were stratified by sex. No use, distribution or reproduction is permitted which does not comply with these Results: In neighborhoods undergoing moderate or mild gentrification during the terms. study period, we found widening inequities in mental health between the most disadvantaged social class and the most privileged social class. Between 2011 and 2017, relative differences in poor mental health increased in moderate-low gentrification neighborhoods [women: PRi: 2.51 (1.52–4.17); men: PRi: 1.99 (1.09– 3.61)], equivalent to an increase of 12.9 and 11.5 percentage points, respectively. No statistically significant differences were found in the other neighborhoods. Discussion: The increase in mental health inequalities observed among residents of transitional neighborhoods could be explained by factors such as residential insecurity, eviction from the neighborhood, and rising housing prices. KEYWORDS health inequalites, urban health, gentrification, housing, mental health, self-rated health Background Neighborhoods of major cities are experiencing dramatic and rapid demographic and socioeconomic changes. Neighborhoods are known to be core social determinants of health and consequently it is crucial to understand how these changes impact the quality of life, wellbeing and health of their residents. One of these changes is gentrification, Frontiers in Environmental Health 01 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 which can be defined as “a process in which neighborhoods with low neighborhoods have a higher risk of anxiety and depression than SES [socioeconomic status] experience increased investment and an people living in non-gentrified neighborhoods, regardless of the influx of new residents of higher SES” (1). Gentrification has several economic resources available in the area (16). consequences, including the physical displacement of vulnerable On the other hand, other studies have found that self-rated residents and symbolic displacement, which can be defined as a health was better among people living in gentrified environments process whereby residents do not recognize the “new” than among those living in a non-gentrified neighborhood, neighborhood and feel disconnected (2). although the stratification of results showed that racial minorities The drivers of gentrification can vary depending on the living in newly-gentrified areas may experience a negative effect context, making it crucial to understand the urban renewal story on their self-rated health (17, 18). This suggests that of each city and its specific factors (3). In the case of Barcelona, gentrification may improve overall self-rated health in the Spain, the city has undergone significant transformations that neighborhood but conceal negative consequences on the health have altered its urban landscape and social and demographic of vulnerable groups, thus widening health inequalities across composition (4). One notable change is the considerable increase social axes. in tourists visiting the city, especially since the 1992 Olympic Another axis of inequality is gender. Historically, women have Games, which has led to the conversion of long-term housing been assigned different responsibilities to men, mainly focused on into tourist accommodation, mainly in the city center. This reproductive tasks, while men have been assigned responsibilities transformation has significantly affected the daily lives of the the productive sphere (19). These distinct social constructs city’s residents (5, 6). influence how people interact with the city. Typically, men Additionally, young migrant adults with higher incomes and perceive the neighborhood as a place of leisure and rest (20), university education have been drawn to Barcelona’s urban core due while women use it to create support networks (21) and often to the city’s dynamism and lifestyle possibilities. These dynamics make use of existing resources and facilities close to the family have stimulated housing rehabilitation and appreciation, but have home (20). Thus, due to the social and emotional links also resulted in the displacement of long-standing residents, established by women with their residential environment, the particularly older adults (7). Moreover, these dynamics have also urban, economic, and social transformations of the neighborhood altered the commercial network in the city centre (8). brought about by gentrification may have a greater impact on The appeal of visiting and living in Barcelona, along with women than on men (19, 22). political factors such as insufficient public housing and significant Gentrification is a dynamic and progressive phenomenon, liberalization of the real estate market, have contributed to a surge characterized by various processes unfolding over time. in housing prices (9). Consequently, there is a heightened risk of Moreover, there is already broad evidence of health inequalities housing insecurity and accelerated displacement of residents to in Barcelona, which are found in all neighborhoods in the city other neighborhoods or peripheral municipalities (10, 11). (23–25). In this study, we hypothesized that in highly gentrified or gentrifying neighborhoods, inequalities related to health, Gentrification, social inequalities, and especially mental health, would be exacerbated, particularly in health women. This hypothesis was based on the observations mentioned above, showing that processes of gentrification disrupt The literature on the health effects of gentrification is gaining community cohesion, leading to the breakdown of social support increasing attention but is inconclusive. Some studies have shown systems and weakening protective factors for mental health, a relationship between gentrification and psychosocial stress (12) especially for long-term residents as they witness the and poor mental health (13). These effects are often attributed to transformation of their neighborhood. Rising house prices in the the breakdown of social networks, housing insecurity, the loss of area can create additional stress for people if they cannot afford attachment to a place, and displacement of long-term residents. the cost of housing. In addition, as the cost of housing rises, A recent study reported a range of potential poor health residents may be less able to afford other necessities, which can outcomes and pathways associated with gentrification. At the impact their health. individual level, these include individual-level physical and This study aimed to investigate whether health inequalities mental health issues, such as obesity, asthma, chronic stress, and changed in neighborhoods that were gentrified between 2011 and depression. At the neighborhood level, gentrification may affect 2017 in Barcelona, the aftermath of the economic crisis of 2008. health determinants such as safety and the emergence of new drug-dealing/use. At the institutional level, gentrification may also influence health determinants, such as healthcare Methodology precariousness and worsened school conditions (14). However, two recent systematic reviews (1, 15) have concluded Design, study population, and information that the impact of gentrification on health is not homogeneous sources across social groups, with variations along different axes of inequality, such as age, race, gender, and social class. For We conducted a cross-sectional study with two cut-off points. example, research indicates that older adults living in gentrified Our study universe consisted of non-institutionalized individuals Frontiers in Environmental Health 02 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 aged more than 15 years residing in Barcelona (26, 27). The main Level of gentrification and sex (i.e., women/men) were used data sources were the Barcelona Health Survey for the years 2011 as stratifying variables. We made this decision, based on two and 2016/2017. This survey is conducted every 5 years by the hypotheses. Firstly, we hypothesized that health inequalities Barcelona Public Health Agency in a representative sample of the would increase in neighborhoods with high or moderate-low population of the city to obtain data on their health, disabilities, gentrification processes, while these inequalities would remain health-related behaviors, and their physical and socioeconomic stable in non-gentrified neighborhoods. Secondly, we chose to context. Participants are selected in advance and are contacted at stratify by sex (as a proxy of gender), because we hypothesized home by professional interviewers. The survey is administered that inequalities would be more pronounced among women, as through personal, home-based interviews conducted by the they are more affected by changes related to gentrification, professional interviewers. such as changes in businesses, housing prices, and the breakdown of social networks). Age and the average household disposable income index were Study variables included as adjusting variables, to avoid potential confounding factors. The household disposable income index was obtained Dependent variables consisted of self-rated health and the risk from data provided by the Barcelona City Council Department of of poor mental health. To assess self-rated health, participants Statistics (34). This index is a theoretical indicator that is were asked “How is your health in general?” Response options constructed from gross household disposable income and gross were “excellent”, “very good”, “good”, “fair”, and “poor”. We household disposable income per capita, while also including created a dichotomous outcome variable, with the responses variables related to the level of education of the resident “fair” or “poor” coded as “poor self-rated health” (28). Mental population, employment status, the characteristics of the motor health was evaluated using the 12-item version of the General fleet, and housing prices. The indicator reveals the relative Health Questionnaire (12-GHQ). Participants with a score of position of each territorial unit in relation to the average of the ≥3 were classified as having a high probability of poor mental city, set at a value equal to one hundred. health (29–31). Explanatory variables consisted of individual socioeconomic position, the level of gentrification, and the year. Data analysis To assess socioeconomic position, we used the social class classification of the Spanish Society of Epidemiology, which Firstly, we performed a descriptive analysis of the dependent and comprises five categories, based on the individual’s current or last sociodemographic variables, by the level of gentrification (i.e., intense, occupation (32). These five categories were recoded as follows: moderate/mild or none) of the neighborhood, sex, and year. (a) social class I (I + II), the highest social class; (b) social class II Then, we combined the databases of 2011 and 2017 to estimate (III), and (c) social class III (IV + V), the lowest social class. if there were any differences in the magnitude of health-related To evaluate the neighborhoods’ gentrification process, we used the inequalities between 2011 and 2017. We stratified the analysis by Gentrification Index (GI) (33). The GI is a composite index comprising sex and level of gentrification. seven theoretical dimensions associated with various axes of We estimated the prevalence ratios (PR) and their 95% neighborhood socioeconomic transformation: (a) population confidence intervals (95% CI) for poor self-rated health and poor rejuvenation; (b) changes in the origin of the population, understood mental health when comparing class III with class I. We fitted as the growth of the population born in countries with a high Human three Poisson regression models with robust variance, Development Index; (c) changes in family arrangements/values, introducing the interaction between year and social class. The associated with the growth of single-person adult households; inclusion of this interaction allowed us to identify whether (d) attraction to the population with a university degree; (e) variations in health inequalities during the period were population substitution, understood as a loss of the population statistically significant. The result of the interaction can be without a university degree due to the effect of migration and changes interpreted as a relative difference between the PR of each year of residence; (f) speed of change, which introduces the transformative (i.e., as a ratio of prevalence ratios) or, capacity of migratory and residential flows to modify the composition of the population; (g) transformations in the housing market, PRinteraction ¼ PRof class III vs I in 2017 =PRof class III vs I in 2011 measured through price increases. The GI yields a final score ranging from 0 to 1, where 0 indicates the lowest degree of gentrification between 2011 and 2017 and 1 The three models were: indicates the highest degree. We categorized the neighborhoods in (1) Model 1: crude model including only the interaction between three groups based on quartiles (Figure 1): C1 (GI => 0.51), year and social class. neighborhoods that underwent intense gentrification processes (2) Model 2: Model 1 adjusted by age. between 2011 and 2017; C2-C3 (GI > 0.30 and GI < 0.51), (3) Model 3: Model 2 adjusted by the household neighborhoods with moderate or mild processes associated with disposable income index. Only results from model 3 are gentrification; and C4 (GI <= 0.31), neighborhoods not undergoing presented in this article. Using the results of model 3, we any significant gentrification processes between 2011 and 2017 (33). calculated absolute differences by using the margins Frontiers in Environmental Health 03 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 FIGURE 1 Neighborhood typology according to the gentrification index (2011–2017) (33). command in STATA, which allowed us to predict PRs Absolute difference in poor self  rated health ¼ and their 95% CI. Finally, to ease interpretation, we (Prevalenceof people in class III reporting poor self -rated health in 2017 - generated graphs that illustrated the difference between Prevalenceof people in class I reporting poor self -rated health in 2017 Þ individuals in class III and class I who reported poor  (Prevalenceof people in class III reporting poor self -rated health in 2011 - self-rated health and risk of poor mental health in 2011 Prevalenceof people in class I reporting poor self -rated health in 2011 ) and 2017 with 95% CI. Once this was done, we estimated the absolute difference, i.e., the difference of the Databases were anonymized and all analyses were weighted differences: according to the Barcelona Health Survey’s weights. The statistical software used for the analysis was STATA 15. Absolute difference in the risk of poor mental health ¼ (Prevalenceof people in class III reporting risk of poor mental health in 2017 - Results Prevalenceof people in class I reporting risk of poor mental health in 2017 Þ  (Prevalenceof people in class III reporting risk of poor mental in 2011 - The sample included 1,645 women and 1,600 men in 2011 and Prevalenceof people in class I reporting risk of poor mental health in 2011 ) 1,780 women and 1,606 men in 2017. The sociodemographic and Frontiers in Environmental Health 04 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 health characteristics of the sample are shown in Table 1. Analysis Changes in health-related inequalities of social class revealed that neighborhoods without gentrification between 2011 and 2017 processes had a higher percentage of women and men in social class III, which increased sharply from 2011 to 2017. In In neighborhoods with moderate or mild gentrification neighborhoods with mild-moderate gentrification, the processes, the absolute difference in the percentage of women distribution of social class was fairly homogeneous, except for with poor mental health between class III and class I was 1.3 men in the year 2011. Neighborhoods experiencing intense percentage points (Figure 2A). In 2017 this difference was 14.2 gentrification processes had slightly more women and men in percentage points. Thus, inequalities increased during the period class III, and no significant changes were observed between 2011 by 19.9 points, which was statistically significant. The increase in and 2017. inequalities was also reflected in the relative difference in PRs The prevalence of poor mental health in women (PRi) between 2011 and 2017, which more than doubled in all increased between 2011 and 2017, regardless of social class models [e.g., PRi = 2.51 (95% CI = 1.53–4.17)] (for more details and the gentrification process experienced by the see Supplementary Material Appendix 2). The same pattern was neighborhood, with the exception of women in class I living in observed in neighborhoods without gentrification processes, but neighborhoods undergoing mild-moderate gentrification the results were not statistically significant. In neighborhoods processes, where the prevalence decreased. The pattern in men with intense gentrification processes, the absolute difference was similar. between 2011 and 2017 decreased by 0.8 percentage points, but In contrast, the prevalence of poor self-rated heath in this decrease was not statistically significant. women in class I decreased or remained stable between 2011 Among men (Figure 2B), in neighborhoods with moderate or and 2017, but generally increased among women in class III, mild gentrification processes, the absolute difference between class regardless of the gentrification-related process of the III and class I was −2 in 2011, increasing to 9.5 points in 2017 (11.5 neighborhood. In men, the prevalence of poor self-rated health percentage points), which was statistically significant. As among increased or remained stable, regardless of social class, except women, this was also reflected in the relative difference of PRs among those in class I living in neighborhoods undergoing (PRi) between 2011 and 2017, which nearly doubled in all mild or moderate processes, where it decreased (for more models [e.g., PRi = 1.99 (95% CI = 1.09–3.61)] (Supplementary details see Supplementary Material Appendix 1). Material Appendix 2). In neighborhoods with and without TABLE 1 Socioeconomic and health characteristics of Barcelona residents, stratified by the gentrification process of the neighborhood, sex, and year. Women Neighborhoods without Neighborhoods with mild or Neighborhoods with intense gentrification moderate gentrification gentrification 2011 2017 2011 2017 2011 2017 % (n)* % (n) % (n) % (n) % (n) % (n) Total 208 278 925 960 512 542 Age [median (IR)] 47 [63–33] 48 [68–37] 46 [61–34] 50 [37–36] 47 [65–33] 47 [63–33] Socioeconomic position Social class I 20.5 (44) 13.1 (38) 31.7 (313) 35.8 (348) 30.1 (147) 29.6 (157) Social class II 27.6 (57) 23.6 (66) 31.4 (293) 26.0 (254) 25.1 (119) 27.3 (135) Social class III 51.9 (107) 63.3 (174) 36.9 (319) 38.2 (358) 44.8 (246) 43.1 (250) Household disposable income index [median (IR)] 58.3 [64–56] 58.3 [70.8–53.7] 91.7 [125.4–81.6] 86.6 [125.4–76.6] 92.4 [109.1–76.8] 92.4 [109.1–80.9] Health Poor mental health 13.5 (28) 27.1 (70) 17.0 (151) 16.5 (147) 19.6 (99) 21.7 (123) Poor self-rated health 24.5 (48) 29.8 (85) 22.8 (206) 22.3 (217) 22.5 (109) 23.4 (132) Men Total 184 234 908 845 508 527 Age [median (IR)] 40 [61–33] 46 [61–34] 45 [61–32] 47 [63–33] 44 [60–32] 43 [58–33] Socioeconomic position Social class I 13.9 (28) 12.3 (30) 31.8 (304) 37.5 (328) 33.7 (152) 29.6 (148) Social class II 29.8 (52) 18.9 (44) 24.2 (221) 24.2 (203) 20.6 (98) 24.3 (120) Social class III 56.3 (104) 68.7 (160) 44.0 (383) 38.3 (314) 45.7 (258) 46.1 (259) Household disposable income index [median (IR)] 58.3 [64–53.7] 58.3 [64–53.7] 85.8 [125.4–74.9] 86.6 [125.4–76.6] 92.4 [109.1–79.6] 92.4 [97.8–79.6] Health Poor mental health 5.4 (10) 17.4 (40) 10.6 (95) 13.7 (100) 14.1 (75) 20.5 (108) Poor self-rated health 13.0 (25) 19.7 (48) 17.7 (172) 16.4 (138) 19.3 (113) 16.9 (88) % (n) corresponds to the number of residents (n) and each category proportion (%). Frontiers in Environmental Health 05 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 FIGURE 2 (A–D) Absolute differences in poor mental health and poor self-rated health by socioeconomic position, stratified by the gentrification processes of the neighbourhood, sex, and year. intense gentrification processes, we observed no significant between 2011 and 2017 in neighborhoods with a moderate or mild differences between 2011 and 2017. gentrification level during the study period. However, in Inequalities in self-rated health among women (Figure 2C) neighborhoods not undergoing gentrification and those undergoing showed the same pattern as in mental health for intense gentrification, health inequalities remained unchanged neighborhoods without gentrification and moderate or mild between 2011 and 2017. We observed no changes in self-rated health gentrification processes, although the results were not inequalities between 2011 and 2017 in any of the neighborhoods. statistically significant. Among neighborhoods with intense gentrification processes, poor self-rated health increased between 2011 and 2017, but this increase was not statistically Why would mental health inequalities have significant. In men (Figure 2D), the increase in inequalities increased in neighborhoods experiencing between 2011 and 2017 was smaller than that in women, and mild or moderate gentrification? was not statistically significant. Gentrification processes lead to several changes in neighborhoods that may affect residents’ health, but their impact Discussion differs depending on the social group to which residents belong (35). For example, one of the processes occurring in gentrifying This study shows that inequities in mental health between the most neighborhoods is the influx of private capital for reinvestment in disadvantaged social class and the most privileged social class widened the area, which can modify the neighborhoods’ housing market Frontiers in Environmental Health 06 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 (36). Thus, the owners of both land and properties may view the disproportionate burden as caregivers, particularly those in the urban transformation of neighborhoods as a business opportunity most disadvantaged social classes, as women in more to attract individuals with greater purchasing power or tourists, privileged backgrounds are more likely to hire individuals to driving up the prices of housing and commercial premises. perform caregiving tasks. To fulfill these caregiving Consequently, there may be instances of real estate mobbing, with responsibilities, basic services and facilities must be available forced displacement of the most disadvantaged residents to make in the neighborhood. However, gentrification leads to the loss room for more lucrative real estate opportunities (7). of local businesses, nearby leisure and care spaces, and This type of residential insecurity and fear of being driven out neighborhood support networks, making it challenging to of the neighborhood can cause psychosocial stress (12), negatively carry out daily activities and caregiving and resulting in longer affecting mental health (13, 14). In addition, the replacement of and more time-consuming journeys (19). Gentrification tends traditional stores by tourist-oriented or trendy shops that do not to reinforce a city model that prioritizes economic cater to the daily needs of long-term residents from lower social performance and caters to the productive sphere, often classes directly affects their quality of life and health (6). neglecting the public reproductive sphere where women, These mechanisms, among others, contribute to increasing especially those from the most disadvantaged social classes, health inequalities among disadvantaged groups. However, the engage in their daily activities (19). extent of these phenomena varies, depending on the stage of gentrification. They may be more pronounced in neighborhoods that are recently undergoing changes (mild or moderate Limitations and strengths of the study gentrification), where most disadvantaged people from lower social classes have not yet been displaced. In contrast, in This study has several limitations. The main limitation is that neighborhoods with intense gentrification (advanced stages of the sample is not representative at the neighborhood level sociodemographic replacement), most residents would tend to because the information source (the Barcelona Health Survey) is have higher purchasing power and, in general, better health only representative at the district level. However, this issue may status. Even individuals from lower social classes (as measured be minimized to some extent by the grouping of neighborhoods. by occupational classification) who manage to remain in Another limitation is the small sample size of some groups of intensely gentrified areas are likely to possess characteristics neighborhoods, which became more pronounced on stratification related to other axes of inequality, such as gender, immigration by different variables. Moreover, the generalisability of the results status, or income, which enable them to adapt to the changes in is limited because the processes related to gentrification are their neighborhood or even benefit from them. Consequently, highly influenced by the unique social and political context of health inequalities in intensely gentrified areas may persist or each city or territory. Therefore, our results can only be applied even decrease. Indeed, our findings show that health to similar contexts. Finally, the GI may not fully capture the inequalities were maintained in neighborhoods with intense gentrification process of the city’s neighborhoods due to the gentrification between 2011 and 2017, although there was a complexity of the phenomenon. slight tendency for them to decrease in women. Despite these limitations, to our knowledge, this is the first Finally, in non-gentrified neighborhoods, we observed a non- study on health inequalities due to gentrification in Spain and significant increase in health inequalities between 2011 and 2017. it was carried out by a multidisciplinary public health team Most of these neighborhoods are inhabited by people from and experts in neighborhood change and gentrification. In disadvantaged social classes, who may have been particularly affected addition, this study may be useful for local policy makers- or by the consequences of the economic crisis. Since 2011, Spain those in similar contexts -to design and implement implemented austerity policies that affected the viability of the public policies aiming to reduce social and health inequalities. welfare state. These policies included labor market reforms, such as For future research, it would be interesting to study making dismissal cheaper and reducing unemployment benefits, as gentrification with mixed methodologies to further deepen well as increasing value added tax from 18% to 21% and from 8% to understanding of the relationship between gentrification and 10%, and implementing health co-payment (37), among other health. Similarly, the gender and intercultural perspective measures. These changes in the economic landscape increased job should be incorporated, in addition to other axes of inequality instability and the cost of living, which had direct repercussions on such as age. the finances of the most disadvantaged people, affecting their health. A gender lens is needed Conclusion Although inequalities in mental health were similar in The results of this study show that gentrification may increase women and men, gentrification could have a more negative mental health inequalities, especially at the start of the effect on women due to the different ways in which they use gentrification process. This impact is observed both in men and city spaces, which are often linked to their assigned social women, but more research is needed to validate these results and roles (19). Even in contemporary times, women still bear a to understand the mechanisms that may underpin them. Frontiers in Environmental Health 07 frontiersin.org González-Marín et al. 10.3389/fenvh.2023.1202149 Data availability statement supported the analysis and interpretation of findings, reviewed the first draft of the manuscript and coordinated the study. All The datasets presented in this article are not readily available authors contributed to the article and approved the submitted because the datasets are the property of the Public Health version. Agency of Barcelona. Any request has to be done through official channels. Requests to access the datasets should be directed to vasquezhug@paho.org. Conflict of interest The authors declare that the research was conducted in the Ethics Statement absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ethical review and approval was not required for this study in The authors HV and AF declared that they were an editorial accordance with the national legislation and the institutional board member of Frontiers, at the time of submission. This had requirements. Written informed consent was not required for no impact on the peer review process and the final decision. this study in accordance with the national legislation and the institutional requirements. Publisher’s note Author contributions All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated PG designed the research protocol, conducted the analysis and organizations, or those of the publisher, the editors and the wrote the first draft of the article. HV designed the research reviewers. Any product that may be evaluated in this article, or protocol, supported the analysis and interpretation of findings, claim that may be made by its manufacturer, is not guaranteed reviewed the first draft of the manuscript and prepared the final or endorsed by the publisher. version of the article. AL supported methodology and instruments related to gentrification measures, reviewed the first draft of the manuscript. AP supported methodology and Supplementary material instruments related to gentrification measures, reviewed the first draft of the manuscript. MS-S supported methodology and The Supplementary Material for this article can be found instruments related to gentrification measures, reviewed the first online at: https://www.frontiersin.org/articles/10.3389/fenvh.2023. draft of the manuscript. AF designed the research protocol, 1202149/full#supplementary-material. References 1. Smith GS, Breakstone H, Dean LT, Thorpe RJ Jr. Impacts of gentrification on 11. Observatori DESC—Plataforma de Afectados por la Hipoteca. Emergència health in the US: a systematic review of the literature. J Urban Health. (2020) habitacional a Catalunya. (2015). 97:845–56. doi: 10.1007/s11524-020-00448-4 12. Mehdipanah R, Marra G, Melis G, Gelormino E. Urban renewal, gentrification 2. Elliott-Cooper A, Hubbard P, Lees L. Moving beyond Marcuse: gentrification, and health equity: a realist perspective. 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