Annual Review of Public Health Promoting Health Equity Through Preventing or Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Mitigating the Effects of Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org Gentrification: A Theoretical and Methodological Guide Helen V.S. Cole,1 Isabelle Anguelovski,1,2 Margarita Triguero-Mas,1,3 Roshanak Mehdipanah,4 and Mariana Arcaya3 1 Barcelona Lab for Urban Environmental Justice and Sustainability, Institut de Ciència i Tecnologia Ambientals (ICTA-UAB), Universitat Autònoma de Barcelona, Barcelona, Spain; email: helen.cole@uab.cat 2 Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain 3 Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA 4 School of Public Health, University of Michigan, Ann Arbor, Michigan, USA Annu. Rev. Public Health 2023. 44:193–211 Keywords The Annual Review of Public Health is online at gentrification, displacement, urban regeneration, health equity, urban publhealth.annualreviews.org health https://doi.org/10.1146/annurev-publhealth- 071521-113810 Abstract Copyright © 2023 by the author(s). This work is Public health researchers are increasingly questioning the consequences of licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted gentrification for population health and health equity, as witnessed in the use, distribution, and reproduction in any medium, rapid increase in public health publications on the health (equity) effects of provided the original author and source are credited. gentrification. Despite methodological challenges, and mixed results from See credit lines of images or other third-party material in this article for license information. existing quantitative research, qualitative evidence to date points to the role of gentrification processes in exacerbating health inequities. Here we dis- cuss past methodological and theoretical challenges in integrating the study of gentrification with public health research. We suggest taking an inter- disciplinary approach, considering the conceptualization of gentrification in measurement techniques and conceiving this process as a direct exposure or as a part of broader neighborhood changes. Finally, we discuss existing 193 policy approaches to mitigating and preventing gentrification and how these could be evaluated for effectiveness and as public health promotion and specifically as interventions to promote health equity. INTRODUCTION From its origin in 1964, with Ruth Glass’s now classic study of London’s working-class neighbor- hood transformations into higher-income enclaves from which original residents were displaced (55), gentrification has gained huge interest from urban policy and planning, academic disciplines, media, and activism. Many urban residents themselves know how to recognize gentrification, from Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. the introduction of trendy barber shops, organic food stores, $5 barista-made lattes, and yoga studios to iconic parks and, of course, large-scale luxury real estate development and condo conver- Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org sion in previously underinvested yet affordable areas. Yet, moving from a broader understanding of this process of unequal urban (re)development toward formalizing indicators of gentrification and using these measures to investigate the impact of gentrification on health and health equity requires a few key steps: engaging with key literature across the social sciences; innovating mea- surements, methods, and design; incorporating policy and planning perspectives (33); and thus producing a more critical, interdisciplinary, and socially engaged public health scholarship. Here we provide an overview of key conceptual challenges, discuss the progress to date in studying gen- trification from a public health perspective, and finally suggest future directions for research and for the development and evaluation of policies to prevent the negative health (equity) effects of gentrification processes. GENTRIFICATION VERSUS OTHER URBAN PROCESSES Gentrification is often grouped together with urban “renewal,” “regeneration,” or “revitalization” (91, 117), urban development processes all presented globally as means to “improve” neigh- borhoods or address so-called “blight” or “decay.” European scholars tend to use the term regeneration, while the US literature refers to renewal or revitalization. As a group, these terms all involve physical and financial investments, policies, and programs crafted to respond to under- investment, concentrated poverty, building and land abandonment, and related social and health problems (104, 118), including cardiovascular diseases, diabetes, and obesity; substance use; and stress and depression. Yet, gentrification is a direct consequence of new public and private invest- ment in neighborhoods and also leads to further resources and amenities being brought into the area after new, wealthier residents start to arrive (83). Gentrification generally refers to commercial, demographic, and real estate price changes due to local, national, or global investments geared toward higher-income and white residents (24, 31, 80, 81). Social change indicative of gentrification tends to be measured using publicly available data (56, 59, 134), at the census tract or neighborhood level. Gentrification is found to take place when researchers identify increases in median income, percentage of residents with a university educa- tion, white residents, and housing prices/values, along with decreases in non-university-educated residents, nonwhite residents, and lower-priced homes (15, 52). These factors combined with so- ciocultural and physical displacement of long-term traditional residents are the core difference between gentrification and other urban development processes. Scholars have identified a variety of drivers to explain how gentrification processes start. These drivers include an influx of artists (27), commercial revitalization (125), migration of white professionals (67, 126), physical prox- imity of the neighborhood to affluent areas and economic amenities (86), decreased crime rates 194 Cole et al. (16, 98), a gap between existing and potential ground rent (120, 121) including “green gaps” (that is, the perceived benefits and accrued values generated by land cleanup and green interventions) (7), urban renewal and public housing demolition policies (79, 130), and global competition for resources and the so-called “knowledge economy” (82, 133). In response to a long-time scholarly neglect in explaining how racial conflict shapes gentrifi- cation (23), the gentrification literature has recently paid more attention to the racial dimension of gentrification and the central role played by racial capitalism in shaping urban space (103), ex- tracting financial value from previously marginalized neighborhoods (107), especially those with a legacy of segregation, discrimination, and stigmatization. In the United States, cities such as Detroit, Michigan, are at the center of such contemporary urban struggles through new land and property devaluation and acquisition dynamics by white investors and developers, especially since Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. the 2007 financial crisis (108). Racial capitalism, as an economic system through which racial dif- ference defines opportunities for value and profit accumulation (105), is able to use gentrification Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org in order to reproduce difference and exclusion as well as segregation dynamics (73) through a pro- cess known as racial ordering. This ordering maintains or exacerbates racial hierarchies through unequal resource distribution and through the discursive characterization of inferiority geared toward racialized groups whose neighborhoods are seeing redevelopment and reinvestment (23). Through both settler colonial and postcolonial lenses [i.e., those explaining the racial and colonial structures behind gentrification (5, 72)], urban geographers and sociologists are demon- strating the complexities of how racialized hierarchies affect everyday relations in gentrification, most recently in health outcomes (6, 94). For instance, in cities Black and Brown residents have been shown to experience the imposed commercial choices, esthetics, and norms of white set- tlers (22, 125) who devalue and selectively appropriate racialized aspects of neighborhood culture and history. In Washington, DC, for example, the rebuilding and reimagining of the H Street NE (Northeast) corridor involved the branding of a depoliticized Black “coolness” in this multicultural neighborhood. After decades of racialized disinvestment, Blackness is now being appropriated by investors and new residents who are accruing the benefits of new commodities, revamped cultural venues, and new condos (109). Put differently, research shows that gentrification, and commercial- led gentrification in particular, tends to have deep sociocultural ramifications for communities of color because gentrification, through the common process of rent seeking, involves the selec- tive revaluation and appropriation of features that can be attractive to gentrification as “cool” or “vibrant” and thus have been shown to commodify racialized spaces (101, 125). The early stages of gentrification, which may begin with students or artists, for example (27), moving into affordable neighborhoods to benefit from lower commercial or residential rental prices, pave the way for more advanced gentrification processes later on, including those that in- volve large-scale real estate development and more extreme demographic changes occurring over time, in what is sometimes referred to as hypergentrification (78). While early-stage gentrification can seemingly bring a new array of benefits to a neighborhood—including lower crime and new green space—more advanced stages of gentrification tend to create a new wave of social ills and health impacts (75, 96, 111, 132). Several studies also demonstrate that as neighborhoods begin to gentrify, they experience an increase in punitive policing strategies such as order-maintenance citations and proactive arrests, potentially catering to the demands of new residents from the “cre- ative class” (19, 39, 76). As gentrification becomes a more consolidated process, the health impacts of new urban amenities tend to be positive mostly for the gentrifiers, but less so for gentrified residents (38). Despite long-standing debates about the global and local variations of gentrification (70, 81) and about the production-side versus consumption-side explanations for the causes of gentrifi- cation (83), scholars tend to agree that structural forces (production) as defined by Smith (120) www.annualreviews.org • Health Equity and Gentrification 195 and cultural dynamics (consumption) as proposed by Ley (85) are interdependent and coexist in gentrification (30, 60, 83). Of major importance for studying the potential health impacts of gen- trification is whether and how gentrification contributes to displacement; most studies concur about the strong relationship between the two types of gentrification causes (production side and consumption side). Displacement is found to occur through multiple forms of violence, including the destruction of networks and resources vulnerable residents have access to, appropriation of existing or new amenities by gentrifiers, and housing loss and evictions (47, 48, 89, 93). Fear of displacement—with all the anxiety, stress, and uncertainty linked to fighting for one’s home and searching for a new home (21)—is different from experienced displacement—with all the uproot- ing and adaptation it has triggered—and thus likely has different—although also acute—health impacts. Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. From a research standpoint, the health outcomes of gentrification are difficult to measure once residents are forced to move out because it tends to be difficult to track and identify displaced Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org residents and, thus, difficult to monitor their health over time (6, 37). Displacement can also be experienced in multiple ways (6, 89): for example, direct physical displacement caused by homes being demolished and replaced by mixed or upper-income developments, as has been the case throughout urban renewal projects in the United States; financial displacement due to rising rents, home sale prices, and property taxes that price out existing residents; and sociocultural displace- ment causing residents to feel a sense of social erasure, a loss of sense of community and place attachment, and a sense of discomfort as their neighborhood changes. Gentrification–Health Pathways As far as we know, only four studies have previously formally and purposefully explored the po- tential pathways between gentrification and health (6, 13, 51, 109), summarized in Figure 1. We present a comprehensive framework that visualizes the relationships between the main hy- pothesized pathways linking gentrification and health: (a) increased real estate speculation and housing costs leading to displacement; (b) sociocultural, legal, symbolic, and emotional erasure and displacement; and (c) the transformation of the physical environment and changes to amenity accessibility. These different pathways may have varying roles for different health outcomes and for the patterns of health and health inequity among residents of gentrifying neighborhoods, providing many directions for future research. Relationship Between Gentrification and Health: Findings to Date While the literature on the health effects of gentrification is growing, the relationship between gentrification and health—and the health of historically marginalized residents in particular— remains poorly understood, owing, in part, to analytic challenges that are inherent to studying a highly spatially and socially patterned neighborhood-level phenomenon that lacks a singular shared definition, operates over variable geographic and temporal scales, and displaces affected residents to new areas, complicating the collection of longitudinal data on residents’ lives, living conditions, and health. As a result and in response to this core methodological challenge, the liter- ature on gentrification and health uses a wide range of definitions and measures of gentrification, uses repeated cross-sectional designs that fail to track displaced residents, studies the relationship among highly selected (i.e., not representative) samples, lacks theoretical justification for outcome and covariate selection, or covers time or geographic scales of questionable theoretical relevance (49, 129), all of which makes it challenging to combine insights across studies to definitively say how and how much gentrification matters for the health of historically marginalized residents across different time periods. 196 Cole et al. RAC E AND CLAS S PRIVILEGE Increased real estate speculation and housing costs PH YS ICAL AND MENTAL *Eviction *Overall insecurity H EALTH INEQUITIES *Threats of physical displacement *Fear *Sudden and abrupt rent increases *Fading of life opportunities *Property harassment *Invasion of communal space in buildings Double trauma *Increased financial strain *Increased poverty and reduced ability to pay for essential Chronic stress *Increased short-term rentals for visitors (e.g., wealthy services and treatment to maintain good health Lower self-esteem students) and tourists *Physical displacement to poor-quality housing and Depression *Increased costs of living (e.g., property taxes and contaminated and industrialized neighborhoods Feeling unworthy housing maintenance costs) *Working overtime and decreased time for health Suicide GENTRIF IC ATION PROC ES SES promotion activities Feeling powerless Anxiety Sociocultural, symbolic, and emotional erasure and displacement Alienation Depression Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Disaffection *Increased presence of newcomers and their practices *Feeling unwelcomed and out of place in public spaces, Sleep deprivation *Privatization of public spaces (streets, green spaces, etc.) playgrounds, green spaces, and streets Anger *Closure of and revamping of traditional stores *Indifference of newcomers toward traditional residents Cardiovascular diseases Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org *Loss of identity and of belonging to the neighborhood (e.g., hypertension, *Degradation of neighborhood social fabric and networks Feeling vulnerable heart palpitations) *Increased experiences of police control in public spaces *Social detachment *Mistrust toward newcomers Social isolation Obesity *Intense rotation and fast substitution of residents *Increased street violence and crime *Destruction of formal and informal networks of practical support Loneliness Insomnia *New or increased drug trafficking and binge drinking Increased Respiratory diseases emergency visits (e.g., asthma) Transformation of physical environment and amenities Increased Psoriasis *Air, noise, and light pollution *Poor nutrition hospitalizations *Difficulties to access healthy affordable food *Decreased preventive care Negative birth Grief outcomes *Change in quality and access to essential institutions *Disruptions in continuity of care for chronic conditions (health care facilities, schools) and schooling Increased risk of Injuries *Decreased school budget *Decreased access to school green spaces and playgrounds accidents and falls *Increased transit of different types of vehicles *Increased time spent to get healthy affordable food *Numerous waste and pests *Commodification of neighborhood services and amenities Figure 1 Potential pathways through which gentrification can affect physical and mental health inequities. Figure based on information from Anguelovski et al. 2020 (13), Anguelovski et al. 2021 (6), Sánchez-Ledesma et al. 2020 (109), and Formoso et al. 2010 (51). In recent years, several review articles have taken on the challenge of summarizing this literature, all of which concluded that collected evidence on the health effects of gentrification is currently still recent and weak but also that effects, when documented, are highly heterogeneous. However, much of this literature focuses on the health of all residents, including gentrifiers, and thus does not often start from the life changes experienced by vulnerable residents nor does it prioritize health equity considerations. For example, Smith et al. (119) screened the titles and abstracts of ∼6,000 studies for potential inclusion in a systematic review on US population-based studies investigating the health effects of gentrification published as of July 2018. Their search yielded only six peer-reviewed, US-based studies that were eligible for inclusion based on relevance and the use of health and gentrification measures to estimate a quantitative measure of association between the two. Results from the review suggested that while overall associations between gentrification and health were largely null, gentrification was associated with worse health among Black populations in particular (119). A second review study also examined studies on gentrification and health published between 2000 and 2018, concluding, based on 22 empirical studies, that the literature is characterized by a mix of positive, negative, and null associations (111). In 2020, a third review of 36 eligible studies, including 12 published after the cutoff dates of the first two, found similar results, highlighting that gentrification appears not to have a uniform ef- fect across different population groups; those in more marginalized groups such as the elderly and Black residents are affected more than younger, white residents (20). Several other reviews examine the health effects of neighborhood changes theorized to accompany gentrification, for example, www.annualreviews.org • Health Equity and Gentrification 197 urban development more generally (90), transportation infrastructure changes (74), changes in the food environment, or disruption to social networks (64), without direct analyses of gentrification itself. Since the publication of these reviews, additional published studies have suggested that the relationship between gentrification and health, when examined through quantitative data measur- ing associations, is negligible after controlling for potential confounders and is highly contingent on other factors when documented at all. For example, Barton et al. (17) show crude associations between gentrification and worse self-rated physical and mental health, but these associations dis- appear after adjustment for neighborhood collective resources and other neighborhood measures. Schnake-Mahl et al. (110) use a quasi-experimental design to examine the effects of gentrification on body-mass index, psychological distress, and self-rated health among a sample of Hurricane Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Katrina survivors and also find null effects for all three outcomes. Agbai (2) uses longitudinal data from Los Angeles to examine associations between residence in a gentrifying neighborhood and Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org self-reported health and found that longer residence in a gentrifying neighborhood is actually as- sociated with better self-reported health, without variation by race/ethnicity. A lack of longitudinal follow-up data in this case means that it is unclear whether these results may be due to selection bias regarding who leaves and who stays. However, Henson et al. (61) find that gentrification is associated with more asthma-related visits to the emergency department. While these and other primarily quantitative studies about the costs that gentrification imposes on health create a confusing evidence base, qualitative work paints a more nuanced but clearer picture of gentrification as a process that causes stress, exclusion, lower social cohesion, loss of control, and other psychosocial stressors on vulnerable groups (21, 63). This discrepancy points to the need for mixed-methods research to be applied to improving our understanding of how and when gentrification may be linked to health and health equity. Types of Gentrification and Their Unique Implications for Health In addition to a broad focus on gentrification as a form of unequal and extractive urban devel- opment (83), scholars have also distilled different types of gentrification (37), each of them with both common and unique implications for social and health outcomes. For instance, commercial gentrification is implicated by the replacement of traditional stores and businesses with trendy and exclusive boutiques (3, 112). A subset of commercial gentrification is food gentrification. Here new expensive organic stores and supermarkets open up and often replace more affordable options, creating “food mirages” (4, 124) for working-class residents now faced with new food options but with increasing difficulty to pay for that food (and housing) and, therefore, to make healthy nu- trition choices (6, 131). Tourism gentrification—and at times related student gentrification—also concerns the loss of food and other store options in favor of new tourism (and student) venues, although in the case of tourism/student gentrification, access to housing, public services, and safe public spaces also becomes compromised for traditional residents (12, 31, 43, 57, 88, 96, 109, 113). Commercial changes also take place in health care gentrification, whereby health care as an es- sential service and public good is increasingly transformed into a luxury elite amenity for wealthy residents and those with private insurance through the siting of facilities according to payer mix rather than need; transformations in health care systems themselves then lead to the closing of hospitals that do not make a profit and to changes in the types of care provided (6, 35, 37). These factors in turn affect historically marginalized residents’ access to quality health care, especially for those most at risk for chronic disease, for whom providing needed care is not profitable. Greenways, parks, plazas, gardens, or climate infrastructure can also be the object of gentrifi- cation through environmental gentrification (8, 9, 40, 53, 58, 84). Here researchers focus on the role of the improvement or creation of new environmental amenities in driving gentrification 198 Cole et al. processes. This dynamic is itself broken into transit or bike gentrification (42, 50, 122), through new transit and bike infrastructure and their related transit-oriented development; green gentrifi- cation (9, 10, 14, 36, 58), when referring to green infrastructure per se; and climate gentrification, when concerning the role played by climate mitigation or adaptation infrastructure in gentrifica- tion (11, 71, 114, 115). The relationship between new green spaces and gentrification may also vary by time, type of green space, or contextual aspects of the specific city (8, 127). Environmental gentrification poses unique health impacts (36) on historically marginalized residents, including increased loss of place attachment and social cohesion, loss of relational well-being, chronic stress, and mental health burdens (6). These impacts are created by what researchers identify as “disrup- tive green landscapes” (102, 128), whereby the social impacts such as exclusion resulting from gentrification lead residents not to engage with or benefit from new or improved green spaces in Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. their neighborhoods. As environmental gentrification often occurs in areas with histories of en- vironmental degradation, cleanup of environmental hazards and new green amenities occurring Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org along with gentrification may lead instead to compounded environmental health risks (34). Rather than being environmental resources for neighborhood residents, as traditionally conceptualized, the health benefits of new green amenities seem thus to accrue only for higher-income and more educated groups (38). NEW DIRECTIONS FOR RESEARCH ON THE HEALTH EFFECTS OF GENTRIFICATION In addition to the need to further clarify how and when gentrification affects health and health eq- uity, and those challenges in current research mentioned above (i.e., a lack of longitudinal studies, nonrepresentative samples, a lack of theoretically justified outcomes and covariates, and the chal- lenge of selecting a relevant geographical scale), there are several directions in which research on the health effects of gentrification can be advanced. We highlight three such aspects below: future directions in exposure assessment, evaluation of the effects of different types of gentrification, and movement toward interdisciplinary approaches. Exposure Assessment In nearly all studies exploring the associations between gentrification and health, exposure to gen- trification generally implies the existence of gentrification processes near one’s residence, although no standardized method of measuring gentrification, or exposure to it, exists (20, 92, 111, 129). In quantitative research, such as those methods most used by public health researchers, the method commonly used to assess the existence of gentrification has been the use of census data to measure various aspects of demographic and socioeconomic changes, although variations in the variables and details of methods used to calculate gentrification also lead to variation in exposure assessment (92). A common gentrification indicator used in health studies is a composite score that includes all or some of the following dimensions, often benchmarking neighborhood-level change to the average change across the city being studied: changes in household income, percentage of under- privileged races/ethnicities, population level of education, population occupation, rental prices, population age distribution, building age, and/or urbanized area over a period of 3–20 years at the census tract or neighborhood level (38, 54, 65, 68, 69, 87); no gold standard exists, however, regarding which variables and how many variables should be included. Indicators can also vary by country or even city, depending on which groups are locally deemed as most vulnerable. For example, in one study from Barcelona, Spain, researchers included a variable with local relevance on the percentage of residents over age 65 who live alone (10). Different demographic and real www.annualreviews.org • Health Equity and Gentrification 199 estate indicators may be available at different geographical units and at different regularity in different cities and countries, so gentrification exposure assessment is highly dependent on the availability of secondary data. However, as research on gentrification and health increases, having comparable gentrification indicators is increasingly important (20, 111), even if using the same exact measures across different places and types of gentrification may not be advisable (33). Ac- cordingly, researchers may want to develop highly customized indicators to evaluate with high internal validity the associations between gentrification and health in specific cities, while also us- ing more general indicators that can be comparable across contexts; this approach therefore would also increase the external validity of studies on the relationships between gentrification and health. Moreover, determining the appropriate time period to be studied is an important challenge for researchers because different periods may be pertinent for specific health outcomes and popula- Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. tions. For example, anxiety and insomnia may appear during early stages of gentrification, whereas studying the effect of gentrification on birth outcomes and cardiovascular diseases may be rele- Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org vant only after months or years of exposure to gentrification. Complicating these decisions are the practical decisions that one must make owing to the availability of data, particularly when re- lying on secondary data such as census data often used to measure gentrification quantitatively; these data are available only for certain years and cannot track changes more regularly and over short time increments. Similarly, the question of which geographic indicators best approximate a neighborhood is complicated both conceptually and practically, owing to the lack of availability of data attached to finite geographic indicators, especially in the case of health data that must be kept secure and confidential. The use of residential administrative boundaries may not represent actual experiences and exposure to gentrification. Administrative boundaries do not correspond to residents’ experiences of their neighborhoods, and residential location may not correspond with where people spend most of their time. Future studies should shed light on whether associations with health are sensitive to the use of different gentrification indicators, neighborhood defini- tions, and different time periods, balancing the need to produce results that are both valid and generalizable. In addition to using secondary data to estimate levels of gentrification by neighborhood quan- titatively, researchers have begun to develop and validate survey questions to measure subjective gentrification, which they estimate may be more strongly associated with health outcomes than are objective measures because the former express the actual experiences and perceptions of residents (44, 62). Although these indicators can detect differences in perceptions and experiences within neighborhoods, collecting such data requires substantial resources and time from researchers, and thus they are less likely to allow researchers to collect representative data across multiple neighborhoods or cities. Moreover, so far, these questions have been validated only in isolated neighborhoods or cities. Looking forward, researchers should work toward refining subjective gentrification indicators and testing their validity across diverse settings. Future research can also compare how such indicators may reveal associations between gentrification and health (equity) that are different from or similar to those measured in past studies using indexes created using secondary data. Evaluating the Health Effects of Different Types of Gentrification As discussed above, gentrification research to date highlights the many drivers and respective types of gentrification. So far, few studies have conceptualized the type of gentrification—real estate, commercial, tourism, student, green—present when studying its health effects (for exceptions, see 32, 37, 94), despite that different types of gentrification may indicate different impacts on health and different pathways between gentrification and health (37). Thus, in cases where a specific driver or type of gentrification is identified, in designing a study to evaluate the health effects 200 Cole et al. of these processes, the specific type of gentrification should be considered, thus matching the narrative and trajectory of neighborhood changes occurring in the area studied. For instance, in some cases, rather than considering gentrification a primary exposure, it might be more relevant to consider gentrification a moderating or mediating factor and plan analyses ac- cordingly (33). Thus, if the hypothesized pathway includes a driver of gentrification (such as mass tourism, green space or climate mitigation infrastructure development, or a commercial landscape that provides health-promoting resources such as healthy foods but caters to a middle- or upper- class population rather than long-term residents), perhaps the question worth asking is whether the gentrification process resulting from these changes has changed who or how residents benefit from these driving changes and less so how gentrification directly affects health. Because gentrification has been shown to lead to social exclusion (63) and often to lead to Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. actual or threatened physical displacement (47, 48, 89, 93) affecting long-term, lower-income, and/or racialized minority residents, it is important to understand how exclusion resulting from Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org gentrification may affect residents’ access to important neighborhood resources (such as green and open space, healthy food, affordable health care, and others). Research designs must reflect this understanding but also ensure that the corresponding exposures are included in quantitative or qualitative analysis. Doing so may then reflect the intended impact of the study: to advance general knowledge and/or to have an impact on policy or inform the development of interventions and to determine what new knowledge or information could contribute most to debates around the effects of gentrification. Towards an Interdisciplinary Approach Emerging literature relating to the health effects of gentrification generally takes a public health approach, using epidemiological study designs and analytical methods to test whether living in a gentrifying neighborhood may affect one’s health. As such, some investigators have argued for the need for a more standardized quantitative measure of gentrification itself (see above) in order to increase the generalizability of findings across cities using such methods. At the same time, others advocate for a more context-dependent definition and measurement of gentrification, which would allow for a more valid and fine-tuned analysis of a specific gentrification dynamic being studied, despite potentially decreasing generalizability (33). Methods used to understand gentrification from a more nuanced approach include surveys, interviews, observation, participatory methods such as photovoice or photo walks, as well as more ethnographic methods. Here we argue that both approaches are valid and should be recognized and used for their intrinsic value rather than delegitimized by either scholarly tradition. More recently, several authors have pointed to the potential pathways by which gentrification may affect health (6, 13, 109). These analyses have relied on a more interdisciplinary approach, including geography, sociology, and planning, that concerns the potential drivers and consequences of gentrification, which may in turn lead to better or worse health outcomes or to exacerbated health inequities. Moving forward in our understanding of how gentrification impacts health, we must consider not just the rigor of the methods we use but also the appropriateness of the types of questions we ask. Here deductive reasoning—or the determination that if the premises argued are true then the conclusion is also true (29)—is often preferred in biomedical and public health research (for good reason, when research concerns analysis of physiological outcomes or exposures and when the goal of a study is to determine the cause or effect of an exposure or an intervention, with potentially deadly or life-saving implications). Despite that this logic predominates in medical and public health research, it may not be how many people process and understand public health information (41). On the other hand, inductive reasoning is employed in many social sciences, such as those disciplines that have pioneered the development, theorization, and conceptualization of www.annualreviews.org • Health Equity and Gentrification 201 complex urban social processes such as gentrification. This approach uses the synthesis of a set of observations to develop a general principle or theory, therefore allowing for less certainty, but more nuances and a finer understanding of processes and impacts, than the deductive approach (29). By extension, repeatedly asking whether gentrification affects health is potentially not helpful in the overall public health goal of achieving better and more equitable health outcomes for all. Based on what we know about gentrification from a legacy of sociological, urban geography, and urban planning scholars, we might instead ask, Whom does gentrification benefit, or harm, and how? Asking this question requires that we embrace a more inductive approach to asking questions rather than relying on deductive approaches, which lead to results that are sound but may not be useful for developing policies or programs that attempt to reduce the negative effects of gentrifi- Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. cation on health or health equity. As discussed above, the complexities of gentrification processes have so far led to mixed quantitative epidemiological results regarding the health effects of these Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org processes, whereas qualitative work clearly identifies more complex and refined gentrification– health pathways and how social and cultural exclusion resulting from gentrification may change which or how different populations experience their neighborhood environments and changes to them. Thus, taking an interdisciplinary approach to posing questions, and answering them, may ultimately drive forward our ability to address complex social issues such as gentrification from a public health perspective. POLICY IMPLICATIONS Existing research highlights the potential of gentrification to contribute to the exacerbation of health inequities along various pathways. Thus, advancing and evaluating policy interventions that can ameliorate the effects of gentrification, or prevent gentrification from occurring in the first place, could help to improve health equity in neighborhoods and cities experiencing, or at risk for experiencing, gentrification. Preventing Gentrification Interventions addressing affordable housing and community development to prevent gentrifi- cation and displacement have focused largely on efforts that help with the preservation and production of affordable housing and the stabilization of neighborhoods (135). However, interven- tions that tackle the root causes of gentrification (including racial capitalism, the financialization of housing, economic and urban development policy that favors wealthy interests, and lack of po- litical power among low-income and racialized populations) are also needed (66). Here we provide examples of each of these types of efforts. The preservation and new construction of affordable and public housing in existing buildings in gentrified neighborhoods could help counteract displacement within a shorter time frame com- pared with housing production strategies (28). The feasibility of these interventions is often more within the reach and budget of municipalities. Interventions can include protection of unsubsi- dized affordable housing; housing rehabilitations; funding for public and social housing through tax levies, including development tax, transfer tax, tax on empty housing, and tax on tourism venues; and incentives such as density bonuses, inclusionary zoning, tax breaks, or improved fi- nancing conditions for the development of affordable homes (28, 95, 97). By identifying areas that have the potential to be gentrified, cities can either acquire vacant homes and rehabilitate them or provide resources, including funding to owners, to do so. Community land trusts, which offer collective ownership to ensure community stewardship of land, are a more extensive approach to preserving housing. Over time, community land trusts, as compared with conventional home 202 Cole et al. mortgages, help provide low- and middle-income owners with the opportunity to build equity and provide more protection against foreclosures (1, 32). However, much like other interventions, their success relies on various factors, including the combination of several measures, resources to manage them, arrangements for financing with owners, and the current housing market surrounding them (32). Nonetheless, they provide some protection against gentrification and promote the ability for low- and middle-income residents to remain in the neighborhood. The production of new affordable housing not only increases the supply but also could help moderate housing costs by making housing more affordable to more residents. However, research has also shown that new production at the market rate could increase rent across the area, making it unaffordable for low-income households to move in (28). This strategy also does not protect the interests of already housed residents who are threatened with displacement due to rising rents, Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. property taxes, home insurance prices (for low-income homeowners), and other costs of living. Therefore, a focus on the production and permanent protection of subsidized housing or hous- Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org ing intended for lower-income residents could promote income-diverse areas but provide only moderate protection against displacement among current residents. The production of protected housing can also help to house residents previously displaced by gentrification through a Right to Return program in their previous neighborhood (i.e., Portland). Programs aimed at stabilizing neighborhoods, which help ensure that tenants can stay in their gentrified neighborhoods, are considered more direct forms of antidisplacement policies than the production and preservation of housing. Such programs include rent control policies and initia- tives aimed at helping renters and owners at risk for eviction and foreclosure, respectively. Rent control policies that restrict the annual rent increases in certain buildings or areas are one of the more common interventions used in the United States and in many parts of Europe to stabilize rent (123). While these policies could help prevent displacement and stabilize neighborhoods, some studies have found that landlords can let these units deteriorate until tenants leave, allowing landlords to remove the unit so that it is no longer covered by rent control (45, 46). In some places, rent control or rent caps are put in place beyond the city limits, at the state or metropolitan level, such as in Oregon, United States, or Berlin, Germany, a strategy intended to prevent develop- ers from locating their investments right next to their original location. Tenant right-to-counsel programs provide access to legal representation for renters facing eviction, while rental assistance programs can help prevent evictions by providing low-income renters facing economic difficul- ties with emergency funds to pay rent. For low-income owners, foreclosure assistance programs can offer financial support, payment plans, or counseling during economic hardships. In other cities, such as Cleveland, Ohio, local nonprofits and legal groups such as the Legal Aid Society of Cleveland and the Housing Justice Alliance have developed an eviction aversion initiative, an ed- ucational methodology for teaching landlords and tenants in order to build new relations between these two collectives, improve housing security, and reduce displacement. Many examples of such policies and programs exist, but the effectiveness of these programs has rarely been evaluated owing largely to the complexities associated with data availability and the difficulties of measuring gentrification effects. Furthermore, most of the evidence from these evaluations has come from areas with a strong housing market such as San Francisco and New York, when the variability of the housing market between neighborhoods could play a significant role in the effectiveness of the program (18, 99, 100). However, combinations of these efforts can be effective against displacement. Such protections not only provide assistance to individuals, but also help reduce population turnover in neighborhoods, strategies that preserve stability and ultimately prevent cities from displacing low-wage workers needed for city function, including those working in essential professions such as retail, food and beverage services, construction, and building maintenance (106). www.annualreviews.org • Health Equity and Gentrification 203 Evaluating the Health Impacts of Gentrification and Displacement-Prevention Policies and Programs In addition to furthering research on how and when gentrification affects health, and design- ing interventions such as those described above that may either prevent gentrification and gentrification-related displacement or mitigate the social or health effects of gentrification pro- cesses, more research is also needed to evaluate the health impacts of these policies and programs. Along with seeking to understand whether such programs and policies work, evaluating their po- tential health benefits could be an important tool for advocacy and activism around the prevention of gentrification, in line with past strategies used by environmental justice activists more broadly (25, 26, 77, 116). Testing the potential health, or health equity, benefits of interventions meant to prevent or mitigate the effects of gentrification will require careful attention to both theo- Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. retical and methodological considerations. Researchers must decide which types of interventions Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org to study, weighing the usefulness of evaluating common, but not comprehensive, interventions, against more intensive, but harder-to-fund, interventions. For example, researchers might want to test the ways in which building slightly more affordable housing blunts the effects of gen- trification processes and therefore protects health so that they can show the importance of this standard housing production process. Researchers might want to study housing production vic- tories won in the context of building housing justice movements, through direct action to protest racialized wealth extraction through real estate, or through power shifting to community actors with the logic that effect sizes associated with a more comprehensive response to gentrification would likely be larger. Theoretical and content area expertise will also be required to determine which health out- comes would be most likely to respond to specific anti-gentrification interventions. For example, while largely quantitative papers show negligible or mixed associations between gentrification and health, qualitative data underscore the effects of gentrification in the form of stress, loss of control, damaged social cohesion, and other psychosocial outcomes. Evaluating interventions will require measuring health outcomes that are most affected by, or related to, the psychosocial processes described confidently in qualitative studies on gentrification and health. Methodologically, stud- ies evaluating antidisplacement interventions with respect to health outcomes will need to grapple with identifying locally appropriate, available, recent, and interpretable measures of gentrification. They will also need to establish both geographic and temporal boundaries that make sense for the study of an inherently ever-evolving process. Finally, they will need to account for the health status of residents displaced by gentrification during the sampling phase of the project. CONCLUSIONS Over the past 15 years, interest in and discussion on the consequences of gentrification have reached the public health community and the community at large. This interest can be seen in the rapid increase in public health publications on the health effects of gentrification and in the increased discussions of gentrification in social and mass media as well as in local policy fo- rums and municipal working groups. Despite methodological challenges, and mixed results from existing quantitative research, qualitative evidence to date points to the role of gentrification pro- cesses in exacerbating health inequities. To move public health research on this topic forward, we suggest taking an interdisciplinary approach, considering the conceptualization of gentrifi- cation in measurement techniques and conceiving this process as a direct exposure or as a part of broader neighborhood changes. Consideration should also be taken for the specific drivers of gentrification, in turn resulting in different types of gentrification and potentially different im- pacts on health or health equity. Finally, existing policy approaches to mitigating and preventing 204 Cole et al. gentrification should be evaluated for effectiveness and as public health promotion, and specifically as interventions to promote health equity. SUMMARY POINTS 1. Although results of research examining the relationship between gentrification and the health of the population at large are mixed, a growing collection of quantitative and qualitative research shows that exposure to gentrification may be particularly detrimental to the health of historically marginalized groups. 2. External validity of studies on the relationship between gentrification and health may be Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. improved by both (a) developing customized indicators to evaluate with high internal validity the associations between gentrification and health in specific cities, and (b) using Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org more general indicators that can be comparable across contexts. 3. Future studies should shed light on whether associations with health are sensitive to the use of different gentrification indicators and neighborhood definitions and whether associations vary over different time periods, balancing the need to produce results that are both valid and generalizable. 4. Researchers should work toward refining subjective gentrification indicators and testing their validity across diverse settings. Future research can also compare how such in- dicators may reveal different or similar associations between gentrification and health (equity) as compared to those measured in past studies using indexes created using secondary data. 5. Taking an interdisciplinary approach to posing questions, and answering them, may ul- timately drive forward our ability to address complex social issues such as gentrification from a public health perspective. DISCLOSURE STATEMENT The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. ACKNOWLEDGMENTS The authors received financial support from the following sources during the writing of this article: the UAB–Banco Santander TALENT Fellowship program (to H.V.S.C.) and the Unit of Excellence María de Maeztu Programme of the Spanish Ministry of Science and Innovation (CEX2019-000940-M) (to H.V.S.C., I.A., and M.T.-M.). LITERATURE CITED 1. 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In Handbook of Urban Geography, ed. T Schwanen, R van Kempen, pp. 63–75. Cheltenham, UK: Edward Elgar 135. Zuk M. 2020. Preventing gentrification-induced displacement in the U.S.: a review of the literature and a call for evaluation research. In The Routledge Handbook of Housing Policy and Planning, ed. KB Anacker, MT Nguyen, DP Varady, pp. 302–16. New York: Routledge. 1st ed. www.annualreviews.org • Health Equity and Gentrification 211 PU44_FrontMatter ARjats.cls February 14, 2023 10:28 Annual Review of Public Health Contents Volume 44, 2023 Epidemiology and Biostatistics Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. A Literature Review of the Effects of Air Pollution on COVID-19 Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org Health Outcomes Worldwide: Statistical Challenges and Data Visualization A. Bhaskar, J. Chandra, H. Hashemi, K. Butler, L. Bennett, Jacqueline Cellini, Danielle Braun, and Francesca Dominici p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 1 On-the-Go Adaptation of Implementation Approaches and Strategies in Health: Emerging Perspectives and Research Opportunities Elvin H. Geng, Aaloke Mody, and Byron J. Powell p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p21 Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research Marian L. Neuhouser, Ross L. Prentice, Lesley F. Tinker, and Johanna W. Lampe p p p p p p p p37 Innovations in Public Health Surveillance for Emerging Infections Peng Jia, Shiyong Liu, and Shujuan Yang p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p55 Cancers Attributable to Modifiable Risk Factors: A Road Map for Prevention Giulia Collatuzzo and Paolo Boffetta p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 279 Using Rapid Randomized Trials to Improve Health Care Systems Leora I. Horwitz and Holly A. Krelle p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 445 Social Environment and Behavior Early Childhood Education: Health, Equity, and Economics Robert A. Hahn and W. Steven Barnett p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p75 Environmental Justice: Where It Has Been, and Where It Might Be Going Merlin Chowkwanyun p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p93 Health Misinformation Exposure and Health Disparities: Observations and Opportunities Brian G. Southwell, Jessica Otero Machuca, Sabrina T. Cherry, Melissa Burnside, and Nadine J. Barrett p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 113 vii PU44_FrontMatter ARjats.cls February 14, 2023 10:28 Leveraging Mobile Technology for Public Health Promotion: A Multidisciplinary Perspective Jennifer L. Hicks, Melissa A. Boswell, Tim Althoff, Alia J. Crum, Joy P. Ku, James A. Landay, Paula M.L. Moya, Elizabeth L. Murnane, Michael P. Snyder, Abby C. King, and Scott L. Delp p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 131 When Moving Is the Only Option: The Role of Necessity Versus Choice for Understanding and Promoting Physical Activity in Low- and Middle-Income Countries Deborah Salvo, Alejandra Jáuregui, Deepti Adlakha, Olga L. Sarmiento, and Rodrigo S. Reis p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 151 Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Promoting Health Equity Through Preventing or Mitigating the Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org Effects of Gentrification: A Theoretical and Methodological Guide Helen V.S. Cole, Isabelle Anguelovski, Margarita Triguero-Mas, Roshanak Mehdipanah, and Mariana Arcaya p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 193 The Impacts of Paid Family and Medical Leave on Worker Health, Family Well-Being, and Employer Outcomes Ann Bartel, Maya Rossin-Slater, Christopher Ruhm, Meredith Slopen, and Jane Waldfogel p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 429 Environmental and Occupational Health A Literature Review of the Effects of Air Pollution on COVID-19 Health Outcomes Worldwide: Statistical Challenges and Data Visualization A. Bhaskar, J. Chandra, H. Hashemi, K. Butler, L. Bennett, Jacqueline Cellini, Danielle Braun, and Francesca Dominici p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 1 Environmental Justice: Where It Has Been, and Where It Might Be Going Merlin Chowkwanyun p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p93 Climatic and Environmental Change, Migration, and Health Celia McMichael p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 171 Promoting Health Equity Through Preventing or Mitigating the Effects of Gentrification: A Theoretical and Methodological Guide Helen V.S. Cole, Isabelle Anguelovski, Margarita Triguero-Mas, Roshanak Mehdipanah, and Mariana Arcaya p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 193 Public Health Implications of Drought in a Climate Change Context: A Critical Review Coral Salvador, Raquel Nieto, Sergio M. Vicente-Serrano, Ricardo García-Herrera, Luis Gimeno, and Ana M. Vicedo-Cabrera p p p p p p p p p p p p p p p p p 213 viii Contents PU44_FrontMatter ARjats.cls February 14, 2023 10:28 Review of the Impact of Housing Quality on Inequalities in Health and Well-Being Philippa Howden-Chapman, Julie Bennett, Richard Edwards, David Jacobs, Kim Nathan, and David Ormandy p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 233 Sustainable and Resilient Health Care in the Face of a Changing Climate Jodi D. Sherman, Andrea J. MacNeill, Paul D. Biddinger, Ozlem Ergun, Renee N. Salas, and Matthew J. Eckelman p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 255 Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Public Health Practice and Policy Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org On-the-Go Adaptation of Implementation Approaches and Strategies in Health: Emerging Perspectives and Research Opportunities Elvin H. Geng, Aaloke Mody, and Byron J. Powell p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p21 Innovations in Public Health Surveillance for Emerging Infections Peng Jia, Shiyong Liu, and Shujuan Yang p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p55 Leveraging Mobile Technology for Public Health Promotion: A Multidisciplinary Perspective Jennifer L. Hicks, Melissa A. Boswell, Tim Althoff, Alia J. Crum, Joy P. Ku, James A. Landay, Paula M.L. Moya, Elizabeth L. Murnane, Michael P. Snyder, Abby C. King, and Scott L. Delp p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 131 Public Health Implications of Drought in a Climate Change Context: A Critical Review Coral Salvador, Raquel Nieto, Sergio M. Vicente-Serrano, Ricardo García-Herrera, Luis Gimeno, and Ana M. Vicedo-Cabrera p p p p p p p p p p p p p p p p p 213 Cancers Attributable to Modifiable Risk Factors: A Road Map for Prevention Giulia Collatuzzo and Paolo Boffetta p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 279 Public Health Preparedness for Extreme Heat Events Jeremy J. Hess, Nicole A. Errett, Glenn McGregor, Tania Busch Isaksen, Zachary S. Wettstein, Stefan K. Wheat, and Kristie L. Ebi p p p p p p p p p p p p p p p p p p p p p p p p p p p p 301 The State of the US Public Health Workforce: Ongoing Challenges and Future Directions Jonathon P. Leider, Valerie A. Yeager, Chelsey Kirkland, Heather Krasna, Rachel Hare Bork, and Beth Resnick p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 323 The Value and Impacts of Academic Public Health Departments Paul C. Erwin, Julie H. Grubaugh, Stephanie Mazzucca-Ragan, and Ross C. Brownson p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 343 Contents ix PU44_FrontMatter ARjats.cls February 14, 2023 10:28 Community Health Worker Integration with and Effectiveness in Health Care and Public Health in the United States Molly Knowles, Aidan P. Crowley, Aditi Vasan, and Shreya Kangovi p p p p p p p p p p p p p p p p p p p p 363 Public Health and Prisons: Priorities in the Age of Mass Incarceration David H. Cloud, Ilana R. Garcia-Grossman, Andrea Armstrong, and Brie Williams p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 407 Health Services Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Sustainable and Resilient Health Care in the Face of a Changing Climate Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org Jodi D. Sherman, Andrea J. MacNeill, Paul D. Biddinger, Ozlem Ergun, Renee N. Salas, and Matthew J. Eckelman p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 255 Community Health Worker Integration with and Effectiveness in Health Care and Public Health in the United States Molly Knowles, Aidan P. Crowley, Aditi Vasan, and Shreya Kangovi p p p p p p p p p p p p p p p p p p p p 363 Multilevel Determinants of Digital Health Equity: A Literature Synthesis to Advance the Field Courtney R. Lyles, Oanh Kieu Nguyen, Elaine C. Khoong, Adrian Aguilera, and Urmimala Sarkar p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 383 Public Health and Prisons: Priorities in the Age of Mass Incarceration David H. Cloud, Ilana R. Garcia-Grossman, Andrea Armstrong, and Brie Williams p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 407 The Impacts of Paid Family and Medical Leave on Worker Health, Family Well-Being, and Employer Outcomes Ann Bartel, Maya Rossin-Slater, Christopher Ruhm, Meredith Slopen, and Jane Waldfogel p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 429 Using Rapid Randomized Trials to Improve Health Care Systems Leora I. Horwitz and Holly A. Krelle p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 445 Indexes Cumulative Index of Contributing Authors, Volumes 35–44 p p p p p p p p p p p p p p p p p p p p p p p p p p p 459 Cumulative Index of Article Titles, Volumes 35–44 p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p p 466 Errata An online log of corrections to Annual Review of Public Health articles may be found at http://www.annualreviews.org/errata/publhealth x Contents PU44_FrontMatter ARjats.cls February 14, 2023 10:28 Related Articles From the Annual Review of Animal Biosciences, Volume 11 (2023) Access provided by Universitat Autonoma de Barcelona on 04/18/23. See copyright for approved use. Animal Models, Zoonotic Reservoirs, and Cross-Species Transmission of Emerging Human-Infecting Coronaviruses Annu. Rev. Public Health 2023.44:193-211. Downloaded from www.annualreviews.org Yakhouba Kane, Gary Wong, and George F. 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