Food Access and Chronic Disease Risk Among Original Residents of Gentrifying Neighborhoods in the United States

Introduction. Gentrification may affect cardiometabolic health, but most studies are limited by lack of longitudinal data. To accurately assess impacts on original residents of gentrifying neighborhoods, it is necessary to follow individuals who remain in their neighborhoods (stayers) and those who leave (movers). Methods. Gentrification measures derived from the US census and retail measures derived from the National Establishment Time Series were linked to the National Longitudinal Study of Adolescent to Adult Health. Study 1 assessed longitudinal associations between gentrification and the proportion of food retailers generally providing healthy food. Study 2 assessed cross-sectional associations between gentrification and cardiometabolic risk factors (metabolic syndrome and its components, food and housing insecurity, stress, racial discrimination). Both studies focused on residents of census tracts eligible for gentrification who grew up in below-median income households, examined two time periods (Wave 3 to 4 [N=3,397], Wave 4 to 5 [N=2,836]), and assessed moderation by self-reported race/ethnicity. Results. In Study 1, among stayers, gentrification from Wave 3 to 4 was associated with a lower share of healthy food retailers in the overall sample and among White participants; there were no associations for movers. Gentrification from Wave 4 to 5 was associated with a higher share of healthy retailers for Black stayers, but not other stayers, and a lower share of healthy retailers for Hispanic/Latino movers, but not other movers. In Study 2, among stayers, gentrification from Wave 3 to 4 was associated with lower food insecurity and fast food consumption in the overall sample. These beneficial associations were driven by White participants; meanwhile, there were harmful associations between gentrification and risk factors for Black stayers (racial discrimination) and movers (central obesity) and Hispanic/Latino stayers (low HDL-cholesterol) and movers (hypertension). Gentrification from Wave 4 to 5 was associated with higher odds of central obesity in the overall sample for stayers, but there were beneficial associations between gentrification and risk factors for Black movers (central obesity) and Hispanic/Latino movers (hypertension). Conclusions. Gentrification is not consistently harmful or beneficial for cardiometabolic health of original residents. Policymakers should not assume gentrification improves food environments or chronic disease risk.