UCLA

Even before the COVID-19 pandemic, the emergence of a housing affordability crisis in the United States threatened a growing number of families with displacement from their homes and communities, with minoritized and low-income families at highest risk. Vulnerable individuals may also experience a sense of displacement pressure even without moving, if circumstances in their neighborhood contribute to social and cultural conflict and exclusion. Relatively little is known about how residential displacement and displacement pressure affect health at the population scale.

This dissertation explores the health implications of displacement and displacement pressure from the lens of unaffordable housing and gentrification. The first study analyzed population health survey data to show that moving in search of less expensive housing was associated with worse self-rated general health, greater psychological distress, less walking for leisure, fewer preventive visits, and more emergency department visits among California renters, relative to not having moved. The second study leveraged longitudinal data from a large, integrated health care system to assess relationships between gentrification and hypertension and diabetes control. Findings suggested that gentrification may support—or at least not harm—cardiometabolic health for some residents, but inconsistent associations across population subgroups emphasized the need to ensure that neighborhood development does not exacerbate health disparities. The third study systematically reviewed health associations of interventions to improve housing affordability and stability, finding moderate-certainty evidence that eviction moratoriums were associated with reduced COVID-19 cases and deaths, but certainty of evidence was low for health associations of most included interventions.

Taken together, results suggest that while displacement due to unaffordable housing is tightly linked to poor health, gentrification may have health benefits that outweigh the harms of displacement and displacement pressure for some residents, and interventions to promote housing affordability and stability may be necessary but not sufficient to support improved health. Better understanding how housing and neighborhood supports and stressors originate from urban planning and social policies and go on to impact population health and well-being can help inform more effective policies to improve equity in both housing and health.