Neighbourhood redevelopment, which transforms low-income neighbourhoods through rezoning, new construction, and renovation, can lead to health benefits, such as greater access to fresh produce, improved housing, and more green spaces.

But these benefits may not extend to all area residents. Consequently, more information is needed on the impact of urban renewal on health, particularly if it contributes to inequities among middle-aged and older adults.

Researchers led by Earle Chambers, PhD, MPH, at New York-based Albert Einstein College of Medicine and Montefiore Health System, have received a four-year, $2.9 million grant from the National Institutes of Health to study how neighbourhood redevelopment affects cardiovascular disease (CVD) among older Black and Hispanic residents in the Bronx, home to the country’s poorest urban congressional district and numerous renewal projects.

“Neighbourhood redevelopment is a powerful tool to transform an area, but we need to learn how it affects human health, for good or ill,” said Dr Chambers, professor and director of research in the department of family and social medicine, and professor of both epidemiology and population health and of psychiatry and behavioural sciences. “Montefiore Einstein is uniquely positioned to track health outcomes associated with redevelopment because so many residents of the Bronx – a focus of redevelopment activity – receive care here, allowing us to zero in on health changes to our population.” 

The study will focus on cardiovascular disease, which accounts for one in four deaths in the United States and is the country’s leading cause of mortality. Well-known risk factors for CVD, such as hypertension and diabetes, typically emerge in middle age – the time of life when health inequities associated with the disease widen. CVD risk can also be affected by social determinants of health, such as economic and housing stability, education level, neighbourhood features, and social experiences – all of which can be influenced by redevelopment efforts.

The research team – which includes collaborators at Icahn School of Medicine at Mount Sinai, Columbia University’s Mailman School of Public Health, and the City University of New York Graduate School of Public Health & Health Policy – will use several approaches to measure the impact of both medical and non-medical risk factors on cardiovascular disease health to better understand how redevelopment affects heart health over time.

With access to de-identified electronic medical records of more than 15,000 Bronx residents, the researchers will compare the prevalence of cardiovascular disease events, such as heart attacks and strokes, and CVD risk factors, such as hypertension, among cohorts of mid-life and older residents of two Bronx neighbourhoods: one that is undergoing redevelopment, and another that is not. Plans for the former include adding more than 4000 housing units, rezoning areas to increase retail businesses, establishing new schools, and upgrading public parks.

Walking tours and computer modelling

The team will also conduct walking tours, on which they will meet and survey 300 residents from the neighbourhood undergoing redevelopment, to better understand how this activity has personally affected them and their access to healthful resources. The survey will include questions about food intake and physical activity, as well as on social needs, such as residents’ housing status and economic stability.

“The combination of resources and how people perceive access to them likely contribute to their overall health and how they prioritise heart-healthy behaviours,” said Dr Chambers.

The redevelopment study will also use computer simulation modelling to predict the long-term effects of redevelopment on cardiovascular disease-related outcomes and inform future urban renewal strategies. 

“Our study will help show whether or not redevelopment efforts are moving communities forward,” said Dr Chambers. “When neighbourhoods undergo redevelopment, we must be sure to honour the people who are already living in those communities and ensure everyone benefits.” 

The grant is funded by the National Heart, Lung, and Blood Institute.