Title: advancing urban health equity in the United States in an age of health care gentrification: a framework and research agenda

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• dc.contributor.author Cole, Helen
• dc.contributor.author Franzosa, Emily
• dc.date.accessioned 2022-11-08T07:34:34Z
• dc.date.available 2022-11-08T07:34:34Z
• dc.date.issued 2022
• dc.description.abstract Background: access to health care has traditionally been conceptualized as a function of patient socio-demographic characteristics (i.e., age, race/ethnicity, education, health insurance status, etc.) and/or the system itself (i.e., payment structures, facility locations, etc.). However, these frameworks typically do not take into account the broader, dynamic context in which individuals live and in which health care systems function. Purpose: the growth in market-driven health care in the U.S. alongside policies aimed at improving health care delivery and quality have spurred health system mergers and consolidations, a shift toward outpatient care, an increase in for-profit care, and the closure of less profitable facilities. These shifts in the type, location and delivery of health care services may provide increased access for some urban residents while excluding others, a phenomenon we term "health care gentrification." In this commentary, we frame access to health care in the United States in the context of neighborhood gentrification and a concurrent process of changes to the health care system itself. Conclusions: we describe the concept of health care gentrification, and the complex ways in which both neighborhood gentrification and health care gentrification may lead to inequitable access to health care. We then present a framework for understanding health care gentrification as a function of dynamic and multi-level systems, and propose ways to build on existing models of health care access and social determinants of health to more effectively measure and address this phenomenon. Finally, we describe potential strategies applied researchers might investigate that could prevent or remediate the effects of health care gentrification in the United States.
• dc.description.sponsorship Helen Cole received funding as Juan de la Cierva Incorporation Fellow from the Spanish Ministry of Economy and Competitiveness (IJC-2018- 035322-I) and from the European Research Council under grant agreement No. 678034 (PI: Isabelle Anguelovski).
• dc.format.mimetype application/pdf
• dc.identifier.citation Cole HVS, Franzosa E. Title: advancing urban health equity in the United States in an age of health care gentrification: a framework and research agenda. Int J Equity Health. 2022 May 11; 21(1): 66. DOI: 10.1186/s12939-022-01669-6
• dc.identifier.doi http://dx.doi.org/10.1186/s12939-022-01669-6
• dc.identifier.issn 1475-9276
• dc.identifier.uri http://hdl.handle.net/10230/54750
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/678034
• dc.rights Copyright © The Author(s) 2022. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Gentrification
• dc.subject.keyword Health care access
• dc.subject.keyword Health equity
• dc.subject.keyword Urban health
• dc.title Title: advancing urban health equity in the United States in an age of health care gentrification: a framework and research agenda
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion