Neighborhood redevelopment, which transforms low-income neighborhoods 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 advantages may not extend to all area residents. More information is needed about the impact of redevelopment, also known as urban renewal, on health, particularly if it contributes to inequities among middle-aged and older adults. 

Researchers led by Earle Chambers, Ph.D., M.P.H., at Albert Einstein College of Medicine and Montefiore Health System, have received a four-year, $2.9 million grant from the National Institutes of Health (NIH) to study how neighborhood 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 redevelopment projects.

“Neighborhood 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 epidemiology & population health and of psychiatry and behavioral 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,” he added.

The Heart of the Matter 
The study will focus on CVD, which accounts for 1 in 4 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 be affected by nonmedical factors such as economic and housing stability, education level, neighborhood 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 nonmedical risk factors on CVD health to better understand how redevelopment affects cardiovascular 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 CVD 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 neighborhoods: the Jerome Avenue area, which is undergoing redevelopment, and the Southern Boulevard area, which is not. Plans for Jerome Avenue include adding more than 4,000 housing units, rezoning areas to increase retail businesses, establishing new schools, and upgrading public parks.

Walking Tours and Computer Modeling 
The team will also conduct walking tours on which they will meet with and survey 300 Jerome Avenue residents to better understand how their neighborhood’s ongoing redevelopment 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 prioritize heart-healthy behaviors,” said Dr. Chambers.

The redevelopment study will also use computer simulation modeling to predict the long-term effects of redevelopment on CVD-related outcomes and inform future redevelopment strategies.  

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

The grant, titled “Bronx Neighborhood Redevelopment and CVD in mid-life and older adults,” is funded by the National Heart, Lung, and Blood Institute, part of the NIH (1R01HL166318).

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