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International Journal for Equity in Health

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Open Access 01-12-2022 | Care | Commentary

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

Authors: Helen V. S. Cole, Emily Franzosa

Published in: International Journal for Equity in Health | Issue 1/2022

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.

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Title: Advancing urban health equity in the United States in an age of health care gentrification: a framework and research agenda
Authors: Helen V. S. Cole
Emily Franzosa
Publication date: 01-12-2022
Publisher: BioMed Central
Keyword: Care
Published in: International Journal for Equity in Health / Issue 1/2022
Electronic ISSN: 1475-9276
DOI: https://doi.org/10.1186/s12939-022-01669-6

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Purpose

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purpose

Conclusions

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