Healthy Neighborhoods Study

The Healthy Neighborhoods Study (HNS), based in Boston, is the largest resident-driven, participatory action research project in the US about neighborhood change processes, like gentrification and climate change, and their impact on health. 

We believe in the expertise of the residents most harshly impacted by gentrification and climate change and of the advocates who work to address these impacts. They are exactly the leaders we need to understand these injustices and develop solutions to correct them. 

We use research to fuel organizing and action for equitable development without displacement in Greater Boston. Through Participatory Action Research (PAR), residents, advocates, and planners work with academic researchers to turn their lived experiences, insights, and expertise into the data, facts, and information.

Project website

Rising home values and Covid-19 case rates in Massachusetts

We explore whether housing displacement pressure could help explain place-based disparities in Massachusetts COVID-19 prevalence. We use qualitative data from the Healthy Neighborhoods Study to illustrate how rising and unaffordable housing costs are experienced by residents in municipalities disproportionately affected by COVID-19. We then predict municipal-level COVID-19 case rates as a function of home value increases and housing cost burden prevalence among low-income households, controlling for previously identified community-level risk factors. We find that housing value increase predicts higher COVID-19 case rates, but that associations are ameliorated in areas with higher home values. Qualitative data highlight crowding, “doubling up,” homelessness, and employment responses as mechanisms that might link housing displacement pressure to COVID-19 prevalence.

‘It feels like money’s just flying out the window’: financial security, stress and health in gentrifying neighborhoods

The health consequences of gentrification are little-understood, and researchers have called for qualitative studies to uncover potential causal pathways between gentrification and health. Resident Researchers in a Participatory Action Research study of community health in nine gentrifying neighborhoods across the Boston area hypothesized that financial insecurity is one pathway through which gentrification might harm health. We analyze qualitative data from semi-structured interviews with 40 financially vulnerable respondents to understand how the experience of living in a gentrifying neighborhood produces feelings of financial insecurity, and how such feelings may be harmful to health. Results indicate that experiencing gentrification exacerbates respondents’ sense of exposure to financial risk, while simultaneously reducing the perceived efficacy of available buffers against financial risks. The threats to an individual’s financial security introduced by gentrification-related changes in the neighborhood environment are stressful because they are appraised as taxing and exceeding the coping resources available to individuals. This gentrification-related financial insecurity is a meso-level phenomenon, produced by interactions between respondents and the contexts in which they live, with uncertain and uneven outcomes. Based on our findings, we argue that feelings of financial insecurity are one pathway through which the experience of living in a gentrifying neighborhood shapes health.

The Moving Mapper: Participatory Action Research with Big Data

Big data promises new insights for planning but threatens to exclude community expertise from knowledge creation and decision-making processes. Participatory methods are needed to ensure that big data is marshaled to address problems of importance to communities, that hypotheses and interpretations are shaped by evidence from lived experience, and that results are ultimately useful to residents. In this study we used a participatory action research (PAR) framework to engage Boston (MA)–area residents in leveraging a longitudinal consumer credit database to understand shared planning challenges. We describe how residents, community organizations, and academic researchers collaborated to co-design an interactive map of residential moves across Massachusetts. The resulting estimates were largely consistent with residents’ understandings of local moving patterns, providing a case of big data analysis confirming, and further specifying, phenomena identified through centering lived experience. Collaborative data analysis also generated new insights; for example, showing misalignment between regional planning boundaries and low-credit movers’ moving patterns. This work shows how sustained PAR partnerships can combine the strengths of community expertise and big data analyses to inform planning.

Community change and resident needs: Designing a Participatory Action Research study in Metropolitan Boston

The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.

Making the City Livable: Caregiving and Health in Gentrifying Boston

How does the urban environment shape everyday caregiving practices? How does care mediate the relationship between cities and health? What are the planning ingredients of urban environments that support caregivers and viable caring relations? I answer these questions by analyzing data from interviews with caregivers conducted as part of the Healthy Neighborhoods Study, a longitudinal Participatory Action Research project exploring the relationship between gentrification and community health in nine Boston-area neighborhoods. First, I find that the strategies respondents employ to fulfill caregiving goals are shaped by the availability and adequacy of specific components of the urban environment, which I argue comprise the urban infrastructure of care. However, this infrastructure may be unavailable, inaccessible, inadequate, or poorly connected. Caregivers compensate for these shortcomings by securing, connecting and maintaining the components of the urban infrastructure of care to ensure satisfactory background conditions for caregiving. By shaping the extent and nature of this “infrastructural labor,” cities influence what forms of care are possible and what the work of care demands from caregivers. Second, comparing caregivers’ experiences at different stages of gentrification, I find significant differences in their perceptions of changes in local urban infrastructures of care, and in what the work of care entails. I argue that gentrification produces “care insecurity” for respondents: diminished confidence in the ability to provide satisfactory care in the future and to adapt to neighborhood changes that impact caregiving. Finally, I explore the hypothesis that changes in the urban infrastructure of care could produce caregiver stress, and that stress might thus be a pathway through which the relationship between caregiving and the urban environment becomes embodied by caregivers. I find that the challenges of performing infrastructural labor necessary to care can be physically, mentally and emotionally depleting for caregivers with negative consequences for their health and wellbeing. I conclude by proposing a framework for “planning for care” focused on the intertwined priorities of alleviating and equitably distributing the burden of care work, proliferating the possible forms that care can take, and maximizing people’s freedoms to give and receive care in ways that they value.

Ownership of change: Participatory development of a novel latent construct for neighborhoods and health equity research

Processes of neighborhood change are important determinants of health. One salient dimension of the experience of neighborhood changes is a person's evolving sense of empowerment over the changes around them, such as development of new housing or shifts in economic opportunity. Community residents collaborating on a Participatory Action Research study developed the novel construct “ownership of change” to capture this psychosocial process, and hypothesized that it may help explain the relationship between neighborhood change and health. In this paper, we describe our participatory process for developing a way to measure ownership of change, explore the construct's validity, test the hypothesis that it is associated with health, and analyze qualitative data to understand the process through which one's sense of ownership of change is produced. We argue that the construct is useful for studying the role of neighborhood changes in shaping health, and that building ownership over neighborhood change must be a key dimension of urban planning and policy for health equity.