Primary Submission Category: Health care/services
Social and geographic displacement in Miami-Dade: Impact on mental health and health disparities in HIV positive patients
Authors: Felicia Casanova Jordan Baeker Bispo
Presenting Author: Zinzi Bailey*
Background: Miami-Dade County (MDC) in Florida has the highest rate of new HIV cases in the United States. Deep racial/ethnic inequities in HIV/AIDS outcomes persist. Because of overarching structural racism in the form of residential segregation, HIV/AIDS inequities are spatially patterned across neighborhoods. Gentrification and displacement in historically segregated neighborhoods might impede local efforts to address the needs of people living with HIV/AIDS (PLWH).
Objectives: To investigate the relationship between displacement from gentrifying neighborhoods and patterns in healthcare utilization & disease progression among PLWH.
Methods: The study includes a convergence mixed method approach using: (1) HIV and mental health-related community key informant semi-structured interviews of two Black communities experiencing gentrification in MDC; (2) a quantitative analysis of electronic health records from federally qualified health centers and gentrification trajectories for MDC neighborhoods using negative binomial regression; and (3) Town Hall-style meetings of community advisors.
Results: Key informants reported that the COVID-19 pandemic has exacerbated gentrification in already gentrifying neighborhood and weakened ties between local HIV outreach personnel and patients. Classification of neighborhood gentrification may have different health-impacting effects based on the dimensions of gentrification at play.
Conclusions: Investigating the impact of gentrification on HIV care requires conceptualizing and measuring these phenomena in a valid and rigorous manner – both quantitatively and qualitatively. Gentrification can be measured in a range of ways that may capture potential mechanisms between gentrification and health outcomes. Continued work will assess the relationships between census tract-level gentrification categories and patient-level health care utilization patterns at federally qualified health centers in MDC.