Urban gentrification and infectious diseases: an interdisciplinary narrative review.

Abstract

Urban gentrification, the transformation of neighbourhoods by influx of new residential groups, leading to displacement of lowerincome communities, is a complex, multifaceted process with significant but generally unexplored public health implications. This study focused on the impact of this process on infectious disease dynamics investigating key factors such as sociodemographic disparities, economic conditions, housing and urban environmental changes. A systemic literature research was performed based on the search terms: gentrification and infectious disease in PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar, with additional references identified using the snowballing method. After screening the resulting 542 articles, 14 studies were selected based on relevance, with data were extracted through a consensusdriven process. This review identified the complex challenges posed by gentrification in the context of infectious disease dynamics and burdens providing valuable insights both to academic discourse and public health policy discussions. Gentrification may contribute to higher infection rates within specific urban neighbourhoods or among certain residents. For blood-borne and Sexually Transmitted Infections (STIs), gentrification leads to reduced access to essential healthcare services, including HIV and STI testing, particularly among marginalised populations, such as female sex workers and LGBTQ+ communities. For airborne diseases, gentrification can exacerbate health inequalities by increasing residential overcrowding and displacement from gentrified areas to more disadvantaged suburbs. Housing and urban planning associated with changes in the urban environment are primarily linked with vector-borne diseases, tick-borne diseases in particular, among displaced populations. We advocate the use of spatial epidemiology to examine the potential impact of gentrification on the risk for infectious diseases. Since many gentrification metrics are area-specific, mapping and visualising key indicator data can pre-emptively support practical decision-making. This approach also helps capture the complex dynamics of displacement and the within-place changes experienced by populations affected by gentrification, which might affect infectious disease dynamics. Finally, we outline key research priorities to bridge existing knowledge gaps in future multidisciplinary research on infectious diseases and gentrification.