Urban Revitalization and Long-Term Effects on Diet, Economic, and Health Outcomes

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Project Summary Food insecurity—a lack of consistent access to enough food for an active, healthy life—is a fundamental social determinant of health linked to poor nutrition, obesity, and chronic disease. During the initial months of the COVID-19 pandemic, existing racial inequities in food insecurity were exacerbated. Compared to an estimated increase of 60% in the U.S. general population, food insecurity increased nearly 80% among residents of two low-income African American food desert neighborhoods in Pittsburgh, Pennsylvania. Other data from our cohort as well as other studies suggests there were also substantial upticks in financial instability and mental health challenges as the pandemic and policy responses to it unfolded. We propose these three factors may be part of a syndemic (synergy of epidemics), i.e., that food insecurity, financial instability and mental distress may share similar causal roots, that they also influence one another, and that this process is exacerbated by disadvantage. Few scientific studies have longitudinal data with which to examine these factors. Our longitudinal cohort of low-income African Americans allows an opportunity to examine the health and economic impact of the pandemic. We propose analyses of our Pittsburgh Research on Neighborhood Change and Health (PHRESH) cohort data collected during three periods, including before and during the COVID-19 pandemic, to test these ideas. Specifically, our aims are to: (1) Examine the effects of the COVID-19 containment and mitigation efforts (shut downs, stay at home orders, school closings) on food security, financial stability, and mental health from pre-pandemic (2018) to its early months (Spring 2020), to more than one year following the U.S. outbreak (through mid-year 2021), testing for trends in these outcomes and how these trends are associated with one another. In addition, we will (2) test the extent to which pre-existing (2018) individual-level perceived (e.g., self-reported discrimination, low social status) and structural (neighborhood investments, improved socioeconomic conditions, walkability) inequities moderated pandemic impacts, buffering or exacerbating its influence on residents’ food security, financial stability and mental health.