As Covid-19 spread across Massachusetts in March, the hardest-hit communities weren’t necessarily those with the highest poverty rates or densest housing. Many did, however, have one thing in common: they were selected years ago as sites for the Healthy Neighborhoods Study, a project examining the link between housing and health. Since 2015, Mariana Arcaya MCP ’08, associate professor of urban planning and public health and associate head of the Department of Urban Studies and Planning (DUSP) at MIT, has been leading the study with Vedette Gavin at the Conservation Law Foundation and with community-based organizations.

Arcaya and her fellow researchers set out to understand the health implications of rapid neighborhood change, identifying six municipalities and three Boston neighborhoods that were facing real estate development pressure that community members and the researchers feared could damage health. “In rapidly gentrifying areas, economically and socially vulnerable families have set up their lives in places that until recently were affordable,” says Arcaya. “Now, all of a sudden, they’re not affordable.” Study participants have reported that the changes in their neighborhoods, including increasingly unaffordable housing, have caused financial stress and overcrowding, factors that can increase susceptibility to a viral pandemic.

Of the six municipalities being studied, four turned out to be among the five communities hardest hit by Covid-19 in Massachusetts this summer. Arcaya points out that high housing costs can spur poorer residents in gentrifying areas to double up or rent out rooms in their homes. These same residents typically can’t afford to stockpile groceries to shelter in place, and many had to continue working, often in service jobs, increasing their risk of Covid-19 infection.

“Social distancing is a privilege,” says Arcaya, who with her team wrote an open letter in March urging public officials to factor community stressors into their pandemic response. “Covid has made obvious to everyone what communities have been saying for years—that insecure and unaffordable housing, jobs that don’t pay enough to make ends meet, and a lack of paid sick leave and other social protections are public health problems.”

The Healthy Neighborhoods Study’s “participatory action research” approach is still relatively uncommon in academia: researchers work with community-based organizations, which then recruit residents to codesign survey questions, collect data within their own communities, and analyze and interpret results collaboratively. That approach is slower than typical academic research, but it has led to new insights, Arcaya says.

“When trying to understand displacement risk related to gentrification, for example, we listen to the precise words people use, and they are saying, ‘People are being pushed out,’” Arcaya says. Such resident reports led her and her colleagues to request consumer credit data from the Federal Reserve; analysis of that data by DUSP doctoral student Madeleine Daepp, recipient of a DUSP graduate student fellowship, revealed patterns of migration out of Boston for residents of the study communities.

“Participatory action research gives us a different perspective on Covid-19 centered on understanding what creates unequal types of risk, for whom, and what can be done about it,” explains Arcaya. By investigating these topics, Arcaya and her team hope to broaden the conversation about what factors put communities at risk for health consequences, particularly in urban environments. “We need to listen to communities when they say the pressures they are under are unhealthy and unsafe. Covid is making clear that secure, affordable housing for everyone should be a public health priority.”

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