Do we really understand the impact of gentrification? The term was first used in the 1950s by sociologist Ruth Glass to describe the regeneration of post-war Bethnal Green in east London – today, gentrification can be found in the regeneration of poor neighbourhoods by middle-class families and businesses moving into the cheaper, traditionally working-class areas of the city. The inner city is made available to the young, the educated and the creative at the expense of those who had called it home.
Some commentators note that gentrification might be a good thing: a process that improves a neighbourhood over time. For others, it’s a natural process that happens as cities evolve. But more critical observers point out that displacement causes problems for health and community cohesion as existing neighbours are forced out, dispersed across a large area, often into places with worse conditions, poorer housing, bad transport links and massive demands on an already straining health service.
A report by the Centre for London, Inside out: the new geography of wealth and poverty in London, outlines how poverty rates have fallen since 2001 in many inner London neighbourhoods, such as Hackney, Haringey and Newham. The suburbs in England’s capital, meanwhile, are becoming increasingly impoverished and disconnected from the rest of the city.
However, the impact of gentrification on inner-city communities is not as straightforward as it sounds. Most studies have concentrated on the process of displacement and health specialists have long been aware of the dangers of this regime of expulsion. But, as recent reports indicate, displacement is not always as fast as we have assumed – and often overlooked is the fate of the vulnerable who remain, or are left behind.
Paris heatwave
Take, for example, the heatwave of August 2003, one of the hottest on record for Europe, which caused the 14,800 deaths in France. In particular the heat affected the very old and infirm, especially in Paris.
As well as age, there were other unexpected parallels between many of those that died. Many lived alone and during summertime – when most families are away for the holidays – without help. They also lived in buildings that had been built before 1975, often inhabiting small flats in the upper floors of the building. In this case, gentrification did not drive the old and infirm out, but up, into the poorly insulated garrets and worst grades of housing where there was no one to look out for them.
While studies often chart the impact of gentrification on health in a borough or neighbourhood, the process itself often happens street by street. This creates unequal places on a very intimate level, where huge disparities can be felt just walking down the road. The social and economic gaps between new neighbours are palpable, as privately owning “haves” crowd into the spaces of predominantly renting “have-nots”. Rents are raised, while landlords look for ways to push out those who cannot afford the new rates. This has long-term consequences for the future health of a city, creating places that reduce opportunities and promote exclusion. It demands an urgent rethink of health, education and housing services, especially in an era of increasing austerity.
TB in London
One of the most dramatic examples of the inequality created by gentrification on a very local level can be found in the re-emergence of tuberculosis in cities. The most recent UK government report (pdf) on combatting the disease found fewer instances of TB over the past three years, following a peak in 2012 – partly due to better screening of non-UK born patients as they enter the country. However, the rates of TB among UK born patients has remained steady.
As the report notes: “TB continues to disproportionately affect the most vulnerable people in society, and the most vulnerable patients with TB continue to have the poorest outcomes … This highlights the crucial importance of tackling TB in the most under-served populations through systematic joined-up care between health and social services, the third sector, public health and housing.”
What’s particularly striking is that the highest density of TB victims are found in many of the more rapidly gentrifying neighbourhoods of UK cities, such as Hackney. Housing is key; the TB team at Homerton University Hospital notes: “Although Hackney has undergone rapid gentrification recently, there are still significant numbers of people living in deprivation and poverty, and the borough still acts as a magnet to migrants both legal and undocumented, many of whom join hard to reach, socially excluded groups.” The team is to be lauded for its efforts to find housing for TB patients, but it is likely to become increasingly difficult.
When we look at the effects of gentrification on health and wellbeing, we might be searching in the wrong place, or missing vital symptoms because we are not expecting them. The battle against poverty and inequality is being played out on urban streets. Gentrification creates poverty not only through displacement but also on our doorsteps, hiding poverty as it appears to regenerate a neighbourhood. But the poor and vulnerable do not disappear.
Leo Hollis is the author of Cities Are Good For You: The Genius of the Metropolis
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