Can Neighborhood Eviction Filings Explain the Impact of Gentrification on Preterm Birth Among Black Birthing People in the San Francisco Bay Area? A Multi-Level Mediation Analysis

Neighborhood inequality contributes to the persistent racial disparity in preterm birth in the United States. Gentrification has received increasing attention in public health literature as a neighborhood change process rooted in inequality. However, current research in this area has produced mixed results. One study found that living in gentrifying neighborhoods increases the risk of preterm birth for Black women. However, another found a protective effect. The purpose of this study was to reconcile these findings by using a robust measure of gentrification and exploring the mediating role of displacement in the relationship. The study used multilevel logistic regression to examine the association between gentrification and preterm birth and mediation analysis to assess the role of neighborhood-level eviction filing rates. The results suggest that residing in low-income neighborhoods with advanced gentrification is associated with lower odds of preterm birth compared to neighborhoods at risk of gentrification. This relationship is mediated by eviction filing rates. The study concludes that neighborhoods undergoing advanced gentrification are "healthier" for Black infants in part because of increased direct displacement in neighborhoods at risk of gentrification.