Charles Branas answers your questions about Changing Places for Health and Safety

Home/Charles Branas answers your questions about Changing Places for Health and Safety

Dr. Charles Branas, PhD, was the PAPREN Grand Rounds speaker in February 2021. He reviewed his work with collaborators on "in situ" place-based change ...

GENTRIFICATION

What happens to the abandoned houses after they are cleaned up? If they are sold, how do you ensure that they are sold at a fair price that doesn’t “gentrify” the neighborhood?

Branas: After they’re cleaned up, many of the abandoned houses and abandoned buildings remain as such for years. In cities where the abandoned buildings or houses are largely publicly owned by the city itself, these get sold at auction to new developers or homeowners who want to further improve on the house or building to make it more livable. These are nearly always auctions at affordable prices for communities and occur through affordable housing associations. The municipalities themselves thus often have controls on the affordability of the abandoned buildings that are cleaned and fixed, and they make arrangements to see that they’re sold at a fair, affordable price.

Can you discuss a bit more about how gentrification is assessed in these studies?

Branas: We assess issues of gentrification by looking at metrics that can help understand this very broad topic in the context of our work. To be fair, gentrification means different things to different people and is often difficult to measure. We have done this a few ways, by looking at what happens to the properties themselves as well as the neighborhoods over time.

For the vacant lots, the vast majority remain in their original, treated condition, as basic public amenities for local residents.

We have also looked at changes in property taxes before and after making changes like vacant lot greening and have found no increase in property taxes for homeowners in neighborhoods around newly greened/formerly vacant lots. The vast majority of spaces that get this sort of non-luxury greening do not, as far as we have measured or can detect, have subsequent increases in costs for the surrounding residents such that those residents are forced to move out of their neighborhoods (a common marker of gentrification).

Would you comment on the conflicting priorities of cities/economists for greening compared to health and communities, i.e. greening as a mode to create more investment versus as permanent green spaces for the people who already live there?

Branas: The perception that developers may use greening or place-based enhancements as a precursor to gentrification is not unfounded and very much does occur. There are indeed community development corporations that focus on building luxury installations with the primary purpose of driving up property values. In these situations what we call gentrification and its worst features, such as runaway increases in the cost of living for local neighborhoods, ultimately create an unaffordable environment for residents who are economically driven out of their own neighborhoods. But, on the other hand, further ignoring decades of dilapidation and disinvestment in our poorest city neighborhoods is equally unacceptable.

For these reasons, we’ve pursued ”in situ” place-based changes; that is, place-based changes that are not luxury developments or expensive installations or destination amenities for people who do not live in the neighborhood. Because they’re so inexpensive, these sorts of in situ place-based changes, like simple vacant lot greening or basic fixes to abandoned buildings, can be offered across whole cities. It’s been our experience that these do not create what some call gentrification or forced economic out-migration. They are specifically designed by local residents, and for local residents, to improve health and quality of life and to provide fundamental neighborhood comforts that would otherwise not have been present, like greenspace, parks, or the absence of crumbling and dilapidated buildings. We have evidence of this through our vacant lot work where ~97% of the lots that were greened remained so, undeveloped and as basic public amenities for local residents.

We also have documented analytic evidence that indicators such as property taxes did not increase in areas where vacant lot greening occurred, further supporting the idea that basic (not expensive or luxury) place-based changes are positive additions to local communities.

CONTEXT

It’s interesting to hear you present on your work in Philadelphia and New Orleans. What factors draw you to those cities rather than your home city of New York?

Branas: A great question. I am also part of work in New York City along these lines, including with the NYC Housing Authority. However, it is worth stating that cities like New York, Boston, or San Francisco have a relatively lower proportion of abandonment, disinvestment, and dilapidation than other cities where much of the work I’ve described has been focused. That’s not to say that such challenges and the need for this sort of work are not present in NYC; of course they are. But cities like Detroit, Philadelphia, New Orleans, Newark, Youngstown, or Flint have a different level of contextual challenges and are not as well-resourced to contend with the record levels of abandonment and disinvestment that they’ve experienced over the past 50 years or so and the higher percentage of abandoned property stock that has resulted.

Also, while my home university is in New York City, I work in support of local universities, communities, and residents in other cities, like New Orleans and Philadelphia, who are the leads for any research and place-based changes in their local communities.

The Lower East Side of NY saw the emergence of many community gardens in the 1970’s. Has the influence of such gardens have been studied? Do they differ from those of simpler improvements?

Branas: Community gardens are wonderful opportunities for positive place-based change. However, community gardens have seen very little study in terms of documenting their on-the-ground impact on health and safety. One of the reasons is that a community garden is actually a much more complicated place-based installation than the simple vacant lot greening that we see more of and that we’ve managed to study much more completely. These simpler, less expensive versions of greening and park-making can be better distributed across an entire city, and as such, provide more opportunities for impact and study.

Also, while community gardens are potentially excellent opportunities, they can become members-only enterprises with tall fences and locked doors that end up only serving select people in the community. At times they also can become destination amenities that even end up serving mostly people who don’t live in the local community. That said, there are other benefits to community gardens such as the potential for the production of food for local communities and the social capital and connectedness that comes along with the first-hand experience of nature and the gardening itself. So they are certainly worth future investment, consideration, and study.

What ramifications do you see of COVID-19 related demographic changes and potential growth in small to mid-size cities for maintaining or elevating greening efforts?

Branas: Although it remains to be seen what will fully occur, movement from larger cities to mid-size smaller cities seems to have occurred, at least in the short-term, over the course of the pandemic. Given this, many of the opportunities for greening and place-based improvements of vacant and abandoned properties can be applied in small and mid-sized cities. Much of the work that’s been done in Youngstown, Flint, and even New Orleans is relevant here because these are actually small to midsize cities. And placed-based initiatives in all three of these small to midsize cities have shown to have significant improvements for multiple health and safety outcomes.

Would you comment on place-based efforts in rural communities? A different culture, issues, but similar need.

Branas: Indeed, the need for place-based effort in rural communities is there, and on-the-ground programs should certainly be explored with engaged communities to improve their health and safety. There are distinct place-based challenges that rural communities face. Being creative about coming up with place-based opportunities to change the specific contexts that affect the health of residents in rural communities and improve social connectedness and reduce things like loneliness in rural communities is a great next horizon for research and practice.

MEASUREMENT AND EVIDENCE GAPS

How were biological outcomes measured?

Branas: The biologic outcomes we measured were things like people’s weight and height, and in one study people’s ambulatory heart rate as they walked outside near greened and un-greened spaces. We also collected many different self-reported biologic and mental health measures. People’s ambulatory heart rate in the one study was shown to be significantly reduced when they were in sight of a newly green lot. We took this as an indication that place-based greening changes can have an effect on heart rate but also on unnecessary daily stressors and even manifest fears that people experience when in proximity to abandoned, vacant, and overgrown lots.

What do you know about links between physical activity and increased pedestrian traffic and violence or fear in neighborhoods?

Branas: We have findings from multiple studies that show when people’s feelings of safety go up and their fears of spaces outside their homes go down because of positive place-based changes in their neighborhoods, they begin to spend more time outside and begin to participate in greater physical activity outside. That physical activity can be formal exercise or simply being able to go to the store or walk more around their neighborhood. Again, basic greening of vacant lots and straightforward fixes to long-abandoned and dilapidated buildings in some of our poorest city neighborhoods can be the impetus for feeling safer and doing more physical activity, especially in outdoor spaces.

Did any of the studies capture health metrics pre-post greening?

Branas: Almost all our studies capture measurements before and after greening or other place-based changes, such as before and after remediation of abandoned buildings. We often do this in what’s called a difference-in-differences (DD) analysis. The first difference in the DD is the difference between spaces that get a particular treatment, like vacant lot greening or abandoned building remediation, and spaces that do not. The second difference is the pre-post changes in all those spaces, before and after a particular place-based treatment. When you “difference those two differences”, you get a bottom-line, net effect of the impact of a particular place-based treatment on whatever health or safety outcome you are studying.

What evidence gaps do you see as priority areas to inform place-based change policy?

Branas: There are a few major evidence gaps and needs for study in terms of place-based changes and policies. One of those is a better understanding of “dosage”. That is, how much greening or how much of a change to an abandoned building needs to occur to achieve a necessary or a sufficient amount of positive improvement to health or safety? This needs to be better investigated.

Another major priority area is to concurrently study not simply place-based change that gets initiated by a community, but also the combination of place-based change alongside structured community involvement and activities. We have some evidence from Flint, Michigan and Youngstown, Ohio, that the combination of positively changing a place, such as with greening, along with structured community activities and engagement with the new spaces, synergistically enhances health and safety more than place-based changes alone.

MAINTENANCE/SUSTAINABILITY

Who facilitated maintenance of the renovated lots during the study? Who was responsible for continued maintenance after study completion?

Branas: In our studies, maintenance of the renovated lots was facilitated by third-party contractors based in the community and not directly the universities or local governments. This included groups like horticultural societies, botanical societies, landscapers, union contractors, housing authorities, and land banks, all of which were contracted to maintain the spaces, typically on a monthly basis. In many of the cities, these contractors were predominantly minority-owned and in multiple cities have become part of long-term, institutionalized investments by city managers and city councils to continue the maintenance long after the research study itself ended.

How much you have dealt with litter/trash removal and how have you worked with cities and jurisdictions regarding their role?

Branas: We have just now begun to study litter and trash removal as a stand-alone approach to improving health and safety. We think this is a major opportunity for a lot of reasons. We’re getting some early insight that it may actually have an impact on health and safety outcomes but also it’s really quite inexpensive to do litter and trash removal. And community members have been telling us that litter-strewn detritus on their streets is a key quality-of-life and health concern. In fact, we would like to now conduct a larger community-based, community-engaged, and indeed community-initiated trash removal experiment to get a better handle on what the full benefits of this kind of an approach may be for health and safety in cities.

What are some common public funding sources (federal, state, local) for implementing these place-based changes?

Branas: At this point there are a number of federal agencies that have noticed the power of place-based programs and place-based changes, including for instance the Centers for Disease Control, the National Institutes of Health, the U.S. Forest Service, the Department of Justice, and the Department of Housing and Urban Development. In addition, many states and municipalities have begun to put line items into their city council budgets, overtly investing in place-based programs for purposes of improving health and safety. Chicago is a great example of this. Many foundations have also taken notice, for instance the Joyce Foundation, and have now listed place-based changes as leading community intervention opportunities to improve health and safety.

What mechanisms (e.g. funding, stakeholder and community engagement, permitting) do you see for continuing this work once grant funding and organizing is no longer present?

Branas: The initial studies showing that neighbors had already implemented at a small scale, and very much wanted further place-based change to be implemented, and that such changes were first-line top choices for them, were indicators that the work was worth pursuing. When the findings from subsequent federally-funded studies showing that those place-based changes had a measurable impact on health and safety outcomes were made more public, policymakers took notice and began to invest for their cities. When policymakers notice and then have scientific justification for creating a line item in their city council budgets, these place-based programs can be scaled to more neighborhoods and be sustained over long periods of time. So the combination of community initiation from residents and neighbors, followed by good science and some publicity as well as continued to community engagement, can promote both scalability and sustainability of these programs and their benefits.

COMMUNITY ENGAGEMENT

Many community development corporations and community groups have done this work for years with no support. How do we account for making it an “expert” category of work and securing funding where they might not have done so?

Branas: It’s been pretty clearly shown at this point that the more community-based programs you have in a neighborhood, the better off residents are in terms of their health, quality-of-life, and safety. But having a connection to evaluators or scientists, who are hopefully part of the local community, further elevates the probability that these community groups, and the good work they’re doing, get noticed by people who hold the purse-strings in their local municipalities and states and who are looking to implement programs with documented return-on-investment. This is a way to really capitalize on all those good years of expertise and work that so many community groups and organizations have developed and that will allow them to get more resources for the often life-saving work they are doing and possibly allow them to expand to other, similar communities.

How do you encourage hospitals and clinicians to get involved and what actions could they undertake?

Branas: I think we’ve all heard the story of how important “Eds and Meds” are to the health of local communities. But one thing that I often argue to healthcare systems leaders and hospital CEOs is that possibly the greatest contribution to better health that they’re creating for their local community is not via the medical care they provide, but rather it is via the jobs they create for their local community. In fact, many local hospitals and healthcare systems are the largest employers in their regions. So it stands to reason that hospitals and clinicians have a lot to contribute to the local community.

But they need to get out of the hospital itself, step into the community, and begin to do things in the community to directly benefit local residents, before these residents even need medical care. It’s really important that clinicians understand that once they treat someone in the hospital or the clinic, but then send that person back into a chaotic or unhealthy environment, even the best medical care can be undone. Understanding this and the critical importance of place, and not simply treating patients without understanding first-hand the challenges that surround them in their homes, schools, and neighborhoods, is a key way to motivate hospitals and clinicians to get involved.

What suggestions do you have for getting the community involved in making these changes?

Branas: I suggest finding a representative group of people in the community – both people with a political voice in the community and people without a political voice. Ask these people what are the major problems and health issues that need to be addressed, and more importantly, ask them how they would go about solving these problems.

Our group spent years working with communities and doing all manner of different programs with a modicum of success. It wasn’t until we went to members of the community, really spent time with them, and asked them what they thought had the greatest chances of improving the health and safety, that we made headway. Community members said to us that they were concerned about a lot of things but most concerned about the abandoned and vacant places and spaces that they saw next to and around their homes, their schools, and their workplaces every day. This is what really made us start to think about the importance of place-based changes and how they could have a major impact on health and safety, and led to the body of work that I presented.