Gentrification, changes in the physical environment and health in Porto: an analysis of photographs and verbal data from a photovoice study

Abstract

Background: Gentrification is transforming urban environments with significant implications for residents' health. This study examines the health impact of gentrification-led changes in the urban physical environment in Porto, Portugal. Methods: We conducted a deductive and integrated content analysis of 458 photographs and discussion transcriptions produced during a photovoice study with 16 participants from gentrifying, deprived non-gentrifying, and affluent areas. We did a descriptive quantitative analysis of photographs, and then qualitatively compared and cross-checked each analytical category and subcategory with the interview transcripts. Results: All the analytical categories including in the coding matrix - pollution, green infrastructure, social infrastructure housing accommodation infrastructure, food environment, commerce and services, transport infrastructure, safety, crowding and building (except housing) were identified in both the pictures. Participants discussed how these aspects of the physical environment have changed, how those changes were affected by gentrification, and how they could be relevant to health. Green infrastructure was by far the most photographed aspect, while social infrastructure was portrayed by a negligible number of photos. Most categories were linked both to changes seen as beneficial for the city, including for health, and changes considered negative and unhealthy. Discussion: The photographs taken by the participants, together with the transcripts of the sessions where they were discussed, suggest that gentrification changes the physical environment in meaningful ways, which may bring important consequences for health. However, some gentrification changes the physical environment in the ways that, in the long run, may also bring some benefit to the city, including the health of most inhabitants. This illuminates the contradictory nature of gentrification processes and their consequences. Conclusion: This research highlights the complex relationship between gentrification, changes in the physical environment and public health, emphasising the need for balanced policies that promote equitable urban regeneration and sustainability. Keywords: public health, urban health, photovoice, gentrification, social determinants of health, health inequalities.