Adapting the environmental risk transition theory for urban health inequities: An observational study examining complex environmental riskscapes in seven neighborhoods in Global North cities

Theories of epidemiologic transition analyze the shift in causes mortality due to changes risk factors over time, and through processes urbanization development by comparing between countries or time. These theories do not account for health inequities such as those resulting from environmental injustice, which minority lower income residents are more likely be exposed hazards have less access goods. Neighborhoods with histories injustice also at gentrification they undergo improvements new greening projects. We aimed understand how urban renewal green could inform understanding transitions. examined 7 case neighborhoods cities United States Western Europe were representative terms city region type, 1) had experienced a history 2) exhibited evidence recent and/or gentrification. In each city, we conducted semi-structured qualitative interviews (n = 172) representatives, activists, non-profits, developers residents. Respondents reported implications traditional (heavy pollutants, poor social conditions), transitional (decontamination, amenities), (gentrification, emerging (displacement, climate-related risks, re-emergence exposures) exposures. renewed, complexified overlapping exposures leading mental physical patterns inequity. Our findings point need transitions incorporate analysis trends on city-scale, acknowledging that segregation created unequal conditions within shorter time period, taking into worsening inequity cities.