Public Health Impacts and Intra-Urban Forced Displacement due to Climate Gentrification in the Greater Miami Area—Community Lawyering for Environmental Justice and Equitable Development

Because Miami-Dade County is “ground zero” for such climate effects as sea-level rise and increasingly hazardous, climate-driven Atlantic hurricanes, the coral rock ridge that runs along the Eastern coast of South Florida is a prime target for redevelopment and “climate” gentrification. Through a community and movement lawyering for environmental justice approach, we partnered with local community organizations to contribute to the ongoing work of community-driven equitable development. In partnership, we developed an environmental public health study to understand and document the public health effects on disadvantaged communities in Miami-Dade County from forced intra-urban displacement due to redevelopment that is being influenced by elevation concerns. We disseminated an online survey to examine environmental hazards, housing conditions, threat of displacement, and current mental and physical health status. We collected seventy-four responses between August 2021 and August 2022. The Qualtrics survey consisted of twenty-five questions to determine the breadth and extent of mental and physical health impacts due to threats of forced displacement related to redevelopment along the coral rock ridge. We assessed movement into and out of areas of gentrification in Miami-Dade County and any correlations with health impacts and forced displacement due to environmental housing conditions and redevelopment in these areas. Migration patterns by zip code and elevation were analyzed using data obtained from the U.S. Census Bureau and served to supplement and cross-validate geographical data and existing literature that showed a pattern of migration and movement in line with climate gentrification. This work was used to develop and support policies with the potential to slow down the rapid gentrification along the rock ridge and mitigate the process of forced displacement occurring amongst the environmental justice communities living there

Early career outcomes of a large four-year MD/ MPH program: Results of a cross sectional survey of three cohorts of graduates.

The University of Miami Miller School of Medicine started a four-year MD/ MPH program in 2011 with a mission to graduate public health physician leaders to address the public health needs of the 21st century, with emphasis on three areas: leadership, research, and public health. A prospective cross-sectional survey of early graduates was conducted to understand how they incorporate public health training into their careers. There were two study questions: What are the self-described early career activities of the graduates of the first three cohorts in the areas of leadership, research, and public health and what are the perceptions regarding the influence of the public health training on their careers? In the summer of 2020, a survey was sent to graduates from the classes of 2015, 2016, and 2017. In addition to several multiple-choice questions, the survey included an open-ended question on the impact of public health training in their careers. Inductive content analysis was used to analyze the responses to the open-ended question. Eighty-two of the 141 eligible graduates (63%) completed the survey; 80 of whom had participated or was currently participating in residency training. Forty-nine joined a residency in a primary care field. Many graduates had leadership roles in their early careers, including 35 who were selected as chief residents. Fifty-seven participated in research, most commonly in quality improvement (40), clinical (34) and community based (19). Over one third (30) chose to do work in public health during residency. Themes that emerged regarding the influence of public health training on their careers were: 1) Shifts in perspective, 2) Value of specific skills related to public health, 3) Steppingstone for professional opportunities 4) Focus on health disparities, social determinants, and inadequacies of the healthcare system, 5) Perception as leaders and mentors for peers, and 6) Preparedness for the pandemic. Graduates self-reported involvement in leadership, research, and public health activities as well as a commitment towards addressing some of our most pressing public health needs. Although long-term career outcomes need to be determined over time, graduates currently report considerable benefits of their public health training for their professional outcomes