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Health and Health-Related Resources in Newly Designated Federally Qualified Opportunity Zones

view of a city from above

January 30, 2020

New research, led by Jana A. Hirsch, PhD, assistant research professor at the Drexel Urban Health Collaborative, the Dornsife School of Public Health, benchmarks conditions in federally qualified opportunity zones (QOZ) and how they may impact health.

The federal government implemented QOZs through the Tax Cuts and Jobs Act in 2017. This new federal legislation, intended to incentivize investment in distressed communities, could have a dramatic effect on US neighborhoods and the health of residents who live within them. QOZs are intended to encourage private investment through tax breaks to spur economic development in distressed communities.

This legislation could greatly affect neighborhood resources and ultimately health. QOZ designation could impact economic conditions and change the neighborhood’s retail and physical environment. These changes could promote healthy behaviors, such as increased physical activity and enhance diet quality, to ultimately improve cardiovascular and other chronic health outcomes. However, QOZs could also have less beneficial or unequal effects through changes in population, shifts in social engagement among neighbors, gentrification, and displacement of vulnerable populations.

On average QOZs had fewer people, a younger population, and lower proportions of non-Hispanic White residents. QOZ tracts also had lower economic status and substantially lower density of physical activity resources. QOZs also had a higher density of walkable destinations for daily living, food stores, social destinations, and social services than tracts that were eligible for the program but were not designated. In addition, prevalence of all unhealthy behaviors, except binge drinking, was higher in QOZs. The paper also provides results by state and within an interactive app to facilitate evaluation of FQOZ by local stakeholders.

Evaluating the effects of QOZ on health is important because previous research linking place-based policies like QOZ to health is limited. QOZs will most benefit distressed communities if investors, local governments, and community organizations guide investment and shape how this policy is implemented. Public health can and should be part of that discussion.

There are a few key strategies public health could engage in to maximize health benefits in QOZ. Enacting policies that would increase affordable housing in these zones could have the potential to reduce displacement and its subsequent health impacts. Public health practitioners should also collaborate with local urban planning departments to implement zoning that could encourage health-promoting businesses in QOZs. Similarly, larger benefits may emerge by pairing public and private investments that impact health, including new or improved parks or pedestrian infrastructure. Public health may play a key role in ensuring that future evaluations assess impacts on health disparities. Finally, QOZ designation may offer public health an opportunity to engage locally and mobilize residents around neighborhoods’ impacts on health.

In collaboration with other experts aiming to understand the social, economic, or business outcomes of this federal legislation, public health has a key role to play; we must work to ensure that the health impacts of this place-based policy are not just tracked across time but also used to advance health equity across communities.  

This study was published in the American Journal of Public Health.