1 of 18

October 25, 2021

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Health implications of housing, zoning, and social vulnerability characteristics in the City of Miami, Florida

Anamarie Ferreira de Melo, MPH (1); T. Lucas Hollar, PhD (2); Patrick Hardigan, PHD, MBA (2) and Sofia Cuenca (3)

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

(1) Urban Health Solutions, LLC, Miami, FL, (2) Nova Southeastern University, Fort Lauderdale, FL, (3) Healthy Little Havana, Miami, FL

2 of 18

Introduction

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Housing is a key driver of health, and zoning laws play an important role in determining how different land uses are distributed and co-exist.

Although zoning laws aim to encourage urban growth in a reasonable, sustainable manner, zoning laws can contribute to housing and health equity challenges.

Research on the link between zoning, housing, and health is necessary to advise reform in zoning laws by local municipalities to improve the social determinants of health.

We explored how housing, zoning, and social vulnerability characteristics came together in ways associated with better or poorer health, in light of the City of Miami, Florida’s 2010 implementation of Miami 21 Zoning Code, which prioritized building form over land use regulation of and reduced housing density in specifically zoned areas.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

3 of 18

Background & Context

Form-based zoning

Form-Based Zoning Codes are a method of regulating development to achieve a specific urban form. Form-based codes place an emphasis on the relationship between the street and buildings, pedestrian and vehicles, public and private spaces, and the relationship between multiple buildings, a block, a neighborhood and transitions in scale.

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

Traditional zoning

Traditional, or Euclidean, zoning codes are characterized by establishing and regulating land based on use. Typical types of land-use districts in Euclidean zoning are: residential, commercial, institutional, and industrial.

4 of 18

Background & Context

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Miami 21 and T4 Zoning

In 2010, the form based-code, Miami of the 21st Century (Miami 21)

introduced T4 Transect Zones, which reduced the density allotment for specific portions of properties across City of Miami.

While T4 zones provide a lot of housing supply, current restrictions only permit 36 units/acre or 4 units for a typical 5,000 sq. ft. lot.

T4 units are often too large and therefore too expensive to meet market-rate housing stock for the demographic needs of residents in various

neighborhoods, including Little Havana.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

5 of 18

Background & Context

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

a median household income of around $22,000 73.1% are foreign-born immigrants

For low-income households like those in Little Havana, more than half report hardships related to housing, including but not limited to: crowded conditions, difficulty paying housing or utility bills, or housing expenses that require more than half of their income.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

Little Havana

The census tracts within this portion of Miami have: an estimated 93,846 residents

Healthy Little Havana boundaries of Little Havana

6 of 18

Background & Context

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Healthy Little Havana (HLH) is a community-based organization that supports and advocates for efforts that strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Through recommendations from its Housing Committee, HLH pursued a Health Impact Assessment that assessed the implications of modifying Miami 21 T4 Transect Zones to previously allotted density in Little Havana on housing affordability, quality, and stability.

This research stems from this project.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

7 of 18

Methods

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

WE SOUGH TO:

Characterize census tracts within the City of Miami in terms of zoning, housing, development, and social vulnerability through latent profile analysis

01

02 Describe tract characteristics associated with each profile

Determine the extent to which different presentations of characteristics among the profiles affect health

03

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

8 of 18

Methods

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

STUDY DESIGN

To identify the underlying structure of census tracts and to test for their affects on health status among census tract residents, we conducted a cross-sectional, observational secondary data analysis of measures from 95 Census tracts within the City of Miami.

DATA SOURCES

We utilized census tract data from the Centers for Disease Control and Prevention’s (CDC) Social Vulnerability

Index (SVI), the CDC’s 500 Cities Project, the Reinvestment Fund’s Displacement Risk Ratio (DRR) data, the

U.S. Census Bureau’s American Community Survey, and parcel data aggregated to the census tract level from the Florida Department of Revenue real property roll.

STUDY POPULATION

Our study population consisted of the 95 census tracts contained within the City of Miami.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

9 of 18

Methods

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

MEASURES

Zoning and development

Percent of parcels within each tract designated as T4 Total just value

New construction just value Total living area

Number of residential units.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

Affordability of housing

Naturally occurring affordable housing (NOAH)

Owner cost burden Renter cost burden.

Social and housing vulnerability

CDC’s SVI overall themes Reinvestment Fund’s DRR Estimated median year a housing unit was built, as of 2014-2018.

Neighborhood of interest

Our study was interested in investigating whether or not the neighborhood of Little Havana experienced any differences in terms of profiles and health in comparison to the rest of the City of Miami.

Health

CDC’s 500 Cities’ “physical health not good” variable

The measures of our study encapsulated issues of affordability of housing, social and housing vulnerability, zoning and development, and health.

Sub-analyses within our study also sought to consider the impact of tracts situated inside or outside of the neighborhood of Little Havana, resulting in a measure of geographic location.

10 of 18

Analysis

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

Latent profile analysis (LPA) to look for associations between study variables and the distal outcome health.

Specific advantages of LPA compared to traditional, non-latent clustering methods are that:

  1. Individuals are classified into clusters based upon membership probabilities estimated directly from the model
  2. Variables may be continuous, categorical (nominal or ordinal), counts, or any combination of these
  3. Demographics and other covariates can be used for profile description.

Generalized linear regression was used to examine the relationship between latent profile and health measures.

Stata (Version 16.1) and R (version 3.6.3) statistical packages were used for descriptive calculations, group comparisons, and latent profile modeling.

Statistical significance was found at p<0.05.

11 of 18

RESULTS

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

LATENT PROFILE ANALYSIS

We created and tested four models: 2-profile through 5- profile solutions. Using Akaike’s Information Criterion (AIC), the Bayesian Information Criterion (BIC), and the likelihood ratio test

We found the three-profiled model as the best fit.

12 of 18

RESULTS

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

LATENT PROFILE ANALYSIS

We created and tested four models: 2-profile through 5- profile solutions. Using Akaike’s Information Criterion (AIC), the Bayesian Information Criterion (BIC), and the likelihood ratio test

We found the three-profile model as the best fit.

13 of 18

RESULTS

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

42% of tracts

Higher rates of NOAH, social vulnerability, T4 designation, and renter cost burden

Older buildings Lower total just value,

new construction just value, total living area, and DRR

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

LATENT PROFILE 1

39% of tracts

Lower rates of NOAH, social vulnerability, T4 designation, renter cost burden, and number of residential units Slightly lower total just

value, new construction just value, and total living area.

LATENT PROFILE 2

19% of tracts Notably lower T4 designation

Notably higher total just value, new construction just value, total living area, number of residential units Notably younger buildings

LATENT PROFILE 3

14 of 18

RESULTS

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

GENERALIZED LINEAR REGRESSION

A significant model was found when we regressed latent profile onto the health (R2=.39, F(2,86)=27.65, p<.001).

LP1 has the highest poor health score, which was significantly higher than the mean poor health scores for either LP2 or LP3 (p <0.001).

No difference was found in poor health scores between LP2 and LP3

15 of 18

RESULTS

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

GENERALIZED LINEAR REGRESSION

(Sub-analysis)

To further explore this relationship, we created an additional model, including

location within Little Havana as a

regressor, along with the interaction of latent profile by living in Little Havana.

The Little Havana model was

significant (R2=.45, F(5,82)=13.75,

p<.001).

Overall, latent class membership had a bigger effect on poor health (η2 = .14) than living in Little Havana (η2 = .08)

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

16 of 18

Discussion

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Characterization of census tract profiles and health

We found distinguishing characteristics among census tracts in Miami

Particularly through LP1 having higher rates of NOAH, social vulnerability, T4 designation, and renter cost burden; older buildings; and lower total just value, new construction just value, total living area, and DRR

LP1 aligns with characteristics within the literature associated with poorer health and poorer health equity

We found characteristics of LP1 were associated with poorer health than those of LP2 and LP3

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

17 of 18

Discussion

Public Health Takeaway

Research finds that low-density zoning raises the cost of housing, forcing lower-income households to pay more.

Increasing allowable density in more neighborhoods will not have immediate effects on housing affordability, segregation, or health, but is a necessary step toward a more affordable, healthy, and sustainable future.

Remaining connected to residents of the City of Miami, and continuing to advocate on their behalf to shape policies and zoning, will help improve health equity within the City of Miami.

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH

18 of 18

Anamarie Ferreira de Melo, MPH CPH

Healthy Little Havana

Support and advocate efforts to strengthen Miami's Little Havana neighborhood by focusing on the social determinants of health.

Health implications of housing, zoning, and social vulnerability characteristics in the City of Miami, Florida

Thank You!

Urban Health Solutions

anamarie@urbanhs.com

T. Lucas Hollar, PhD

Dr. Kiran C. Patel College of Osteopathic Medicine Nova Southeastern University

Lucas.Hollar@nova.edu

Patrick Hardigan PhD, MBA

Dr. Kiran C. Patel College of Osteopathic Medicine Nova Southeastern University

Patrick@nova.edu

Sofia Cuenca Aguirre

Healthy Little Havana

Sofia@healthylittlehavana.org

healthylittlehavana.org

info@healthylittlehavana.org

@healthylittlehavana

@healthyLH