Impact of public housing assistance on modifiable cancer risk factors in adults

公共住房援助对成人可改变癌症危险因素的影响

• 批准号: 8837587
• 负责人: NATALIE COLABIANCHI
• 金额: $ 7.76万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-11 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8837587
• 关键词: Address; Adult; Affect; Age-Years; Alcohol consumption; Area; Cancer Research Project; Characteristics; Child; Childhood; Data; Data Set; Economics; Education; Employment; Ensure; Funding; Future; Government; Grant; Health; Health Care Costs; Health Promotion; Health behavior; Household; Housing; Income; Individual; Intervention; Life; Link; Logistic Regressions; Longitudinal Surveys; Low income; Malignant Neoplasms; Masks; Mediation; Mediator of activation protein; Medicaid; Modeling; Neighborhoods; Obesity; Outcome; Overweight; Participant; Pathway interactions; Policies; Population; Prevention; Probability; Public Housing; Research; Research Personnel; Respondent; Risk Factors; Safety; Scoring Method; Selection Bias; Smoking; Societies; Socioeconomic Status; Stress; Supermarket; Surveys; Testing; Weight; behavior influence; cancer risk; comparison group; cost; environmental intervention; health disparity; improved; intervention effect; low socioeconomic status; modifiable risk; mortality; post intervention; programs; psychosocial; public health research; racial and ethnic; response; social; social health determinants; therapy design; treatment effect

DESCRIPTION (provided by applicant): Despite improvements in cancer mortality in the past two decades, significant disparities persist among racial, ethnic, and socioeconomic status (SES) subpopulations. Housing has been identified as an important social determinant for health disparities in general and cancer-related disparities specifically. Public housing (PH) assistance aims to improve housing affordability and quality for the lowest-SES households. Thus, PH represents an intervention to improve housing as a social determinant of health. However, few studies have examined the effects of living in PH on health-related outcomes. Additionally, several researchers have proposed pathways through which PH influences health but have not tested them empirically. The proposed study will use data collected from 1999-2013 in the Panel Study of Income Dynamics (PSID) to estimate the effect of living in PH on four leading modifiable risk factors for cancer (smoking, alcohol use, physical inactivity, and overweight/obesity) in adults <62 years of age. The PSID offers a unique opportunity to examine the effects of PH because it is a nationally representative, longitudinal survey with a wide range of demographic, household, housing, economic, employment, social, and health variables; neighborhood-level variables will also be linked using geocodes. The treatment group will include only respondents who move into PH during the study period (expected n=550). The comparison group will be limited to renters who are income-eligible for PH (expected n=1650). We will apply propensity score methods to the rich set of baseline characteristics available in the PSID to help control for selection bias inherent in observational data. Inverse probability of treatment weights will be calculated from estimated propensity scores and used in logistic regression models to estimate average treatment effects for each risk factor at 2, 4, and 6 years after baseline. Multiple mediation models will be developed to examine the extent to which PH influences modifiable cancer risk factors through individual-level mediators (e.g., non-housing income, stress, residential stability) and neighborhood-level mediators (e.g., neighborhood SES, access to supermarkets, walkability). Study results will be used to help clarify whether living in PH improves or worsens modifiable risk factors for cancer. Importantly, information obtained about pathways through which these effects occur can inform future housing and public health research, practice, and policy.

描述（由申请人提供）：尽管过去二十年来癌症死亡率有所改善，但种族，种族和社会经济地位（SES）亚群的显着差异持续存在。住房已被确定为一般和与癌症相关差异的健康差异的重要社会决定因素。公共住房（PH）援助旨在提高最低SES家庭的住房负担能力和质量。因此，PH代表了改善住房作为健康决定因素的干预措施。但是，很少有研究检查生活在pH中对健康相关结果的影响。此外，一些研究人员提出了PH会影响健康的途径，但尚未经过经验测试。拟议的研究将使用1999 - 2013年收集的收入动态研究（PSID）收集的数据来估计pH中生活对成人<62岁<62岁的癌症（吸烟，酒精使用，体力不佳和超重/肥胖症）的四个领先可改变的危险因素的影响。 PSID提供了一个独特的机会来检查pH的效果，因为它是一项全国代表性的，纵向调查，并具有广泛的人口，家庭，住房，经济，就业，就业，社会和健康变量；邻里级变量也将使用地理编码链接。该治疗组将仅包括在研究期间进入pH的受访者（预期n = 550）。比较组将仅限于符合pH的收入资格的房客（预期n = 1650）。我们将将倾向得分方法应用于PSID中可用的一组基线特征集，以帮助控制观测数据中固有的选择偏差。治疗权重的反可能性将根据估计的倾向得分计算，并在逻辑回归模型中使用，以估计基线后2、4和6年的每个危险因素的平均治疗效果。将开发多种调解模型，以检查pH通过个别级别的调解人（例如，非房屋收入，压力，住宅稳定性）和邻居级别的调解人（例如，邻里SES，进入超市，步行性，步行性，居住在内）来影响可改变的癌症风险因素的程度。研究结果将用于帮助阐明pH中的生活是否改善或恶化可改变的癌症危险因素。重要的是，获得有关这些效果发生的途径的信息可以为未来的住房和公共卫生研究，实践和政策提供信息。