The impact of social drivers, conditional cash transfers and their mechanisms on mental health of the young: an integrated retrospective and forecasting approach using the 100 million Brazilian Cohort

社会驱动因素、有条件现金转移及其机制对年轻人心理健康的影响：使用一亿巴西队列的综合回顾和预测方法

• 批准号: 10538619
• 负责人: Daiane Borges Machado
• 金额: $ 36.46万
• 依托单位: FUNDACAO OSWALDO CRUZ
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-09 至 2026-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538619
• 关键词: Achievement; Address; Adult; Affect; African; Age; Alcohol consumption; Appointment; Behavior; Behavioral; Big Data; Black Populations; Brazil; COVID-19; COVID-19 pandemic effects; Child; Communities; Country; Data; Data Set; Development; Diagnosis; Disease; Economic Recession; Economics; Education; Effectiveness; Emotional; Equation; Equity; Ethnic Origin; Exposure to; Family; Future; Gender; Health; Health Services; Health Services Accessibility; Health care facility; Healthcare; Hospitalization; Household; Improve Access; Impulsivity; Incidence; Income; Individual; Intervention; Life; Life Cycle Stages; Link; Long-Term Effects; Low income; Mediator; Mental Health; Mental disorders; Methodology; Modeling; Municipalities; Neighborhoods; Notification; Outcome; Pathway interactions; Persons; Phase; Policies; Policy Maker; Population; Poverty; Prevalence; Prevention; Program Effectiveness; Qualifying; Race; Schools; Social Change; Social Protection; Specific qualifier value; Subgroup; Suicide; Testing; Time; United States; Violence; Vulnerable Populations; Woman; Youth; aged; beneficiary; cohort; cost effectiveness; design; early life exposure; effective therapy; experience; health data; health disparity; improved; improved outcome; innovation; intergenerational; longitudinal dataset; low and middle-income countries; meetings; models and simulation; mortality; pandemic disease; prevent; programs; reducing suicide; response; scale up; simulation; social; social vulnerability; socioeconomics; trend; violence exposure; Achievement; Address; Adult; Affect; African; Age; Alcohol consumption; Appointment; Behavior; Behavioral; Big Data; Black Populations; Brazil; COVID-19; COVID-19 pandemic effects; Child; Communities; Country; Data; Data Set; Development; Diagnosis; Disease; Economic Recession; Economics; Education; Effectiveness; Emotional; Equation; Equity; Ethnic Origin; Exposure to; Family; Future; Gender; Health; Health Services; Health Services Accessibility; Health care facility; Healthcare; Hospitalization; Household; Improve Access; Impulsivity; Incidence; Income; Individual; Intervention; Life; Life Cycle Stages; Link; Long-Term Effects; Low income; Mediator; Mental Health; Mental disorders; Methodology; Modeling; Municipalities; Neighborhoods; Notification; Outcome; Pathway interactions; Persons; Phase; Policies; Policy Maker; Population; Poverty; Prevalence; Prevention; Program Effectiveness; Qualifying; Race; Schools; Social Change; Social Protection; Specific qualifier value; Subgroup; Suicide; Testing; Time; United States; Violence; Vulnerable Populations; Woman; Youth; aged; beneficiary; cohort; cost effectiveness; design; early life exposure; effective therapy; experience; health data; health disparity; improved; improved outcome; innovation; intergenerational; longitudinal dataset; low and middle-income countries; meetings; models and simulation; mortality; pandemic disease; prevent; programs; reducing suicide; response; scale up; simulation; social; social vulnerability; socioeconomics; trend; violence exposure

PROJECT SUMMARY Physical, emotional, and social changes, including exposure to poverty, abuse, or violence, increases youth vulnerability to mental illness. These factors interfere with development, limit opportunities, and hamper achievement of a fulfilling life as adults. Addressing these issues can lead to improved outcomes at the population level and better cost-effectiveness for health services. This should be especially important to low- and middle-income countries, due to the substantial number of financially and socially vulnerable individuals in these settings. Cash transfer programs have been a promising way to address some of the social drivers for poor mental health among youth. It has been shown that such programs can alleviate income restriction, increase schooling and access to health facilities, and decrease alcohol consumption and violence in families. However, it is still unclear which pathways and mechanisms explain the association between socioeconomic support and lower mental illness among youth. In this project, we will evaluate the effect of social drivers on youth mental health-related hospitalizations and suicide, test mechanisms and pathways of a countrywide socioeconomic intervention, and examine the timing of the intervention during the life course. For example, determining whether cash transfers delivered earlier in life can contribute to better outcomes over time. This project will also investigate the cash transfer effect on vulnerable groups (African descendants, women, and youth with lower income). We will evaluate social drivers’ determination and the association between being beneficiaries of the Conditional Cash Transfer program, called the Bolsa Família Program (BFP), and mental illness and its long-term effects using robust methodologies for big datasets, such as Regression Discontinuity Designs, Propensity Score Matching and difference-in-differences. We will test mechanisms and pathways, between BFP and mental health-related hospitalizations and suicide among youth using Structural Equation Modeling. Furthermore, we will perform microsimulations to generate projections regarding how mental health-related hospitalizations and suicide trends will be in the future based on the current state, and how BFP implementation scenarios will affect these trends. The results of this project will be of vital importance to guide policies and programs to improve mental health and reduce mental health-related hospitalizations and suicide in youth. It will provide information to improve the effectiveness of these programs worldwide. Finally, it can potentially advance the global debate on the economic response to the pandemic and times of economic crises. If cash transfers can decrease mental health problems among youth and reduce suicide, it will have a dramatic impact on saving lives.

项目摘要 身体，情感和社会变化，包括暴露于贫困，虐待或暴力，增加了青年 对精神疾病的脆弱性。这些因素干扰了发展，限制机会和障碍 实现成年人的充实生活。解决这些问题可能会导致在 人口水平和卫生服务的成本效益更好。这对于低 - 和 中等收入国家，由于其中大量财务和社会脆弱的人 设置。 现金转移计划是解决一些社会驱动因素，以使心理健康不良 在青年中。已经表明，此类计划可以减轻收入限制，增加教育和 获得医疗设施，减少家庭的酒精消费和暴力。但是，这仍然不清楚 哪些途径和机制解释了社会经济支持与降低精神的关联 年轻人的疾病。 在这个项目中，我们将评估社会驱动因素对青年心理健康相关住院和 自杀，测试机制和全国社会经济干预的途径，并检查时间安排 人生过程中的干预措施。例如，确定是否较早交付现金转移 随着时间的流逝，生活可以为更好的结果做出贡献。该项目还将调查现金转移效果 弱势群体（非洲后裔，妇女和收入较低的青年）。 我们将评估社会驱动力的决心和有条件的受益者之间的关联 现金转移计划，称为BolsaFamília计划（BFP）和精神疾病及其长期影响 使用可靠的方法来用于大数据集，例如回归不连续设计，倾向分数 匹配和差异差异。我们将在BFP和心理之间测试机制和途径 使用结构方程建模与健康相关的住院和自杀。此外，我们 将执行微模拟，以生成有关心理健康相关住院和如何 自杀趋势将在未来根据当前状态以及BFP实施方案如何影响 这些趋势。 该项目的结果对于指导政策和计划至关重要，以改善心理健康和 减少与心理健康相关的住院和青年自杀。它将提供信息以改善 这些计划在全球范围内的有效性。最后，它可以潜在地推进有关经济的全球辩论 对大流行和经济危机时代的反应。如果现金转移可以减少心理健康问题 在青年中，减少自杀，这将对挽救生命产生巨大影响。