Neighborhood opportunity and child health using a randomized trial of low-income mothers

使用低收入母亲的随机试验研究邻里机会和儿童健康

• 批准号: 10693323
• 负责人: Tim Allen Bruckner
• 金额: $ 19.14万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10693323
• 关键词: Academy; Address; Adverse effects; Affect; Age; Birth; Black race; Brain; Censuses; Child; Child Development; Child Health; Childhood; Cigarette; Consumption; Control Groups; Criminal Justice; Cross-Sectional Studies; Data; Data Set; Databases; Developing Countries; Development; Dimensions; Disparity; Ecology; Education; Enrollment; Environmental Hazards; Exploratory/Developmental Grant; Exposure to; Family; Funding; Future; Geography; Gifts; Green space; Health; Health Food; Health behavior; Hispanic; Household; Income; Individual; Infant; Influentials; Infrastructure; Life; Life Cycle Stages; Link; Low income; Measures; Mediating; Mediation; Mediator; Mental Health; Mothers; National Institute of Child Health and Human Development; Neighborhoods; Newborn Infant; Not Hispanic or Latino; Outcome; Parents; Pathway interactions; Pattern; Pollution; Poverty; Public Health; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Design; Research Personnel; Residential Mobility; Resources; Risk; Role; Running; Sterile coverings; Weight; Woman; Work; child bearing; child poverty; design; early childhood; experimental study; fruits and vegetables; health data; health disparity; high risk population; improved; indexing; innovation; lower income families; maternal stress; minority children; neighborhood disadvantage; noise pollution; payment; physical conditioning; poverty reduction; programs; racial minority; randomized trial; recruit; residence; residential segregation; sleep quality; social health determinants; treatment group

Project Summary (30 lines) A recent influential National Academies Report concludes that poverty during early childhood (i.e., <3 years) may causally increase the risk of adverse physical health, mental health, and developmental outcomes. A key challenge now involves how best to intervene on poverty to improve child health. In addition to individual poverty, one critical aspect of income-based health disparities in the US involves neighborhood poverty. Poverty in the US remains highly spatially patterned. Extensive research documents high levels of racial residential segregation in the US as well geographic concentration of both poverty and affluence. Black and Hispanic racial minority children in particular have non-overlapping worse distributions of childhood opportunity than do non- Hispanic white children. Above and beyond individual poverty, living in disadvantaged neighborhoods may damage child health, including via high residential segregation, limited healthy food outlets, fewer green spaces, and higher neighborhood poverty. We will use the R21 mechanism to explore the potentially causal role on child health of moving to neighborhoods characterized by childhood opportunity. We will build on the NICHD-funded Baby's First Years (BFY) study, initiated in 2018, which is the first large-scale US experiment of unconditional cash transfers to poor families with infants. The randomized trial recruited 1,000 mothers of newborn infants with household cash incomes below the poverty line. Mothers in the treatment group receive monthly cash payments of $333 ($4,000 per year) for the first 52 months of the child's life, and mothers in the control group receive $20 per month. We will use randomization to the high-cash gift in an intent-to-treat design to examine two questions. First, do mothers with a partial alleviation of cash constraints move to neighborhoods characterized by greater childhood opportunity? And second, are gains in child health (by age-2) in this high-cash group mediated by neighborhood moves? We will leverage both residential address and rich child health data from BFY across three waves, as well as neighborhood indices of childhood opportunity and geocoded distance measures, to achieve all aims. For the child health aim, we will focus on neighborhood mediation of main effects that already have emerged by age-2: sleep quality, increased consumption of fruits and vegetables, and mother's reduced purchasing of cigarettes. Our work is significant in two ways. First, we focus on redressing large, widespread, and robust income-based disparities in child health in the US. Second, we examine the important question of whether low-income parents who are partially relieved of income constraints move to childhood opportunity neighborhoods at a sensitive period of their child's development. Given the rigorous intent-to-treat study design and the infrastructure of BFY to achieve our Aims, our analyses may identify causal estimates of neighborhoods on child health. Even precisely estimated null findings for the neighborhood/child health aim hold strong scientific value since they would suggest non-neighborhood mediators through which income affects child health.

项目摘要（30行） 最近有影响力的国家学院报告得出结论，幼儿期的贫困（即<3年） 可能会增加身体健康，心理健康和发展成果的不良风险。钥匙 现在的挑战涉及如何最好地干预贫困以改善儿童健康。除了个人 贫困，这是美国基于收入的健康差异的关键方面涉及社区贫困。贫困 在美国，在空间上仍然具有高度的图案。广泛的研究记录了高水平的种族住宅 美国的隔离以及贫困和富裕的地理集中。黑人和西班牙裔种族 尤其是少数民族儿童的童年机会的分布比非 - 西班牙裔白人孩子。超越个人贫困，生活在处境不利的社区中可能 损害儿童健康，包括通过高住宅隔离，健康食品媒体有限，绿色空间较少， 和更高的邻里贫困。 我们将使用R21机制来探索搬到社区的儿童健康中的可能因果关系 以童年的机会为特征。我们将建立在NICHD资助的婴儿的第一年（BFY）研究的基础上 于2018年开始，这是美国第一个大规模的无条件现金转移实验 与婴儿。随机试验招募了1,000名有家庭现金收入的新生婴儿母亲 在贫困线下方。治疗组的母亲每月现金支付为333美元（每人$ 4,000 一年）在孩子一生的前52个月中，对照组的母亲每月获得20美元。我们将 在意图处理设计中使用随机分配给高现金礼物，以检查两个问题。首先，母亲 随着部分缓解现金限制，转移到以更大的童年为特征的社区 机会？其次，在社区介导的这个高现金组中，儿童健康的收益（按2岁）获得 移动？我们还将利用来自三波浪潮的BFY的住宅地址和丰富的儿童健康数据 作为童年机会和地理编码距离措施的邻里指数，以实现所有目标。为了 儿童健康目标，我们将专注于邻里的主要影响，这些影响已经出现了2岁以下的主要影响： 睡眠质量，水果和蔬菜的消费量增加，母亲减少了香烟的购买。 我们的工作在两种方面都很重要。首先，我们专注于纠正大型，广泛且基于收入的强大 美国儿童健康的差异。其次，我们研究了低收入父母的重要问题 部分释放收入限制的人转移到童年的机会社区敏感的社区 孩子的成长期。考虑到严格的意图研究设计和BFY的基础设施 为了实现我们的目标，我们的分析可能会确定有关儿童健康社区的因果估计。甚至精确 估计邻里/儿童健康目标的无效发现具有强大的科学价值，因为它们会 建议非邻国调解人通过，收入会影响儿童健康。