Housing assistance, Outcomes, Medicare, and SEER (HOMES): using a novel data linkage to understand cancer inequities

住房援助、结果、医疗保险和 SEER (HOMES)：使用新颖的数据链接来了解癌症不平等

• 批准号: 10610452
• 负责人: Craig Evan Pollack
• 金额: $ 52.79万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10610452
• 关键词: Advisory Committees; American; American Cancer Society; Area; Attention; Breast; Buffers; Cancer Patient; Cancer Survivor; Caring; Cells; Color; Colorectal; Colorectal Cancer; Data; Data Linkages; Data Set; Diagnosis; Diagnostic Procedure; Disparity; Early Diagnosis; Elderly; Eligibility Determination; Emergency department visit; Equity; Ethnic Origin; Family; Foundations; Goals; Guidelines; Health; Health Personnel; Health Services; Health Services Research; Healthcare Systems; Home; Household; Housing; Incidence; Individual; Inequity; Institutional Racism; Intervention; Investigation; Knowledge; Link; Low income; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Medical; Medicare; Medicare claim; National Cancer Institute; Neighborhoods; Newly Diagnosed; Non-Small-Cell Lung Carcinoma; Outcome; Patient Care; Patient-Focused Outcomes; Patients; Policies; Policy Maker; Prostate; Psychological Stress; Public Housing; Quality of Care; Race; Recording of previous events; Research; Risk Factors; Risk Reduction; Role; Services; Social Work; Stage at Diagnosis; Testing; Time; Toxicant exposure; U.S. Department of Housing and Urban Development; Waiting Lists; cancer care; cancer health disparity; cancer site; cancer therapy; caregiving; clinical care; cost; design; experience; financial toxicity; high risk; improved; innovation; long-standing disparities; low socioeconomic status; malignant breast neoplasm; novel; personalized medicine; policy recommendation; programs; racial disparity; residence; social; social factors; socioeconomic disparity; survivorship; voucher

Project Summary Socioeconomic and racial disparities in cancer care and outcomes among older adults have been persisted and even widened in recent years. At the same time, the lack of safe and affordable housing has become a national crisis. Despite the strong potential for housing insecurity to impact cancer inequities, there is a paucity of evidence connecting these two areas. The Housing assistance, Outcomes, MEdicare, and SEER (HOMES) Study is a highly innovative investigation of the association between housing insecurity and cancer inequities. It focuses on the role of federal housing assistance which, through a variety of programs, including Housing Choice Vouchers, public housing, and multifamily housing, limit household spending on rent and utilities. By increasing housing affordability and stability, improving housing quality, changing neighborhood context, and connecting residents with health and social services, federal housing assistance has the potential to improve the quality of care that patients with cancer receive and, more broadly, shed light on the intersection of cancer and housing. The study focuses on older adults diagnosed with breast, colorectal, prostate, and non- small cell lung cancers given their high incidence and well-documented inequities. The study makes use of a novel dataset being constructed by the National Cancer Institute that merges linked SEER-Medicare data on patients diagnosed (2006-2019) with U.S. Department of Housing and Urban Development data on the receipt of federal housing assistance. Because individuals who receive housing assistance may be fundamentally different from those who do not, the study makes use of an innovative pseudo-waitlist control design that leverages the limited supply of housing assistance relative to demand and the random timing of the receipt of housing assistance. The first aim examines the overall relationship between receipt of federal housing assistance and cancer care (time to treatment, receipt of guideline concordant care, emergency department visits) and outcomes (stage at diagnosis). The second aim investigates whether these relationships vary by cancer site and, given experiences of systemic racism that intersect with cancer disparities and housing policy, by race/ethnicity. The final aim studies whether the association between housing assistance and cancer care and outcomes varies by the form of housing assistance and across different neighborhood contexts. Informed by a policy advisory committee in conjunction with representatives from the American Cancer Society Cancer Action Network and National Cancer Roundtables, the HOMES Study has the strong potential to provide actionable housing and cancer policy recommendations and inform changes to practice designed to improve cancer equity.

项目摘要 癌症护理中的社会经济和种族差异以及老年人的成果持续存在 甚至近年来也扩大了。同时，缺乏安全可负担的住房已成为 国家危机。尽管住房不安全感可能会影响癌症不平等，但仍然很少 连接这两个领域的证据。住房援助，成果，医疗保险和先知 （房屋）研究是对住房不安全感与癌症之间关联的高度创新研究 不平等。它着重于联邦住房援助的作用，通过各种计划，包括 住房选择优惠券，公共住房和多户住房，限制家庭支出 公用事业。通过提高住房负担能力和稳定性，提高住房质量，不断变化的社区 环境，并将居民与卫生和社会服务联系起来，联邦住房援助有潜力 为了提高癌症患者接受的护理质量，更广泛地阐明了交叉路口 癌症和住房。该研究的重点是被诊断为乳腺癌，结直肠癌，前列腺和非 - 小细胞肺癌的发病率很高且有据可查的不平等。该研究利用了 由国家癌症研究所（National Cancer Institute 诊断为（2006-2019）的患者在美国住房和城市发展部数据 联邦住房援助。因为获得住房援助的个人可能是从根本上 与没有不同的人不同，该研究利用了创新的伪标清控制设计设计 相对于需求和收到的随机时间，利用住房援助的供应有限 住房援助。第一个目的检查了收到联邦住房的总体关系 援助和癌症护理（治疗时间，收到指南协调，急诊科 访问）和结果（诊断阶段）。第二个目标调查了这些关系是否因 癌症场所以及鉴于与癌症差异和住房政策相关的系统性种族主义的经历， 通过种族/种族。最终目的研究住房援助与癌症护理之间的关联是否 结果随着住房援助的形式以及在不同的社区环境中的形式而异。通知 由政策咨询委员会与美国癌症协会癌症的代表一起 行动网络和国家癌症圆桌会议，家庭研究具有强大的潜力 可行的住房和癌症政策建议，并为旨在改善的实践变更提供信息 癌症公平。

项目成果

Association of Historical Housing Discrimination and Colon Cancer Treatment and Outcomes in the United States.

美国历史住房歧视与结肠癌治疗和结果协会。

• DOI: 10.1200/op.23.00426
• 发表时间: 2024
• 期刊: JCO oncology practice
• 影响因子: 4
• 作者: Hussaini,SMQasim;Fan,Qinjin;Barrow,LaurenCJ;Yabroff,KRobin;Pollack,CraigE;Nogueira,LeticiaM
• 通讯作者: Nogueira,LeticiaM

Association of area-level mortgage denial and guideline-concordant non-small-cell lung cancer care and outcomes in the United States.

美国地区级抵押贷款拒绝和符合指南的非小细胞肺癌护理和结果协会。

• DOI: 10.1002/cam4.6921
• 发表时间: 2024
• 期刊: Cancer medicine
• 影响因子: 4
• 作者: Fan,Qinjin;Hussaini,SMQasim;Barrow,LaurenCJ;Feliciano,JosephineL;Pollack,CraigE;Yabroff,KRobin;Nogueira,Leticia
• 通讯作者: Nogueira,Leticia