The effect of HOusing instability and neighborhood deprivation on Maternal hEalth-HOME

住房不稳定和邻里剥夺对孕产妇健康的影响-HOME

• 批准号: 10756017
• 负责人: Julia B Dickson-Gomez
• 金额: $ 61.35万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2030-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10756017
• 关键词: Acute; Address; Adult; Advocate; Affect; Area; Attention; Biological; Biological Markers; Birth; Black race; COVID-19 pandemic; Case Management; Categories; Characteristics; Child; Chronic; Church; Cities; Communities; Continuity of Patient Care; County; Disabled Persons; Disparity; Economics; Electronic Health Record; Eligibility Determination; Emergency Situation; Family; Friends; Funding; Future Generations; Health; Health Status; Healthcare; Homelessness; Housing; Income; Indigenous; Individual; Infant; Institutional Racism; Knowledge; Longitudinal Surveys; Low Income Population; Low income; Maps; Marketing; Maternal Deprivation; Maternal Health; Maternal Mortality; Measures; Mental Health; Mental Health Services; Morbidity - disease rate; Mothers; Neighborhoods; Outcome; Participant; Persons; Physical assessment; Policies; Population; Postpartum Period; Poverty; Pregnancy; Pregnancy Outcome; Premature Birth; Psychiatric Social Work; Racial Segregation; Recording of previous events; Research; Risk; Risk Factors; Sampling; Screening procedure; Second Pregnancy Trimester; Section 8; Services; Shelter facility; Site; Social Work; Stress; Surveys; Third Pregnancy Trimester; Time; U.S. Department of Housing and Urban Development; Veterans; Visit; Wisconsin; Work; allostatic load; deprivation; ethnic segregation; experience; health disparity; health inequalities; housing instability; improved; infant outcome; lower income families; maternal morbidity; maternal risk; member; metropolitan; mortality; physical conditioning; physical health service; pregnant; programs; racial disparity; racial health disparity; residential segregation; segregation; social health determinants; social structure; structural determinants; substance use; supported housing; transitional housing; voucher

PROJECT SUMMARY/ABSTRACT: HOME Racial disparities in pregnancy outcomes, including heightened morbidity and mortality for mothers and their infants, persist and are not fully explained by individual risk factors. Black birthing people in the US are three times more likely to be affected than their white counterparts, and in Wisconsin, the risk is five times greater. Due to Milwaukee, Wisconsin being one of the five most segregated cities in the US, Black birthing families are also more likely to be low-income than their white counterparts and experience housing instability. Housing instability is a crucial social determinant of health that affects birthing people and their children, perpetuating poverty and poor health in future generations. There is an important gap in knowledge of the effect of housing instability on maternal health, that we seek to address in this proposal. The “Reducing HOusing instability and neighborhood deprivation for Maternal hEalth” (HOME) proposal’s central hypothesis is that investigating the effects of different housing statuses and stability on maternal physical and mental health will lead to more profound understanding of the impact of housing instability on pregnancy outcomes and motivate policy change to reduce maternal health disparities. In Aim 1, we will understand how personal and neighborhood characteristics and services contribute to housing stability among low-income pregnant people to inform programs to improve stability. In Aim 2, we will explore the impact of housing instability/homelessness and neighborhood conditions on allostatic load, physical and mental health, and pregnancy outcomes. In Aim 3, we will identify the service needs of pregnant people in each housing status, and advocate for policy-level change to address housing instability among birthing people. The proposed study will tease out the contribution of these factors and characteristics and correlate them to maternal health outcomes. This work could inform screening tools to assess pregnancy risk, inform policy change, and elucidate biological mechanisms by which structural factors result in health disparities.

项目摘要/摘要：家 怀孕结果中的种族分布，包括母亲的发病率和死亡率升高 和他们的婴儿，坚持不懈，没有被个体危险因素完全解释。黑色生日的人 美国受影响的可能性是其白人的三倍，在威斯康星州， 风险高五倍。由于密尔沃基，威斯康星州是五个最隔离城市之一 美国，黑人生日家庭也比白色对手更可能是低收入 体验住房不稳定。住房不稳定是影响健康的至关重要的社会决定者 生日的人和他们的孩子，使后代的贫困和健康状况不佳。有 知道住房不稳定性对物物健康的影响的重要差距，我们试图 在此提案中的地址。 “减少住房不稳定和邻里剥夺 孕产妇的健康”（家庭）提议的中心假设是调查不同的影响 住房状况和对孕产妇身心健康的稳定将导致更深刻 了解住房不稳定对怀孕结果和动机政策变化的影响 减少母亲健康差异。在AIM 1中，我们将了解个人和社区 特征和服务有助于低收入孕妇的住房稳定性 告知程序以提高稳定性。在AIM 2中，我们将探索住房的影响 不稳定/无家可归和邻里条件，身心负荷，身心健康， 和怀孕结果。在AIM 3中，我们将确定每个人的孕妇的服务需求 住房状况，并倡导政策级别的变更来解决分娩之间的住房不稳定 人们。拟议的研究将教授这些因素和特征的贡献， 将它们与孕产妇的健康结果相关联。这项工作可以为筛选工具提供信息来评估 怀孕风险，为政策变化提供信息，并阐明结构性因素的生物学机制 导致健康分布。