Housing policy, neighborhood context, and pathways to midlife mortality in a social experiment

社会实验中的住房政策、社区环境和中年死亡率的途径

• 批准号: 10868129
• 负责人: THERESA LOUISE OSYPUK
• 金额: $ 50.81万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10868129
• 关键词: Address; Adult; Age; Area; Behavioral; Biological; Biological Process; Black race; Censuses; Cessation of life; Cities; Complement; Complex; Control Groups; Data; Data Set; Demographic Factors; Discrimination; Divorce; Economics; Environment; Epidemiologist; Ethnic Origin; Etiology; Evaluation; Experimental Designs; Family; Geography; Health; Heterogeneity; Hispanic; Household; Household Heads; Housing; Individual; Inequality; Inequity; Life; Life Cycle Stages; Link; Location; Low income; Mediating; Mediation; Mental Health; Methodology; Modeling; Modification; National Institute on Minority Health and Health Disparities; Neighborhoods; Observational Study; Outcome; Pathway interactions; Physical environment; Policies; Population; Population Process; Poverty; Productivity; Proliferating; Public Housing; Race; Randomized; Research; Residential Mobility; Risk Factors; Scholarship; Social Environment; Social Policies; Social Processes; Social Security; Socioeconomic Status; Specificity; Subgroup; Surveys; Testing; United States National Center for Health Statistics; arm; built environment; design; economic outcome; experience; experimental study; health determinants; health disparity; health inequalities; improved; indexing; middle age; mortality; mortality risk; physical conditioning; population health; predictive modeling; prospective; racial minority; residential segregation; social; social health determinants; socioeconomics; voucher

PROJECT SUMMARY/ABSTRACT The spatial separation of populations along racial-ethnic lines is a fundamental cause of health inequities across the life course via cascades of interlocking social determinants of health at multiple levels. Although neighborhood-health multilevel research has proliferated in the past 20 years, it remains weak methodologically: addressing one point in the life course rather than a long temporal period using prospective data; failing to integrate social processes and biological data; not attending to heterogeneity or pathways; and remaining divorced from policy solutions. Our study of place-based inequities in mid-life mortality addresses these limitations, leveraging data from a promising policy experiment: The Moving to Opportunity (MTO) Study. The MTO follows 4600 low-income racial minority families, living in public housing at baseline, in five large US cities, who were randomized to receive one of three treatments: one of two types of housing vouchers to improve housing affordability and neighborhood opportunity or an in-place control group that remained in public housing. Evaluation surveys were conducted at baseline (1994), in 2001-02, and in 2008-10. This study expands and enriches the MTO data by linking it to three administrative datasets across 28 years—(1) NCHS’s National Death Index, (2) Social Security’s Numident, and (3) the Census Master Address File—allowing us to analyze the effects of housing mobility on mid-life mortality and long-term residential mobility. An experienced and productive population health and social epidemiologist scholar leads our accomplished, interdisciplinary team. Our project has five specific aims: Aim 1: Test if the MTO low-poverty housing voucher treatment improves neighborhood opportunity in year 2023, versus the in-place public housing or standard voucher group; Aim 2: Test if the MTO low-poverty housing voucher treatment reduces mortality risk through mid-life versus in-place public housing or the standard voucher group; Aim 3: Examine subgroups that are more or less likely to benefit from the MTO housing voucher experiment, i.e., test heterogeneity of MTO effects on mortality by baseline demographic factors; Aim 4: Test which of many multilevel factors across the life course mediate the effect of the MTO housing voucher experiment on mortality; Aim 5: Calculate the number of deaths that would be avoided and how the racial/ethnic mortality gap would be narrower, at the population level, if voucher-based housing policy were broadly implemented to promote opportunity moves. The proposed project aligns with NIA Population and Social Processes Branch to elucidate “life course pathways leading to disparities in health outcomes.” Our study presents a unique and important opportunity for population health: to understand a long chain of causation from random assignment of a housing voucher to a change in neighborhood environment and area-based contexts to the biological, physical, mental health, and behavioral pathways to mortality.

项目摘要/摘要 人口沿种族族裔的空间分离是造成健康不平等的基本原因 在整个生活课程中，通过互锁的社会决定者的级联在多个层面上。虽然 在过去20年中，邻里健康多层次研究激增，它仍然很弱 从方法论上：解决生活课程中的一点，而不是使用潜在的漫长临时期 数据;无法整合社会过程和生物数据；不参加异质性或途径；和 剩下的与政策解决方案不同。我们对中年死亡率地址中基于地点的不平等的研究 这些局限 学习。 MTO跟随4600个低收入拉面少数民族家庭，居住在基线公共住房中，五个 美国大城市，他们被随机接受三种处理之一：两种类型的住房凭证之一 改善住房负担能力和邻里机会或留在原地的对照组 公共住房。在基线（1994），2001 - 02年和2008 - 10年进行了评估调查。这项研究 通过将其链接到28年的三个管理数据集，扩展和丰富了MTO数据 - （1）NCHS的数据 国家死亡指数，（2）社会保障的数字和（3）普查主地址文件 - 使我们愿意 分析住房迁移率对中年死亡率和长期居民流动性的影响。经验丰富的 生产性人口健康和社会流行病学家学校领导着我们成就的跨学科 团队。我们的项目有五个特定的目标：目标1：测试MTO低贫困住房凭证处理是否 改善2023年的邻里机会，而不是现场公共住房或标准凭证 团体; AIM 2：测试MTO低贫困住房凭证处理是否会通过中年降低死亡率的风险 与现场公共住房或标准凭证集团相比；目标3：检查或多或少的子组 可能受益于MTO住房凭证实验，即MTO对死亡率的效果的测试异质性 根据基线人口因素； AIM 4：测试整个生命过程中的许多多层次因素中的哪个中介 MTO住房凭证实验对死亡率的影响；目标5：计算死亡人数 如果人口层面 广泛实施了基于优惠券的住房政策，以促进机会迁移。拟议的项目 与NIA的人口和社会过程保持一致，以阐明“生命途径 健康结果的差异。”我们的研究为人口健康提供了一个独特而重要的机会： 了解从随机分配住房凭证到更改的长长原因 邻里环境和基于区域的生物学，身心健康和行为的环境 死亡率的途径。