Child and Family Health in Subsidized Housing: A Randomized Experiment in NY City

描述(由申请人提供)：从公共卫生的角度来看，搬到补贴住房、不那么贫困的社区、犯罪率较低的住房开发项目或更混合的收入环境可能会缩小低收入儿童和家庭与没有收入的儿童和家庭之间的健康差距。儿童和青少年可能特别受到住房的影响，因为他们大部分时间都呆在家乡社区，当地便利设施和机构的可及性和质量很重要，而且他们受到父母对居住地点的反应的影响。我们提议的重点是获得原地补贴住房，这可能有助于通过多种途径改善高危青年的健康和发展轨迹。拟议的实验研究将利用纽约市住房保护和发展部的抽签系统来识别、处理和控制符合我们研究标准的家庭。小组分配将包括有孩子的家庭搬到11个新建住房地点之一的补贴公寓(治疗)，以及没有获得住房的匹配家庭(控制)。该提案的设计改进和扩展了早期住房试验的设计，因为它(A)比较了在接受补贴住房的人中，搬到新社区与住在同一社区的影响，(B)比较了搬进混合收入建筑和仅住在低收入建筑中的影响，(C)审查了补贴住房对近贫困家庭(而不仅仅是低于贫困线的家庭)的影响，(D)审查了补贴住房的影响，在接受补贴的住房的接受率为90%(而不是在转移机会方面不到一半)，和(E)审查补贴住房的影响，这些家庭可能会住在补贴住房中(在搬家争取机会的过程中，超过一半的确实搬家的人最终又搬了回来，通常是回到贫困社区)。我们拟议的数据收集战略将包括在申请住房时收集基线数据，使用由主要照顾者填写的自我管理问卷，并辅之以从住房申请本身获得的信息。后续评估将包括与主要照顾者面谈，以及每个参与家庭最多两名共同居住的儿童的详细信息。我们将通过代理8岁以下儿童和亲自与8至18岁的儿童一起收集关于儿童的后续信息。将使用实验分析来量化搬迁到补贴住房的影响，并将进行额外的探索性分析，以调查住房相对于社区的潜在好处，并评估那些获得特定类型补贴住房的人之间存在差异影响的证据。家庭、住房和社区特征之间的关系将被视为潜在结果以及个人水平健康结果的中介因素。 公共卫生相关性：儿童和成人的健康受到他们所处环境的影响。实验研究表明，搬到特定类型的社区的新住房可能会改善贫困家庭的生活机会；然而，之前的研究混淆了住房和社区的流动性，没有调查混合收入住房开发的好处。我们的随机实验将解决这些不足之处，以解决纽约市儿童和家庭通过住房摇号申请就地补贴住房的问题，并测试获得此类住房是否改善了儿童和照顾者的健康和福祉。

DESCRIPTION (provided by applicant): From a public health perspective, moving to subsidized housing, to less poor neighborhoods, to housing developments with low rates of crime, or to more mixed income settings might reduce health disparities between children and families who have low income and those who do not. Children and young adolescents may be particularly influenced by housing given that they spend a large proportion of their time in their home neighborhood where the accessibility and quality of local amenities and institutions matter, and because they are influenced by their parents' responses to residential location. Receipt of in-place subsidized housing, the focus of our proposal, may help to improve the health and developmental trajectories of at-risk youth through multiple pathways. The proposed experimental research will utilize the NYC Department of Housing Preservation and Development's lottery system to identify treatment and control households that fit our study criteria. Group assignment will include families with children who move to a subsidized apartment in one of eleven newly constructed housing sites (treatment) and matched families who do not receive housing (control). This proposal's design improves and expands upon the design of earlier housing experiments in that it (a) compares the impact of moving to a new neighborhood versus staying in the same neighborhood among recipients of subsidized housing, (b) compares the impact of moving into mixed-income versus solely low- income buildings, (c) examines the impact of subsidized housing on near-poor families (rather than just families below the poverty threshold), (d) examines the effect of subsidized housing where the uptake of the offer is 90% (rather than less than one-half in Moving to Opportunity), and (e) examines the effect of subsidized housing where the families are likely to stay in the subsidized housing (in Moving to Opportunity, over half of those who did move ended up moving again, typically back to poor neighborhoods). Our proposed data collection strategy will include baseline data collection at time of application for housing, using a self-administered questionnaire to be completed by the primary caregiver and augmented by information obtained from the housing application itself. Follow-up assessments will include in-person interviews with the primary caregiver and detailed information on up to two co-resident children for each participating household. Our follow-up information on children will be collected by proxy for children under age eight and in-person with children ages eight to eighteen. Experimental analyses will be used to quantify the impact of moving to subsidized housing and additional exploratory analyses will be conducted to investigate the potential benefits of housing relative to neighborhoods and assess evidence of differential impacts among those receiving particular types of subsidized housing. Relationships among household, housing, and neighborhood features will be examined as potential outcomes as well as mediators of individual-level health outcomes. PUBLIC HEALTH RELEVANCE: The health of children and adults is influenced by the environments in which they live. Experimental research has shown that moving to new housing in particular kinds of neighborhoods may improve the life chances of poor families; however, previous research confounded housing- and neighborhood mobility and did not investigate the benefits of mixed-income housing developments. Our randomized experiment will address these shortcomings will NYC children and families who apply for in-place subsidized housing allocated through a housing lottery and test whether receipt of such housing improves the health and well-being of children and caregivers.