Health of Low-Income Adults in Subsidized Housing: Randomized Experiment, 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、低犯罪率的住房开发或更多混合收入的环境可能会通过多种途径减少健康差距。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确定符合我们研究标准的治疗和控制家庭。小组分配将包括搬进10个新建住房点之一的补贴公寓的家庭（治疗组）和没有得到住房的匹配家庭（对照组）。我们估计我们的实验样本将由大约1300个参与治疗的家庭和1690个彩票匹配的对照组成。本提案的设计改进并扩展了早期住房实验的设计，因为它(a)比较了在补贴住房接受者中搬到新社区与留在同一社区的影响，(b)比较了搬进混合收入与单独低收入建筑的影响，(c)检查了补贴住房对接近贫困家庭的影响（而不仅仅是低于贫困线的家庭）。(d)检查了补贴住房的效果，其中90%的人接受了补贴住房（而不是在以前的补贴住房示范中不到一半），(e)检查了补贴住房的效果，这些家庭可能会留在补贴住房中（相比于代金券的研究，超过一半的人最终再次搬家，通常是回到贫困社区）。我们建议的数据收集策略将包括在申请房屋时使用一份自行填写的问卷收集基线数据，该问卷由一名成年家庭成员填写，并辅以从房屋申请本身获得的信息。后续电话访谈将在迁入后12-18个月进行，对于未迁入者，则进行同等时间的电话访谈。将在基线和随访时收集关于当前健康状况和健康行为的各种信息，以便能够评估家庭内部的变化以及随访时比较组之间的平均变化。实验分析将用于量化移居到新社区的补贴住房相对于在申请时移居到同一居住社区的补贴住房的影响。探索性分析将比较两种类型的处理：混合收入住房和专门的低收入住房开发。家庭、住房和社区特征之间的关系将作为潜在结果以及个人水平健康结果的中介进行研究。

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 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 households who move to a subsidized apartment in one of ten newly constructed housing sites (treatment) and matched households who do not receive housing (control). We estimate that our experimental sample will be comprised of about 1,300 participating treatment households and 1,690 lottery- matched controls. 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 previous demonstrations of subsidized housing), and (e) examines the effect of subsidized housing where the families are likely to stay in the subsidized housing (compared to studies of vouchers, where 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 a single adult household member and augmented by information obtained from the housing application itself. Follow-up telephone interviews will take place 12-18 months after move-in, or equivalent for non-movers. A variety of information on current health status and health behaviors will be collected at baseline and follow-up to enable assessment of within-household change as well as average change between comparison groups at follow-up. Experimental analyses will be used to quantify the impact of moving to subsidized housing in a new neighborhood relative to moving to subsidized housing in the same neighborhood of residence at time of application. Exploratory analysis will compare two types of treatment: moves to mixed-income housing and exclusively low-income housing developments. 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: 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 track about 1,300 households who receive city-subsidized housing and about 1,700 matched households who do not receive housing over the first 12-18 months after move-in to assess changes in physical and mental health, and health behaviors. In addition, we will explore changes in physical, economic, and social environments that may mediate the relationship between residential context and health and well-being of low-income residents.