Variation in Health Outcomes within Disadvantaged Neighborhoods

我们建议扩大亚特兰大市现有的公共住房搬迁研究，以检查 公屋居民搬迁到新社区将如何影响他们的健康。我们现有的 研究包括对来自7个公共住房项目的387名受访者的抽样调查(6和18 搬迁后几个月)，因为他们被迁出公共住房，搬到私人市场住房。我们的 我们申请资金的具体目标是：1)评估新建房屋和已建成的房屋 公屋居民迁入的新社区的环境，以确定他们的 对样本健康的影响；以及2)评估居民的人与环境的适合性 社区，并调查它是否在社区劣势之间的关联中起中介作用 和健康。社区有障碍，使得所有人都很难满足他们的健康需求。 人-环境匹配框架断言，人员拥有资源和能力，可以 处理社区障碍，因此当人们的需求被他们的社区满足时，他们就会在那里 是非常合适的。使用关于社区的管理数据，对新房和社区进行审计 结合来自调查的个人水平数据，我们将检验以下因素影响的路径模型 健康的邻里关系允许人的环境适合调解关联。我们假设 建成环境和住宅的各个方面将解释新建筑中健康症状的变化 社区以及对新家持积极主观态度的受访者 社区将比那些没有健康的社区体验更好的健康，即使他们的客观衡量标准 社区都很穷。我们的最终目标是向住房政策和卫生政策提供有关以下方面的信息 搬迁如何影响公屋居民的生活和健康，并在此基础上开发一个模型 社区劣势是如何通过人们与其环境的适应来运作的。我们最大的 重要的长期目标是减少种族健康差距，这是一个健康状况不佳的群体 造成现有健康差距的主要原因。

We propose to expand an existing study of public housing relocations in the City of Atlanta to examine how relocation among public housing residents to new neighborhoods will affect their health. Our existing study consists of following a sample of 387 respondents from 7 public housing projects over time (6 and 18 months post-relocation), as they are relocated out of public housing and into private market housing. Our specific aims, for which we are requesting funding, are 1) to assess the new homes and the built environments of the new neighborhoods, that public housing residents relocate to, in order to determine their impact on the health of the sample; and 2) assess the person-environment fit of residents with their new neighborhoods, and investigate whether it mediates the association between neighborhood disadvantage and health. Neighborhoods have barriers that make it difficult for all individuals to meet their health needs. The person-environment fit framework asserts that persons have resources and competencies with which to deal with neighborhood barriers, therefore when persons' needs are met by their neighborhoods then there is a good fit. Using administrative data on neighborhoods, audits of new homes and neighborhoods combined with individual level data from surveys, we will examine path models of the effects of neighborhoods on health allowing the person environment fit to mediate the associations.We hypothesize that aspects of the built environment and homes will explain variation in health symptoms within the new neighborhoods and that respondents who have positive subjective attitudes towards their new homes and neighborhoods will experience better health than those that do not even if the objective measures of their neighborhoods are poor. Our ultimate goal is to inform both housing policy and health policy in regards to how relocations affect the lives and health of public housing residents, and beyond that to develop a model of how neighborhood disadvantage operates through the fit of persons with their environments. Our most important long term goal is to reduce racial health disparities and this is the group whose poor health is a major reason for existing health disparities.