Variation in Health Outcomes within Disadvantaged Neighborhoods

我们建议扩大亚特兰大市公共住房搬迁的现有研究， 公屋居民搬迁到新的社区会如何影响他们的健康。我们现有 研究包括以下样本的387名受访者从7个公共住房项目随着时间的推移（6和18 在搬迁后的几个月内，他们将从公共住房搬迁到私人市场住房。我们 我们要求资金的具体目标是：（1）评估新住房和已建住房， 新社区的环境，公共住房居民搬迁，以确定他们的 对样本健康的影响;以及2）评估居民与其新的 社区，并调查它是否介导邻里之间的关联劣势 与健康社区存在障碍，使所有人难以满足其健康需求。 人与环境的契合框架认为，人拥有资源和能力， 处理邻里障碍，因此，当人们的需求得到满足，他们的邻居，然后在那里 很合适使用社区的行政数据，对新房和社区进行审计 结合调查中的个人水平数据，我们将研究以下因素影响的路径模型： 社区对健康的影响，使人与环境的适应性成为中介。我们假设 建筑环境和房屋的各个方面将解释新的健康症状的变化， 社区和受访者谁有积极的主观态度，他们的新家园， 社区将经历更好的健康比那些不，即使他们的客观措施， 邻里都很穷。我们的最终目标是为住房政策和卫生政策提供信息， 搬迁如何影响公共住房居民的生活和健康，并建立模型 邻里劣势是如何通过人与环境的适应来运作的。我们最 一个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， 这是目前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.