Variation in Health Outcomes within Disadvantaged Neighborhoods

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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.