Impact of public housing assistance on modifiable cancer risk factors in adults

公共住房援助对成人可改变癌症危险因素的影响

• 批准号: 8837587
• 负责人: NATALIE COLABIANCHI
• 金额: $ 7.76万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-11 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8837587
• 关键词: Address; Adult; Affect; Age-Years; Alcohol consumption; Area; Cancer Research Project; Characteristics; Child; Childhood; Data; Data Set; Economics; Education; Employment; Ensure; Funding; Future; Government; Grant; Health; Health Care Costs; Health Promotion; Health behavior; Household; Housing; Income; Individual; Intervention; Life; Link; Logistic Regressions; Longitudinal Surveys; Low income; Malignant Neoplasms; Masks; Mediation; Mediator of activation protein; Medicaid; Modeling; Neighborhoods; Obesity; Outcome; Overweight; Participant; Pathway interactions; Policies; Population; Prevention; Probability; Public Housing; Research; Research Personnel; Respondent; Risk Factors; Safety; Scoring Method; Selection Bias; Smoking; Societies; Socioeconomic Status; Stress; Supermarket; Surveys; Testing; Weight; behavior influence; cancer risk; comparison group; cost; environmental intervention; health disparity; improved; intervention effect; low socioeconomic status; modifiable risk; mortality; post intervention; programs; psychosocial; public health research; racial and ethnic; response; social; social health determinants; therapy design; treatment effect

DESCRIPTION (provided by applicant): Despite improvements in cancer mortality in the past two decades, significant disparities persist among racial, ethnic, and socioeconomic status (SES) subpopulations. Housing has been identified as an important social determinant for health disparities in general and cancer-related disparities specifically. Public housing (PH) assistance aims to improve housing affordability and quality for the lowest-SES households. Thus, PH represents an intervention to improve housing as a social determinant of health. However, few studies have examined the effects of living in PH on health-related outcomes. Additionally, several researchers have proposed pathways through which PH influences health but have not tested them empirically. The proposed study will use data collected from 1999-2013 in the Panel Study of Income Dynamics (PSID) to estimate the effect of living in PH on four leading modifiable risk factors for cancer (smoking, alcohol use, physical inactivity, and overweight/obesity) in adults <62 years of age. The PSID offers a unique opportunity to examine the effects of PH because it is a nationally representative, longitudinal survey with a wide range of demographic, household, housing, economic, employment, social, and health variables; neighborhood-level variables will also be linked using geocodes. The treatment group will include only respondents who move into PH during the study period (expected n=550). The comparison group will be limited to renters who are income-eligible for PH (expected n=1650). We will apply propensity score methods to the rich set of baseline characteristics available in the PSID to help control for selection bias inherent in observational data. Inverse probability of treatment weights will be calculated from estimated propensity scores and used in logistic regression models to estimate average treatment effects for each risk factor at 2, 4, and 6 years after baseline. Multiple mediation models will be developed to examine the extent to which PH influences modifiable cancer risk factors through individual-level mediators (e.g., non-housing income, stress, residential stability) and neighborhood-level mediators (e.g., neighborhood SES, access to supermarkets, walkability). Study results will be used to help clarify whether living in PH improves or worsens modifiable risk factors for cancer. Importantly, information obtained about pathways through which these effects occur can inform future housing and public health research, practice, and policy.

描述(申请人提供)：尽管癌症死亡率在过去20年中有所改善，但在种族、民族和社会经济地位(SES)亚群中仍然存在显著差异。住房已被确定为健康差距的一个重要社会决定因素，特别是与癌症有关的差距。公共住房(PH)援助旨在提高最低收入家庭的住房负担能力和质量。因此，PH值代表了一种干预措施，旨在将住房作为健康的社会决定因素来改善。然而，很少有研究研究生活在PH中对健康相关结果的影响。此外，一些研究人员提出了PH影响健康的途径，但尚未对其进行实证检验。这项拟议的研究将使用1999年至2013年在收入动态小组研究(PSID)中收集的数据来估计在62岁的成年人中，生活在PH中对四个主要的可改变的癌症风险因素(吸烟、饮酒、缺乏体育锻炼和超重/肥胖)的影响。PSID提供了一个独特的机会来检验PH值的影响，因为它是一项具有全国代表性的纵向调查，包含了广泛的人口、家庭、住房、经济、就业、社会和健康变量；邻里级别的变量也将使用地理代码联系起来。治疗组将只包括在研究期间进入PH的受访者(预计n=550)。比较组将仅限于符合住房政策收入资格的租户(预计n=1650人)。我们将对PSID中提供的丰富的基线特征集应用倾向评分方法，以帮助控制观测数据中固有的选择偏差。治疗权重的逆概率将根据估计的倾向得分计算，并用于Logistic回归模型，以估计基线后2、4和6年每个危险因素的平均治疗效果。将开发多种中介模型，以考察PH通过个人层面的中介(例如，无住房收入、压力、居住稳定性)和社区层面的中介(例如，社区社会经济状况、超市准入、步行能力)对可修改的癌症风险因素的影响程度。研究结果将被用来帮助澄清生活在PH中是改善还是恶化可改变的癌症风险因素。重要的是，获得的关于这些影响发生的途径的信息可以为未来的住房和公共卫生研究、实践和政策提供信息。