At-Risk Neighborhoods and Health Outcomes

 描述(由申请人提供)：我们的论点是，即使我们能够客观和准确地衡量犯罪，黑帮居住地可能会对人口健康产生独特的影响，而不是减少到犯罪。帮派活动和暴力的性质仍然是人口健康的一个看似独特的因素--尽管它对人口健康和健康差距有潜在影响，但这一因素在很大程度上仍未得到探索。我们进一步认为，BIRH结果是人口健康的相关晴雨表，因为这一结果对不断变化的社会条件的反应，以及由于我们能够在高度多样化的社区环境中，在很长一段时间内通过大样本评估出生结果。我们这个探索性/发展性(R21)研究提案的项目目标很简单，我们想要评估黑帮居住地是否与人口健康和健康差距有关。鉴于帮派在洛杉矶县的普遍存在，社区类型的巨大差异，以及生育结果对动态社会条件的反应--这个项目有能力揭示一个研究不足的健康社会决定因素。我们的目标如下：目标1.确定黑帮居住地是否对不良生育结果有独立的影响，扣除邻里犯罪和社会人口结构，如贫困和经济和种族/民族构成。目的2.确定黑帮居住地是否会加剧邻里层面犯罪的影响。目的3.确定帮派禁令对改善人群健康是否有效。目的4.评估黑帮居住地是否会造成不良的出生结果差异。该项目试图揭示黑帮居所对人群健康的独立影响，如果成功，将为未来黑帮社区健康研究提供基线。我们相信该项目的创新将缓解人们对它是一项相对风险较高的努力的任何担忧，这就是为什么我们认为R21是这种方法的完美机制。

 DESCRIPTION (provided by applicant): It is our contention that gangland residence may have a unique effect on population health that is not reducible to crime, even if we were able to objectively and accurately measure crime. The nature of gang activities and violence remains a plausibly unique contributor to population health-a factor that has been largely unexplored despite its potential effect on population health and health disparities. We further argue that birh outcomes are a relevant barometer for population health, given the responsiveness of this outcome to changing social conditions and due to the fact that we are able to assess birth outcomes with a large sample in highly diverse neighborhood settings, over a long period of time. Our project goals for this exploratory/developmental (R21) research proposal are simple, we want to assess whether gangland residence is associated with population health and health disparities. Given the pervasiveness of gangs in Los Angeles County, the large variation in neighborhood types, and the responsiveness of birth outcomes to dynamic social conditions-this project has the capability to shed light on an under-researched social determinant of health. Our aims are as follows: Aim 1. To determine if gangland residence has an independent effect on adverse birth outcomes, net of neighborhood crime and socio-demographics such as poverty and economic and racial/ethnic composition. Aim 2. To determine if gangland residence compounds the effect of neighborhood-level crime. Aim 3. To determine whether gang injunctions are efficacious for improving population health. Aim 4. To assess whether gangland residence accounts for adverse birth outcome disparities. This project is an attempt to uncover independent effects of gangland residence on population health and if successful, will provide a baseline for future gangland community health research. We believe the project's innovation will assuage any fears of it being a relatively risky endeavor and that is why we feel that an R21 is the perfect mechanism for such an approach.