Health outcomes and health care spending among residents of smoke-free public housing
无烟公共住房居民的健康状况和医疗保健支出
基本信息
- 批准号:9981772
- 负责人:
- 金额:$ 81.72万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2012
- 资助国家:美国
- 起止时间:2012-03-01 至 2023-04-30
- 项目状态:已结题
- 来源:
- 关键词:AcuteAcute myocardial infarctionAddressAdmission activityAdoptedAffectAirBostonCaringCause of DeathChronic Obstructive Airway DiseaseClinicalCounselingCountryDataDatabasesDevelopmentDrug PrescriptionsDrug usageEmergency department visitEnvironmentEventExperimental DesignsExposure toFee-for-Service PlansFundingHealthHealth BenefitHealth Care ReformHealth ExpendituresHealthcareHospitalizationHousingIndividualInsurance CarriersIschemic StrokeLow incomeManaged Care ProgramsMassachusettsMeasuresMedicaidMedicalMorbidity - disease rateNatural experimentNicotineOtitis MediaOutcomeOutcome MeasurePersonal SatisfactionPolicePoliciesPrincipal InvestigatorPrivatizationPublic HealthPublic HousingResearchResourcesRiskSeriesSignal TransductionSmokeSmoke-free homeSmokerSmokingTobaccoTobacco Smoke PollutionTobacco Use CessationTobacco smokeU.S. Department of Housing and Urban DevelopmentUnited StatesWorkasthma exacerbationauthoritybasecare outcomesdevelopment policyenvironmental tobacco smokeenvironmental tobacco smoke exposureexperiencefine particlesimprovednicotine replacementnon-smokerquitlineresidencesmoke-free policysmoking cessationthirdhand smoketobacco user
项目摘要
ABSTRACT
Tobacco is the leading preventable cause of death in the United States, affecting both tobacco users and those
exposed to second- and third hand smoke. Residents of low-income, multiunit housing are particularly
vulnerable to tobacco smoke exposure. Low-income individuals are more likely to smoke, which in turn
increases the tobacco smoke exposure of people sharing their environments. In November of 2015, the U.S.
Department of Housing and Urban Development (HUD) proposed a rule requiring federally-funded public
housing authorities (PHAs) to establish smoke-free policies for their residences, potentially reducing the
morbidity associated with smoking and tobacco smoke exposure. Massachusetts PHAs have been at the
forefront of smoke-free housing policies and their experience provides an early opportunity to assess the
health benefits of HUD's proposed smoke-free policy, as well as smoke-free policies in other low-income
housing. The principal investigator and colleagues have shown that public housing developments with smoke-
free policies have lower levels of tobacco smoke pollution in the air (fine particle matter [PM2.5], nicotine) than
those without smoke-free policies. In addition, they found that after the Boston Housing Authority introduced its
smoke-free policy in 2012, airborne nicotine in residents' apartments went down by 70%. While the evidence
that smoke-free housing policies reduce tobacco smoke pollution in PHAs is promising, the existing research
has notable limitations. Furthermore, no studies have yet examined changes in health outcomes for residents
following the introduction of smoke-free housing policies. Smokers and non-smokers alike are expected to
benefit from the prohibition of smoking in multiunit housing. We propose assessing the potential health impact
of smoke-free public housing policies on tobacco treatment use, signal adverse clinical events, and health care
spending for all public housing residents in Massachusetts. Our study will use a strong quasi-experimental
design to evaluate a series of natural experiments arising from the staggered introduction of smoke-free
policies in ≥27% of the state's 241 PHAs. Residents in PHAs that do not adopt smoke-free policies will serve
as concurrent controls. We will measure outcomes for PHA residents using 2008-2018 data from the
Massachusetts All Payer Claims Database (APCD), a uniquely comprehensive resource that includes health
care claims for all insured residents from nearly all health insurers in the state. In addition, we will include data
on tobacco treatment use from the Massachusetts state quit line. Findings from this study will have policy-
relevant implications for smoke-free housing in state-funded PHAs (not covered by HUD's policy), other
subsidized and low-income housing, and private housing markets nationally.
摘要
烟草是美国主要的可预防的死亡原因,既影响烟草使用者,
暴露在二手烟和三手烟中。低收入、多单元住房的居民特别多,
易受烟草烟雾的影响。低收入者更有可能吸烟,这反过来又
增加了与他们共享环境的人接触烟草烟雾的机会。2015年11月,美国
住房和城市发展部(HUD)提出了一项规则,要求联邦政府资助的公共
住房当局(PHAs)为他们的住宅制定无烟政策,可能会减少
与吸烟和烟草烟雾暴露有关的发病率。马萨诸塞州的PHA已经在
无烟住房政策的前沿和他们的经验提供了一个早期的机会,
HUD提议的无烟政策的健康益处,以及其他低收入国家的无烟政策
住房首席研究员和他的同事已经证明,有烟雾的公共住房开发-
免费政策的空气中烟草烟雾污染水平(细颗粒物[PM2.5],尼古丁)低于
那些没有无烟政策的人。此外,他们发现,在波士顿住房管理局推出其
在2012年的无烟政策下,居民公寓中空气中的尼古丁下降了70%。虽然证据
无烟住房政策减少PHAs中的烟草烟雾污染是有希望的,现有的研究
具有明显的局限性。此外,还没有研究检查居民健康结果的变化
随着无烟住房政策的实施。吸烟者和不吸烟者都被期望
在多单元住房内禁止吸烟。我们建议评估潜在的健康影响
无烟公共住房政策在烟草治疗使用、信号不良临床事件和医疗保健方面的作用
马萨诸塞州所有公共住房居民的支出。我们的研究将使用强准实验
设计,以评估一系列自然实验所产生的交错引进无烟
在该州241个PHA中,有27%以上的政策。没有采取无烟政策的临时危险区居民将
作为同期对照。我们将使用2008-2018年的数据来衡量PHA居民的结果,
马萨诸塞州所有付款人索赔数据库(APCD),一个独特的综合资源,包括健康
该州几乎所有健康保险公司为所有被保险居民提出的护理索赔。此外,我们还将提供数据
在马萨诸塞州戒烟热线上的烟草治疗使用。这项研究的结果将有政策-
国家资助的PHAs中无烟住房的相关影响(不包括在HUD的政策中),其他
补贴和低收入住房以及全国的私人住房市场。
项目成果
期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Not Just Public Housing: An Ethical Analysis of Expanding Smoke-free Housing Policies in the United States.
不仅仅是公共住房:美国扩大无烟住房政策的伦理分析。
- DOI:10.1177/00333549221099521
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Goldberg,SydneyL;Levy,DouglasE
- 通讯作者:Levy,DouglasE
Validity of Self-Reported Tobacco Smoke Exposure among Non-Smoking Adult Public Housing Residents.
- DOI:10.1371/journal.pone.0155024
- 发表时间:2016
- 期刊:
- 影响因子:3.7
- 作者:Fang SC;Chen S;Trachtenberg F;Rokicki S;Adamkiewicz G;Levy DE
- 通讯作者:Levy DE
Implementation Activities in Smoke-Free Public Housing: The Massachusetts Experience.
- DOI:10.3390/ijerph20010078
- 发表时间:2022-12-21
- 期刊:
- 影响因子:0
- 作者:Lee, Boram;Fung, Vicki;Cheng, David;Winickoff, Jonathan P.;Rigotti, Nancy A.;Shah, Radhika;McGlave, Claire;Goldberg, Sydney;Song, Glory;Doane, Jacqueline;Kingsley, Melody;Henley, Patricia;Ursprung, Sanouri;Banthin, Christopher;Levy, Douglas E.
- 通讯作者:Levy, Douglas E.
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Douglas Levy其他文献
Douglas Levy的其他文献
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Worksite Social Connections and Food Choice: Identifying Opportunities for Obesity Prevention
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9112118 - 财政年份:2016
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工作场所社交联系和食物选择:寻找预防肥胖的机会
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9264535 - 财政年份:2016
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Reducing Environmental Tobacco Smoke Exposure in Public Housing
减少公共住房中的环境烟草烟雾暴露
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8305271 - 财政年份:2012
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$ 81.72万 - 项目类别:
Reducing Environmental Tobacco Smoke Exposure in Public Housing
减少公共住房中的环境烟草烟雾暴露
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8631097 - 财政年份:2012
- 资助金额:
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Reducing Environmental Tobacco Smoke Exposure in Public Housing
减少公共住房中的环境烟草烟雾暴露
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