The impact of social drivers, conditional cash transfers and their mechanisms on mental health of the young: an integrated retrospective and forecasting approach using the 100 million Brazilian Cohort

社会驱动因素、有条件现金转移及其机制对年轻人心理健康的影响：使用一亿巴西队列的综合回顾和预测方法

• 批准号: 10538619
• 负责人: Daiane Borges Machado
• 金额: $ 36.46万
• 依托单位: FUNDACAO OSWALDO CRUZ
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-09 至 2026-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538619
• 关键词: Achievement; Address; Adult; Affect; African; Age; Alcohol consumption; Appointment; Behavior; Behavioral; Big Data; Black Populations; Brazil; COVID-19; COVID-19 pandemic effects; Child; Communities; Country; Data; Data Set; Development; Diagnosis; Disease; Economic Recession; Economics; Education; Effectiveness; Emotional; Equation; Equity; Ethnic Origin; Exposure to; Family; Future; Gender; Health; Health Services; Health Services Accessibility; Health care facility; Healthcare; Hospitalization; Household; Improve Access; Impulsivity; Incidence; Income; Individual; Intervention; Life; Life Cycle Stages; Link; Long-Term Effects; Low income; Mediator; Mental Health; Mental disorders; Methodology; Modeling; Municipalities; Neighborhoods; Notification; Outcome; Pathway interactions; Persons; Phase; Policies; Policy Maker; Population; Poverty; Prevalence; Prevention; Program Effectiveness; Qualifying; Race; Schools; Social Change; Social Protection; Specific qualifier value; Subgroup; Suicide; Testing; Time; United States; Violence; Vulnerable Populations; Woman; Youth; aged; beneficiary; cohort; cost effectiveness; design; early life exposure; effective therapy; experience; health data; health disparity; improved; improved outcome; innovation; intergenerational; longitudinal dataset; low and middle-income countries; meetings; models and simulation; mortality; pandemic disease; prevent; programs; reducing suicide; response; scale up; simulation; social; social vulnerability; socioeconomics; trend; violence exposure

PROJECT SUMMARY Physical, emotional, and social changes, including exposure to poverty, abuse, or violence, increases youth vulnerability to mental illness. These factors interfere with development, limit opportunities, and hamper achievement of a fulfilling life as adults. Addressing these issues can lead to improved outcomes at the population level and better cost-effectiveness for health services. This should be especially important to low- and middle-income countries, due to the substantial number of financially and socially vulnerable individuals in these settings. Cash transfer programs have been a promising way to address some of the social drivers for poor mental health among youth. It has been shown that such programs can alleviate income restriction, increase schooling and access to health facilities, and decrease alcohol consumption and violence in families. However, it is still unclear which pathways and mechanisms explain the association between socioeconomic support and lower mental illness among youth. In this project, we will evaluate the effect of social drivers on youth mental health-related hospitalizations and suicide, test mechanisms and pathways of a countrywide socioeconomic intervention, and examine the timing of the intervention during the life course. For example, determining whether cash transfers delivered earlier in life can contribute to better outcomes over time. This project will also investigate the cash transfer effect on vulnerable groups (African descendants, women, and youth with lower income). We will evaluate social drivers’ determination and the association between being beneficiaries of the Conditional Cash Transfer program, called the Bolsa Família Program (BFP), and mental illness and its long-term effects using robust methodologies for big datasets, such as Regression Discontinuity Designs, Propensity Score Matching and difference-in-differences. We will test mechanisms and pathways, between BFP and mental health-related hospitalizations and suicide among youth using Structural Equation Modeling. Furthermore, we will perform microsimulations to generate projections regarding how mental health-related hospitalizations and suicide trends will be in the future based on the current state, and how BFP implementation scenarios will affect these trends. The results of this project will be of vital importance to guide policies and programs to improve mental health and reduce mental health-related hospitalizations and suicide in youth. It will provide information to improve the effectiveness of these programs worldwide. Finally, it can potentially advance the global debate on the economic response to the pandemic and times of economic crises. If cash transfers can decrease mental health problems among youth and reduce suicide, it will have a dramatic impact on saving lives.

项目摘要 身体、情感和社会的变化，包括暴露于贫困、虐待或暴力， 易患精神疾病这些因素干扰了发展，限制了机会， 作为成年人的一种充实的生活。解决这些问题可以改善联合国系统的成果， 人口水平和更好的保健服务成本效益。这一点对低收入者尤其重要， 中等收入国家，因为这些国家有大量的财政和社会弱势个人， 设置. 现金转移计划一直是解决精神健康状况不佳的一些社会驱动因素的一种有希望的方法 在年轻人中。事实表明，这些方案可以减轻收入限制，增加学校教育， 获得卫生设施，并减少酒精消费和家庭暴力。但目前尚不清楚 哪些途径和机制解释了社会经济支持和低心理健康之间的联系？ 年轻人的疾病。 在这个项目中，我们将评估社会驱动因素对青年心理健康相关住院的影响， 自杀，测试全国范围内社会经济干预的机制和途径，并检查时间 在生命过程中的干预。例如，确定现金转移是否在2009年早些时候交付， 随着时间的推移，生命可以促进更好的结果。本项目还将调查现金转移对 弱势群体（非洲后裔、妇女和低收入青年）。 我们将评估社会司机的决心和有条件的受益者之间的联系， 现金转移计划，称为Bolsa Família计划（BFP），精神疾病及其长期影响 对大数据集使用强大的方法，例如回归不连续性设计，倾向得分 匹配和差异中的差异我们将测试BFP和心理之间的机制和途径 健康相关的住院和自杀的青年使用结构方程模型。而且我们 将进行微观模拟，以预测与心理健康有关的住院治疗和 自杀趋势将在未来的基础上，目前的状态，以及如何BFP实施方案将影响 这些趋势。 该项目的结果将对指导改善心理健康的政策和方案至关重要， 减少青年中与精神健康有关的住院和自杀。它将提供信息，以改善 这些项目在世界范围内的有效性。最后，它可能会推动全球关于经济增长的辩论。 应对大流行病和经济危机。如果现金转移可以减少心理健康问题 这将对挽救生命产生巨大影响。