Neighborhood opportunity and child health using a randomized trial of low-income mothers

使用低收入母亲的随机试验研究邻里机会和儿童健康

• 批准号: 10693323
• 负责人: Tim Allen Bruckner
• 金额: $ 19.14万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10693323
• 关键词: Academy; Address; Adverse effects; Affect; Age; Birth; Black race; Brain; Censuses; Child; Child Development; Child Health; Childhood; Cigarette; Consumption; Control Groups; Criminal Justice; Cross-Sectional Studies; Data; Data Set; Databases; Developing Countries; Development; Dimensions; Disparity; Ecology; Education; Enrollment; Environmental Hazards; Exploratory/Developmental Grant; Exposure to; Family; Funding; Future; Geography; Gifts; Green space; Health; Health Food; Health behavior; Hispanic; Household; Income; Individual; Infant; Influentials; Infrastructure; Life; Life Cycle Stages; Link; Low income; Measures; Mediating; Mediation; Mediator; Mental Health; Mothers; National Institute of Child Health and Human Development; Neighborhoods; Newborn Infant; Not Hispanic or Latino; Outcome; Parents; Pathway interactions; Pattern; Pollution; Poverty; Public Health; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Design; Research Personnel; Residential Mobility; Resources; Risk; Role; Running; Sterile coverings; Weight; Woman; Work; child bearing; child poverty; design; early childhood; experimental study; fruits and vegetables; health data; health disparity; high risk population; improved; indexing; innovation; lower income families; maternal stress; minority children; neighborhood disadvantage; noise pollution; payment; physical conditioning; poverty reduction; programs; racial minority; randomized trial; recruit; residence; residential segregation; sleep quality; social health determinants; treatment group

Project Summary (30 lines) A recent influential National Academies Report concludes that poverty during early childhood (i.e., <3 years) may causally increase the risk of adverse physical health, mental health, and developmental outcomes. A key challenge now involves how best to intervene on poverty to improve child health. In addition to individual poverty, one critical aspect of income-based health disparities in the US involves neighborhood poverty. Poverty in the US remains highly spatially patterned. Extensive research documents high levels of racial residential segregation in the US as well geographic concentration of both poverty and affluence. Black and Hispanic racial minority children in particular have non-overlapping worse distributions of childhood opportunity than do non- Hispanic white children. Above and beyond individual poverty, living in disadvantaged neighborhoods may damage child health, including via high residential segregation, limited healthy food outlets, fewer green spaces, and higher neighborhood poverty. We will use the R21 mechanism to explore the potentially causal role on child health of moving to neighborhoods characterized by childhood opportunity. We will build on the NICHD-funded Baby's First Years (BFY) study, initiated in 2018, which is the first large-scale US experiment of unconditional cash transfers to poor families with infants. The randomized trial recruited 1,000 mothers of newborn infants with household cash incomes below the poverty line. Mothers in the treatment group receive monthly cash payments of $333 ($4,000 per year) for the first 52 months of the child's life, and mothers in the control group receive $20 per month. We will use randomization to the high-cash gift in an intent-to-treat design to examine two questions. First, do mothers with a partial alleviation of cash constraints move to neighborhoods characterized by greater childhood opportunity? And second, are gains in child health (by age-2) in this high-cash group mediated by neighborhood moves? We will leverage both residential address and rich child health data from BFY across three waves, as well as neighborhood indices of childhood opportunity and geocoded distance measures, to achieve all aims. For the child health aim, we will focus on neighborhood mediation of main effects that already have emerged by age-2: sleep quality, increased consumption of fruits and vegetables, and mother's reduced purchasing of cigarettes. Our work is significant in two ways. First, we focus on redressing large, widespread, and robust income-based disparities in child health in the US. Second, we examine the important question of whether low-income parents who are partially relieved of income constraints move to childhood opportunity neighborhoods at a sensitive period of their child's development. Given the rigorous intent-to-treat study design and the infrastructure of BFY to achieve our Aims, our analyses may identify causal estimates of neighborhoods on child health. Even precisely estimated null findings for the neighborhood/child health aim hold strong scientific value since they would suggest non-neighborhood mediators through which income affects child health.

项目摘要(30行) 美国国家科学院最近一份颇具影响力的报告得出结论，儿童早期(即3年)的贫困 可能会因此增加不利的身体健康、心理健康和发育结果的风险。一把钥匙 现在的挑战涉及如何最好地干预贫困以改善儿童健康。除了个人 贫困是美国基于收入的健康差距的一个关键方面，涉及邻里贫困。贫困 在美国仍然是高度空间化的。广泛的研究记录了高水平的种族居住 美国的种族隔离以及贫穷和富裕的地理集中。黑人和西班牙裔种族 特别是少数族裔儿童的童年机会分布不重叠，比非少数民族儿童更差。 西班牙裔白人儿童。除了个人贫困之外，生活在贫困社区的人可能 损害儿童健康，包括通过居民区高度隔离、有限的健康食品商店、更少的绿地、 以及更高的社区贫困率。 我们将使用R21机制来探索搬到社区对儿童健康的潜在因果作用 以童年机遇为特征的。我们将在NICHD资助的婴儿第一年(BFY)研究的基础上， 2018年启动，这是美国第一次向贫困家庭无条件转移现金的大规模试验 和婴儿在一起。这项随机试验招募了1000名家庭现金收入较高的新生儿母亲 在贫困线以下。治疗组的母亲每月收到333美元(每人4000美元)的现金付款 在孩子出生后的前52个月，母亲每月可得到20美元。我们会 在意向治疗设计中，对高额现金礼物进行随机化，以检查两个问题。首先，母亲们 随着现金短缺的部分缓解，搬到以童年时期为特征的社区 机会？其次，这个高现金群体的儿童健康(到2岁)的收益是由社区调节的 搬家？我们还将利用来自BFY的住宅地址和丰富的儿童健康数据跨越三个浪潮 作为童年机会的邻里指数和地理编码的距离度量，以实现所有目标。对于 儿童健康目标，我们将重点放在邻里调解已经出现的主要影响-2岁： 睡眠质量、水果和蔬菜消费量的增加，以及母亲减少香烟购买量。 我们的工作在两个方面具有重要意义。首先，我们专注于纠正大规模、广泛和稳健的基于收入的 美国儿童健康方面的差距。第二，我们研究了一个重要的问题，即低收入父母 部分摆脱了收入限制的人在一个敏感的时期搬到了童年机会社区 他们的孩子处于发育的时期。鉴于BFY严格的意向治疗研究设计和基础设施 为了实现我们的目标，我们的分析可能会确定社区对儿童健康的因果估计。即使是准确地说 社区/儿童健康目标的估计无效发现具有很强的科学价值，因为它们将 建议通过非邻里关系调节收入对儿童健康的影响。