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: 10374288
• 负责人: Daiane Borges Machado
• 金额: $ 34.39万
• 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/10374288
• 关键词: Achievement; Address; Adult; Affect; African; Age; Alcohol consumption; Appointment; Behavior; Behavioral; 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; Ethnic Origin; Exposure to; Family; Future; Gender; Government Programs; Health; Health Services; Health care facility; Healthcare; Hospitalization; Household; Improve Access; Impulsivity; Incidence; Income; Individual; Intervention; Lead; Life; Life Cycle Stages; Link; Long-Term Effects; Low income; Mediator of activation protein; Mental Health; Mental disorders; Methodology; Modeling; Municipalities; Neighborhoods; Notification; Outcome; Pathway interactions; Persons; Phase; Policies; Population; Poverty; Prevalence; Prevention; Program Effectiveness; Qualifying; Race; Savings; Schools; Social Change; Social Protection; Subgroup; Suicide; Testing; Time; United States; Violence; Vulnerable Populations; Woman; Youth; aged; base; 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; mortality; pandemic disease; prevent; programs; reducing suicide; response; scale up; 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.

项目概要 身体、情感和社会变化，包括遭受贫困、虐待或暴力，会增加青少年的数量 容易患精神疾病。这些因素干扰发展、限制机会并阻碍 作为成年人实现充实的生活。解决这些问题可以改善结果 人口水平和更好的卫生服务成本效益。这对于低和 中等收入国家，因为这些国家有大量经济和社会弱势群体 设置。 现金转移计划是解决心理健康状况不佳的一些社会驱动因素的一种有前途的方法 青年之中。事实证明，此类计划可以缓解收入限制、提高教育水平和 获得医疗设施服务，并减少饮酒和家庭暴力。但目前仍不清楚 哪些途径和机制解释了社会经济支持与较低心理水平之间的关联 青少年中的疾病。 在这个项目中，我们将评估社会驱动因素对青少年心理健康相关住院治疗的影响，以及 自杀，测试全国社会经济干预的机制和途径，并检查时机 生命过程中的干预。例如，确定现金转移是否提前交付 随着时间的推移，生活可以带来更好的结果。该项目还将调查现金转移对 弱势群体（非洲后裔、妇女和收入较低的青年）。 我们将评估社会驱动因素的决心以及有条件受益人之间的关联 现金转移计划，称为 Bolsa Família 计划 (BFP)，以及精神疾病及其长期影响 对大数据集使用稳健的方法，例如回归不连续性设计、倾向评分 匹配和差异中的差异。我们将测试 BFP 和心理之间的机制和路径 使用结构方程模型研究青少年与健康相关的住院和自杀情况。此外，我们 将进行微观模拟，以生成有关心理健康相关住院治疗和住院治疗情况的预测 根据目前的状况，未来的自杀趋势以及 BFP 实施方案将如何影响 这些趋势。 该项目的结果对于指导改善心理健康和健康的政策和计划至关重要。 减少青少年因心理健康相关的住院治疗和自杀。它将提供信息以改进 这些计划在全球范围内的有效性。最后，它有可能推动全球经济辩论 应对大流行和经济危机时期。现金转移是否可以减少心理健康问题 减少青少年自杀，这将对拯救生命产生巨大影响。