Revitalization vs. relocation: impacts of community development on opioid and other drug abuse

项目摘要 二十多年来，美国的经济适用房政策一直以重建公共住房为中心 综合体进入混合收入社区，并为公共住房居民提供搬迁凭证 私人房屋市场的资助房屋。这一住房战略对健康的影响是 在研究中进行了评估，这些研究既没有调查它们对阿片类药物和其他药物滥用的影响， 长期以来，阿片类药物流行病一直存在，他们也没有确定是否搬迁到其他国家， 社区，包括那些有更好的设施，是更有益于健康比留在 正在重建的社区。这项拟议的研究将是第一批前瞻性调查， 公共住房重建对阿片类药物和其他药物滥用及相关健康结果的影响 (e.g.,艾滋病毒、丙型肝炎病毒、精神障碍），以及 从重建社区搬迁的居民（n = 125），相对于留在非重建社区的居民， 重建比较公共住房社区（n = 125）。我们将调整和完善我们的招聘， 保留策略，以建立三个小组的公共住房居民，并采用严格的（例如， 倾向分数）和创新方法（例如，步行民族志），以实现以下目标 具体目标：目标1a：评估阿片类药物和其他药物滥用的相似性和差异， 结果（HCV，HIV，精神障碍），卫生服务使用（例如，药物治疗）和微观层面 环境条件（例如，社会、房屋、邻里）的比例 重建前的居民（例如，新建、搬迁等）目标1b：评估 居住在重建社区和从重建社区搬迁，相对于居住 在非发展中国家社区关于类阿片和其他药物滥用及相关成果的一年期员额 招募目标2：从20名成年人中引出关于微观环境条件和健康的叙述， 每个子队列在重建前和入组后一年。通过实现这些目标， 为新的R01建立子队列，以加强经济适用房政策影响的证据 关于阿片类药物和其他药物滥用及相关结果，并告知巴尔的摩未来的住房政策， 其他城市可以设计得更有利于健康。强大的合作者团队，具有以下方面的专业知识： 建立难以接触的人群和公共住房居民的队列，人种学研究，以及 因果推理，将增加可行性，严谨性和成功实现拟议的目标。

Project Summary For more than two decades, U.S. affordable housing policy has centered on redeveloping public housing complexes into mixed-income communities and providing public housing residents with vouchers to relocate to subsidized housing in the private housing market. The health impacts of this housing strategy have been evaluated in studies that neither investigate their impacts on opioid and other drug abuse in contexts where there have been longstanding opioid epidemics, nor have they determined whether relocating to other neighborhoods, including to those with better amenities, is more beneficial to health than remaining in communities that are redeveloping. The proposed study will be among the first prospective investigations of the impacts of public housing redevelopment on opioid and other drug abuse and related health outcomes (e.g., HIV, HCV, mental disorders) among residents who remain in a redeveloping community (n=125) and residents who relocate from a redeveloping community (n=125), relative to residents who remain in a non- redeveloping comparison public housing community (n=125). We will adapt and refine our recruitment and retention strategies to establish the three sub-cohorts of public housing residents and apply rigorous (e.g., propensity scores) and innovative methodologies (e.g., walking ethnographies) to accomplish the following specific aims: Aim 1a: Assess similarities and differences in opioid and other drug abuse, related health outcomes (HCV, HIV, mental disorders), health service use (e.g., drug treatment), and micro-level environmental conditions (e.g., social, housing, neighborhood) among the three sub-samples of public housing residents prior to redevelopment (e.g., new construction, relocation, etc.) Aim 1b: Evaluate initial impacts of residing in the redeveloping community and of relocating from the redeveloping community, relative to residing in the non-developing community on opioid and other drug abuse and related outcomes, one-year post enrollment Aim 2: Elicit narratives on micro-level environmental conditions and health among 20 adults from each sub-cohort prior to redevelopment and one-year post enrollment. By accomplishing these aims we will establish sub-cohorts for a novel R01 that will strengthen evidence on the impact of affordable housing policies on opioid and other drug abuse and related outcomes, and inform how future housing policies in Baltimore and other cities can be designed to be more health-promoting. The strong team of collaborators with expertise in establishing cohorts of hard-to-reach populations and public housing residents, ethnographic research, and causal inference, will increase feasibility, rigor and successful achievement of the proposed aims.