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 将综合体改造成混合收入社区，并向公屋居民提供搬迁代金券 私人住房市场上的补贴住房。这一住房战略对健康的影响是 在既不调查其对阿片类药物和其他药物滥用的影响的研究中进行评估 阿片类药物的流行由来已久，他们也没有确定是否会搬迁到其他 社区，包括那些有更好便利设施的社区，比留在 正在重建的社区。这项拟议的研究将是首批前瞻性调查之一 公共房屋重建对阿片类药物和其他药物滥用及相关健康后果的影响 (例如，艾滋病毒、丙型肝炎、精神障碍)仍在重建社区的居民(n=125)和 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 重建比较公屋社区(n=125)。我们将调整和完善我们的招聘和 保留策略，以建立公屋居民的三个子群，并严格执行(例如， 倾向评分)和创新方法(例如，行走的人种志)，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、相关健康方面的异同 结果(丙型肝炎病毒、艾滋病毒、精神障碍)、卫生服务使用(例如药物治疗)和微观层面 公共住房三个子样本中的环境条件(例如，社会、住房、社区) 重建前的居民(例如新建、搬迁等)目标1b：评估以下项目的初步影响 居住在重建社区和从重建社区搬迁，相对于居住 在非发展中社区，关于阿片类药物和其他药物滥用及相关后果，一年后 招生目标2：在20名成年人中激发关于微观环境条件和健康的叙述 每个子队列在重新开发之前和注册后一年。通过实现这些目标，我们将 为新的R01建立子队列，以加强关于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后果，并告知巴尔的摩和其他地区未来的住房政策 其他城市可以设计成更有利于健康的城市。具有以下专业知识的强大合作者团队 建立难以到达的人群和公共住房居民的队列，人种学研究，以及 因果推论，将增加可行性、严谨性和成功实现所提出的目标。

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.