Residential Characteristics and Child Health and Well-Being

居住特征与儿童健康和福祉

• 批准号: 10004259
• 负责人: Andrew Fenelon
• 金额: $ 23.53万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10004259
• 关键词: Adult; Affect; Attention; Biological Markers; Biometry; Body mass index; Caring; Characteristics; Child; Child Development; Child Health; Child Welfare; Childhood; Complex; Data; Data Linkages; Data Set; Demography; Disadvantaged; Ensure; Family; Foundations; Future; Geography; Glycosylated Hemoglobin; Goals; Health; Health Policy; Health Status; Housing; Intervention; Interview; Investigation; Investments; Knowledge; Lead; Length; Life Cycle Stages; Link; Measurement; Measures; Mediation; Medical; Medicare/Medicaid; Mental Health; Modeling; National Health Interview Survey; National Health and Nutrition Examination Survey; Neighborhoods; Outcome; Parents; Pathway interactions; Patient Self-Report; Pattern; Personal Satisfaction; Play; Policies; Population; Program Development; Public Housing; Records; Reporting; Research; Research Design; Resources; Role; Sampling; Surveys; Time; U.S. Department of Housing and Urban Development; Waiting Lists; Work; cardiometabolic risk; critical period; design; experience; food insecurity; improved; indexing; innovation; lower income families; mortality; novel; physical conditioning; programs; public health research; research and development; social; voucher

PROJECT ABSTRACT Programs that improve housing quality, stability, and affordability present an important opportunity to intervene on a social determinant of child health and wellbeing, and child health is known to play an important role in outcomes across the life course. The US Department of Housing and Urban Development (HUD) provides housing assistance to 5 million families including 3 million children, yet housing assistance is an understudied social determinant of child health and wellbeing. The benefits of housing assistance may be particularly important for children. Improved conditions during critical periods in childhood may lead to better outcomes throughout the life course. Furthermore, most existing research has used small and geographically-limited samples, relied on self-reported housing status, and failed to identify suitable comparison populations, rendering results potentially biased by unobserved confounders. The objective of this project is to overcome these previous limitations and advance understanding of the relationship between housing assistance and child health, focusing on physical health status, wellbeing, and cardiometabolic risk. The project uses a novel data linkage between the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey (NHIS) (expected n's: 2,200 and 3,047, respectively) and HUD longitudinal administrative records. The central hypothesis is that housing assistance leads to improved health and wellbeing for disadvantaged children, although the pattern of this effect may depend on the specific housing program (public housing, housing choice vouchers, multifamily housing). The analysis uses an innovative study design to isolate the causal impact of housing assistance on child health using a pseudo waitlist design. The project examines whether children receiving housing assistance at the time of interview experience better health and wellbeing outcomes than their counterparts who enter housing assistance within 2 years of their interview, the mean length of HUD waitlists (Aim 1). The project also considers whether these effects differ by specific housing program, comparing public housing, housing choice vouchers, and multifamily housing programs (Aim 2). These programs have shown disparate effects in previous research on adults. Finally, the project examines the effects of housing assistance on key intermediate outcomes associated with child health, including: a) parent mental health, b) food insecurity, c) access to medical care, and d) neighborhood context (Aim 3). The results will provide the most comprehensive picture of the potential health impacts of improved housing for a national sample of children, and can inform future public health research, practice, and policies that affect children. This exploratory study will provide preliminary data needed to build a more comprehensive and robust investigation of housing assistance and health, laying the groundwork for our larger research agenda on the impact of housing and neighborhoods on health and wellbeing throughout the life course.

项目摘要 改善住房质量、稳定性和可负担性的计划提供了一个重要的干预机会 关于儿童健康和幸福的社会决定因素，众所周知，儿童健康在以下方面发挥重要作用 在整个生命过程中的结果。美国住房和城市发展部(HUD)提供 向500万个家庭提供住房援助，其中包括300万名儿童，但住房援助尚未得到充分研究 儿童健康和幸福的社会决定因素。住房援助的好处可能特别 对孩子来说很重要。改善儿童时期关键时期的状况可能会带来更好的结果 在整个生命过程中。此外，现有的大多数研究都使用了规模小且受地理限制的 样本，依赖于自我报告的住房状况，未能确定合适的比较人群， 渲染结果可能会受到未观察到的混杂因素的影响。这个项目的目标是克服 这些以前的限制和对住房援助和住房援助之间关系的进一步理解 儿童健康，重点关注身体健康状况、幸福感和心脏代谢风险。该项目使用了一部小说 国民健康和营养检查调查(NHANES)、国民健康 访谈调查(NHIS)(预期人数分别为2200人和3047人)和住房和城市发展部纵向管理 唱片。核心假设是住房援助能改善人们的健康和福祉 弱势儿童，尽管这种影响的模式可能取决于具体的住房计划(公共住房 住房、住房选择代金券、多户住房)。这项分析使用了创新的研究设计来 使用伪候补名单设计来隔离住房援助对儿童健康的因果影响。该项目 检查在采访时接受住房援助的儿童是否体验到更好的健康和 与在面谈后两年内参加住房援助的同龄人相比， 住房和城市发展部等候名单的平均长度(目标1)。该项目还考虑了这些影响是否因具体情况而有所不同 住房计划，比较公共住房、住房选择代金券和多户住房计划(AIM 2)。在之前对成年人的研究中，这些项目显示出了不同的效果。最后，该项目检查了 住房援助对与儿童健康有关的关键中间成果的影响，包括：a) 父母精神健康，b)粮食不安全，c)获得医疗保健，d)邻里环境(目标3)。这个 结果将提供最全面的图景，说明改善住房对健康的潜在影响 全国儿童样本，并可为未来的公共卫生研究、实践和影响 孩子们。这项探索性研究将提供所需的初步数据，以建立更全面和稳健的 调查住房援助和卫生，为我们更大的研究议程奠定基础 住房和社区对生命过程中的健康和福祉的影响。