The effect of HOusing instability and neighborhood deprivation on Maternal hEalth-HOME

住房不稳定和邻里剥夺对孕产妇健康的影响-HOME

• 批准号: 10756017
• 负责人: Julia B Dickson-Gomez
• 金额: $ 61.35万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2030-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10756017
• 关键词: Acute; Address; Adult; Advocate; Affect; Area; Attention; Biological; Biological Markers; Birth; Black race; COVID-19 pandemic; Case Management; Categories; Characteristics; Child; Chronic; Church; Cities; Communities; Continuity of Patient Care; County; Disabled Persons; Disparity; Economics; Electronic Health Record; Eligibility Determination; Emergency Situation; Family; Friends; Funding; Future Generations; Health; Health Status; Healthcare; Homelessness; Housing; Income; Indigenous; Individual; Infant; Institutional Racism; Knowledge; Longitudinal Surveys; Low Income Population; Low income; Maps; Marketing; Maternal Deprivation; Maternal Health; Maternal Mortality; Measures; Mental Health; Mental Health Services; Morbidity - disease rate; Mothers; Neighborhoods; Outcome; Participant; Persons; Physical assessment; Policies; Population; Postpartum Period; Poverty; Pregnancy; Pregnancy Outcome; Premature Birth; Psychiatric Social Work; Racial Segregation; Recording of previous events; Research; Risk; Risk Factors; Sampling; Screening procedure; Second Pregnancy Trimester; Section 8; Services; Shelter facility; Site; Social Work; Stress; Surveys; Third Pregnancy Trimester; Time; U.S. Department of Housing and Urban Development; Veterans; Visit; Wisconsin; Work; allostatic load; deprivation; ethnic segregation; experience; health disparity; health inequalities; housing instability; improved; infant outcome; lower income families; maternal morbidity; maternal risk; member; metropolitan; mortality; physical conditioning; physical health service; pregnant; programs; racial disparity; racial health disparity; residential segregation; segregation; social health determinants; social structure; structural determinants; substance use; supported housing; transitional housing; voucher

PROJECT SUMMARY/ABSTRACT: HOME Racial disparities in pregnancy outcomes, including heightened morbidity and mortality for mothers and their infants, persist and are not fully explained by individual risk factors. Black birthing people in the US are three times more likely to be affected than their white counterparts, and in Wisconsin, the risk is five times greater. Due to Milwaukee, Wisconsin being one of the five most segregated cities in the US, Black birthing families are also more likely to be low-income than their white counterparts and experience housing instability. Housing instability is a crucial social determinant of health that affects birthing people and their children, perpetuating poverty and poor health in future generations. There is an important gap in knowledge of the effect of housing instability on maternal health, that we seek to address in this proposal. The “Reducing HOusing instability and neighborhood deprivation for Maternal hEalth” (HOME) proposal’s central hypothesis is that investigating the effects of different housing statuses and stability on maternal physical and mental health will lead to more profound understanding of the impact of housing instability on pregnancy outcomes and motivate policy change to reduce maternal health disparities. In Aim 1, we will understand how personal and neighborhood characteristics and services contribute to housing stability among low-income pregnant people to inform programs to improve stability. In Aim 2, we will explore the impact of housing instability/homelessness and neighborhood conditions on allostatic load, physical and mental health, and pregnancy outcomes. In Aim 3, we will identify the service needs of pregnant people in each housing status, and advocate for policy-level change to address housing instability among birthing people. The proposed study will tease out the contribution of these factors and characteristics and correlate them to maternal health outcomes. This work could inform screening tools to assess pregnancy risk, inform policy change, and elucidate biological mechanisms by which structural factors result in health disparities.

项目摘要/摘要：首页 妊娠结局的种族差异，包括母亲发病率和死亡率的升高 及其婴儿，这种情况持续存在，并且不能完全用个体风险因素来解释。黑人生育的人 美国受影响的可能性是白人的三倍，在威斯康星州， 风险是原来的五倍。由于威斯康星州密尔沃基是美国种族隔离最严重的五个城市之一 在美国，黑人出生的家庭也比白人出生的家庭更有可能是低收入家庭， 经历住房不稳定。住房不稳定是影响健康的一个重要社会决定因素 生育人口及其子女，使子孙后代永久贫困和健康状况不佳。有 关于住房不稳定对孕产妇健康的影响的认识存在重大差距，我们力求解决这一问题 本提案中的地址。 “减少住房不稳定和邻里剥夺” 孕产妇健康”（HOME）提案的中心假设是调查不同母亲的影响 住房状况和稳定对孕产妇身心健康的影响将更加深远 了解住房不稳定对妊娠结局的影响并推动政策变革 缩小孕产妇健康差距。在目标 1 中，我们将了解个人和邻里如何 特色和服务有助于低收入孕妇的住房稳定 通知程序以提高稳定性。在目标 2 中，我们将探讨住房的影响 不稳定/无家可归和邻里条件对非稳态负荷、身心健康的影响， 和妊娠结果。在目标3中，我们将确定每个地区孕妇的服务需求。 住房状况，并倡导政策层面的变革，以解决生育期间住房不稳定的问题 人们。拟议的研究将梳理这些因素和特征的贡献，并 将它们与孕产妇健康结果联系起来。这项工作可以为筛选工具提供信息以评估 怀孕风险，为政策变化提供信息，并阐明结构性因素的生物机制 导致健康差异。