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.

项目概要/摘要：主页 怀孕结果方面的种族差异，包括母亲发病率和死亡率的升高 和他们的婴儿，持续存在，并不能完全解释个别风险因素。黑人分娩 美国人受影响的可能性是白色人的三倍，在威斯康星州， 风险是五倍。由于密尔沃基，威斯康星州是五个最隔离的城市之一， 在美国，黑人生育家庭也比白色家庭更有可能是低收入家庭， 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，使后代永远贫穷和健康状况不佳。有 在了解住房不稳定对孕产妇健康的影响方面存在重大差距，我们力求 在这个提案中。“减少住房不稳定和邻里贫困， 母亲健康”（HOME）提案的中心假设是，调查不同的 住房状况和稳定性对孕产妇身心健康的影响将更加深刻 了解住房不稳定对怀孕结果的影响，并推动政策变革 减少孕产妇健康差距。在目标1中，我们将了解个人和社区 特点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， 和妊娠结局。在目标3，我们会确定每个地区孕妇的服务需要， 住房状况，并倡导政策层面的变化，以解决生育中的住房不稳定问题， 人拟议的研究将梳理出这些因素和特征的贡献， 与产妇健康结果相关。这项工作可以为筛选工具提供信息， 妊娠风险，告知政策变化，并阐明结构因素 造成健康差距。