Cancer prevention, mental health and social capital of segregated Black Americans

描述（由申请人提供）：本论文拟进行多层次研究，探讨美国宾夕法尼亚州费城种族隔离城市社区非裔美国人乳腺癌和前列腺癌预防筛查行为和心理健康结果的社会决定因素。本提案的具体目标集中在以下几个问题上：在种族和居住隔离的城市环境中，不同的社会资本结合水平和不同的社会资本测量（结构的、认知的）能否预测心理健康结果和癌症预防行为，以及个人层面的构成特征（年龄、性别、社会经济地位、外国出生身份）？2. 是社会资本对隔离社区中癌症预防行为和心理健康结果的影响，受社区特征（贫困程度、暴力程度、非紧急医疗设施的存在、隔离程度）的调节。一个由经验丰富的调查人员组成的指导小组已被召集起来进行这项研究，其中包括社会流行病学（Ichiro Kawachi）、心理健康差异（David Williams）、癌症流行病学（Katrina Armstrong）和人口学（Dolores Acevedo-Garcia）方面的主要国家专家。拟议的论文符合国家癌症研究所的使命“消除癌症造成的痛苦和死亡，抓住一切机会预防癌症”。从这项研究中获得的知识可以帮助理解社会资本在促进非裔美国人（癌症死亡率较高的群体）癌症预防行为方面的作用，这符合NCI加速癌症预防进展和改善早期发现和诊断的愿望。本研究将利用三个主要数据来源：2004年宾夕法尼亚州东南部健康家庭调查（SPHHS）由费城健康管理公司管理的数据，美国人口普查数据和当地公共记录。2004年版本的SPHHS包括心理健康状况的自我报告、癌症预防筛查行为和社会资本社区基准调查的社会资本措施。将使用来自费城街道部门的数据和来自美国卫生和人类服务部卫生资源和服务管理局网站的非急性护理设施的数据来评估街区派对的存在。使用基于2000年美国人口普查数据的一种新的隔离措施，数据将被汇总和地理编码到费城县的隔离地区。

DESCRIPTION (provided by applicant): The proposed dissertation multi-level study will investigate the social determinants of breast and prostate cancer preventive screening behaviors and mental health outcomes on African-American residents of racially, residentially segregated urban neighborhoods of Philadelphia, Pennsylvania. The Specific Aims of this proposal focus on the following questions: 1. Do different levels of bonding social capital and different measures (structural, cognitive) of social capital predict mental health outcomes and cancer preventive behaviors within racially and residentially segregated urban settings, net of individual-level compositional characteristics (age, gender, socioeconomic position, foreign-born status)? 2. Is the effect of social capital on cancer preventive behaviors and mental health outcomes in segregated communities mediated by neighborhood characteristics (level of poverty, amount of violence, presence of non-acute health care facilities, level of segregation). A mentoring team of experienced investigators has been assembled to pursue this study, including leading national experts on social epidemiology (Ichiro Kawachi), mental health disparities (David Williams), cancer epidemiology (Katrina Armstrong), and demography (Dolores Acevedo-Garcia). The proposed dissertation accords with the National Cancer Institute's mission "to eliminate suffering and death due to cancer and to preempt cancer at every opportunity". The knowledge gained from this study can aid in understanding the role of social capital in promoting cancer preventive behaviors in African-Americans - a group with higher cancer mortality rate -- which fits NCI's desire to accelerate progress in cancer prevention and improve early detection and diagnosis. This study will draw on three main sources of data: the 2004 Southeastern Pennsylvania Health Household Survey (SPHHS) administered by the Philadelphia Health Management Corporation data, US Census Data, and local public record. The 2004 version of the SPHHS includes the self-report of mental health conditions, cancer preventive screening behaviors, and social capital measures from the Social Capital Community Benchmark Survey. Presence of block parties will be assessed using data from the City of Philadelphia Department of Streets and presence of non-acute care facilities from the the US Department of Health and Human Services Health Resources and Service Administratrion website. Data will be aggregated and geocoded to segregated areas of Philadelphia County using a novel measure of segregation based on 2000 US Census Data.