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

描述(由申请人提供)：拟议的论文多层次研究将调查宾夕法尼亚州费城种族隔离的城市社区中非裔美国人的乳腺癌和前列腺癌预防性筛查行为和心理健康结果的社会决定因素。这项建议的具体目标集中在以下问题：1.不同程度的社会资本纽带和不同的社会资本措施(结构和认知)是否预测种族和居住地隔离的城市环境中的心理健康结果和癌症预防行为，扣除个人层面的构成特征(年龄、性别、社会经济地位、外国出生状况)？2.社会资本对隔离社区的癌症预防行为和心理健康结果的影响是否通过邻里特征(贫困程度、暴力程度、非急性医疗机构的存在、隔离程度)来调节。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(Kawachi)、精神健康差距(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。这篇论文符合国家癌症研究所的使命：“消除癌症带来的痛苦和死亡，抢占癌症先机”。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预防行为方面的作用，非裔美国人是癌症死亡率较高的群体，这符合NCI加快癌症预防进展和改善早期发现和诊断的愿望。这项研究将利用三个主要数据来源：费城健康管理公司管理的2004年宾夕法尼亚州东南部健康家庭调查(SPHHS)数据、美国人口普查数据和当地公共记录。2004年版的SPHHS包括来自社会资本社区基准调查的精神健康状况自我报告、癌症预防筛查行为和社会资本衡量标准。街区派对的存在将使用来自费城街道部门的数据和来自美国卫生与公众服务部卫生资源和服务行政网站的非急性护理设施的存在进行评估。数据将被汇总，并使用基于2000年美国人口普查数据的一种新的隔离措施，对费城的隔离地区进行地理编码。

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.