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对非裔美国居民的种族，居住隔离的城市社区费城，宾夕法尼亚州。本提案的具体目标集中在以下问题上：1.在种族和居住隔离的城市环境中，不同水平的社会资本和社会资本的不同措施（结构性，认知性）预测心理健康结果和癌症预防行为，个人水平的组成特征（年龄，性别，社会经济地位，外国出生的身份）？2.是社会资本对癌症预防行为和心理健康结果在隔离社区介导的邻里特征（贫困水平，暴力的数量，非急性医疗保健设施的存在，隔离水平）的影响。一个由经验丰富的调查人员组成的指导小组已经组建起来进行这项研究，其中包括社会流行病学（Ichiro Kawachi），心理健康差异（大卫威廉姆斯），癌症流行病学（卡特里娜阿姆斯特朗）和人口统计学（Dolores Acevedo-Garcia）方面的领先国家专家。拟议的论文符合国家癌症研究所的使命“消除痛苦和死亡，由于癌症和先发制人的癌症在每一个机会”。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中的作用-这是一个癌症死亡率较高的群体-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。这项研究将利用三个主要的数据来源：2004年宾夕法尼亚州东南部健康家庭调查（SPHHS）管理的费城健康管理公司的数据，美国人口普查数据，和当地的公共记录。2004年版的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。将使用费城街道部门的数据和美国卫生与公众服务部卫生资源和服务管理局网站上的非急性护理设施的存在来评估街区聚会的存在。将使用基于2000年美国人口普查数据的新型隔离措施对费城县的隔离区域进行汇总和地理编码。

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.