Childhood Housing Assistance and Adult Health: Life Course Critical Periods and Cumulative Impact

儿童时期与住房有关的住房需求增加了成年后患慢性病的风险。在 特别是，在整个童年时期和整个儿童时期， 儿童时期的特定关键时期增加了成年人患慢性健康疾病的风险。政府住房 援助帮助约500万低收入家庭满足与贫困有关的住房需求， 大规模然而，先前的研究并没有调查儿童时期的住房援助是否 减轻与童年贫困有关的住房需求对成年慢性健康发展的影响 条件更具体地说，以前的研究没有审查住房援助的影响， 儿童期对成年期肥胖症及其两种并发症糖尿病和高血压的发展有影响。以来 这三种慢性病正在以流行病的比例增加，迫切需要确定 儿童时期的政府住房援助是否会影响成年肥胖症、糖尿病和 高血压如果是这样的话，扩大政府住房援助可以减轻童年的影响， 在这些成人条件下，在整个人口范围内，与贫困有关的住房需求。这项研究有两个 具体目标：（1）审查政府住房援助的时间（“关键时期”）（如果有的话）是否在 儿童期与成人期肥胖有关，（2）检查是否持续时间（“累积暴露”） 儿童时期接受的政府住房援助（如果有的话）与成人肥胖有关。到 为了实现这些目标，调查人员将利用收入动态小组研究（PSID）的51年 纵向设计（1968 - 2019年），跟踪7,000多名低收入者，从出生前到出生后， 成年他们还将利用PSID的家庭结构来比较兄弟姐妹之间的结果， 家庭固定效应此外，他们还将利用PSID与HUD数据的有限联系， 各州何时采用住房援助的可变性。他们的方法反映了团队的公共健康， 计量经济学观点：将从两个方面审查获得住房援助的情况： 一个县的住房援助（意向治疗）和实际接受住房援助（治疗中的治疗）。 通过意向治疗方法以及倾向评分匹配解决内分泌问题。 这项拟议中的研究意义重大，因为它将填补住房援助是否能 减轻儿童贫困相关住房需求对成年肥胖、高血压和糖尿病的影响 in a population人口wide范围scale规模.此外，通过确定关键期和累积期， 优化住房援助管理所需的暴露，以最大限度地改善 人口规模。 这项研究是创新的，通过其独特的限制链接到HUD数据和其51- 年纵向设计。它也是创新的，利用意向治疗和治疗的治疗 方法和利用各州何时采用住房援助的外生可变性。

Poverty-related housing needs during childhood increase the risk of chronic health conditions as an adult. In particular, cumulative exposure to poverty-related housing needs across childhood and exposure during specific critical periods of childhood elevate the risk of adult chronic health conditions. Government housing assistance assists ~5 million low income families with those poverty-related housing needs on a population- wide scale. However, prior research has not investigated whether housing assistance during childhood mitigates the impact of childhood poverty-related housing needs on the development of adult chronic health conditions. More specifically, prior research has not examined the impact of housing assistance during childhood on the development of adult obesity and two of its complications, diabetes and hypertension. Since these three chronic conditions are increasing at epidemic proportions, there is a critical need to identify whether government housing assistance in childhood impacts the development of adult obesity, diabetes, and hypertension. If so, expansion of government housing assistance could ameliorate the impact of childhood poverty-related housing needs on these adult conditions on a population-wide scale. This research has two specific aims: (1) Examine if the timing (“critical periods”) of government housing assistance (if any) during childhood is associated with adult obesity, and (2) Examine whether duration (“cumulative exposure”) of government housing assistance received during childhood (if any) is associated with adult obesity. To accomplish these aims, the investigators will utilize the Panel Study of Income Dynamics’s (PSID) 51-year longitudinal design (1968 - 2019) to follow over 7,000 low income individuals from before their birth into adulthood. They will also take advantage of PSID’s family structure to compare outcomes among siblings using family fixed effects. In addition, they will leverage PSID’s restricted linkages to HUD data and the exogenous variability of when counties adopted housing assistance. Their approach reflects the team’s public health and econometric perspectives: exposure to housing assistance will be examined in two ways--availability of housing assistance in a county (intent-to-treat) and actual receipt of housing assistance (treatment-on-treated.) Endogeneity is addressed through the intent-to-treat approach as well as through propensity score matching. The proposed research is significant because it will fill a critical gap in whether housing assistance can ameliorate the impact of childhood poverty-related housing needs on adult obesity, hypertension, and diabetes on a population-wide scale. Furthermore, it is significant by identifying the critical periods and cumulative exposures that are needed to optimize the administration of housing assistance to most improve health on a population-wide scale. This research is innovative through its unique restricted linkage to HUD data and its 51- year longitudinal design. It is also innovative by utilizing both intent-to-treat and treatment-on-treated approaches and leveraging the exogenous variability of when counties adopted housing assistance.