Effects of a housing policy experiment on youth behavioral problems

描述（由申请人提供）：不良的邻里环境预测青少年心理健康状况不佳和外化行为，邻里环境中的巨大种族不平等可能在创造和维持健康方面的种族差异方面发挥重要作用。然而，由于大多数研究都是观察性的，而不是实验性的，因此可能存在偏见。邻里健康研究通常对邻里的时间点暴露进行建模，而不是了解邻里暴露轨迹，并且对少数民族，贫困青少年的特定背景关注不够。本研究对5个城市的居民自愿搬迁的社会实验数据进行了二次分析（移动到机会，MTO，研究），以测试如何以及为什么随机分配的报价移动到一个低贫困社区意外地对男孩的行为问题产生不利影响超过4-7年的时间，并告知该计划对心理健康的相反性别影响。我们将补充现有的数据与额外的邻里水平的数据收集，以丰富数据集。MTO是唯一可用的大规模研究，随机分配个人接受不同的社区背景，以支持社区如何塑造心理健康的强因果推断。然而，以往的MTO分析没有整合青少年发展的理论理解，以激励实证分析。以前的分析也没有探讨为什么邻里环境可能会增加男孩的行为问题，某些亚组是否比其他亚组更容易受到邻里搬迁的影响，或者是否有重要的发展敏感期，当暴露于邻里剥夺可能特别影响青少年的心理健康。我们的项目提出了3个目标：目标1：以测试是否移动到一个低贫困社区对男孩的行为问题的影响介导的邻里特征，家庭环境，或物质使用。目标二：分别在男孩和女孩中检查，搬到低贫困社区对行为问题的影响是否受到基线健康状况、家庭/青少年脆弱性或项目地点的影响。目的3：比较暴露于邻里贫困的替代时间或序列模式对男孩行为问题的重要性。该项目将利用一个跨学科的调查团队，包括社会流行病学，精神病学，发展心理学，人口学，公共政策，统计学，医学等领域。该项目将利用实验设计，将创新性地应用因果方法来理解调解，并将模拟随时间变化的邻里接触，这将告知青少年健康的邻里接触期的相关早期生命历程发展时间。由于严格的实验设计，该项目可以提供强有力的政策相关证据的机制，社会政策，如第8节住房券可能会影响人口健康和心理健康。 公共卫生相关性：邻里环境可能是健康差异的一个重要原因，特别是考虑到生命早期积累的风险。这个项目的结果，利用住房搬迁的社会实验，有可能告知文献为什么邻里环境是青少年行为问题的原因，包括探索更多的具体时间和多久生活在低贫困社区可能是最有影响力的青少年心理健康。这些知识将为下一代的干预措施和政策提供信息，以确保青少年不受租金援助政策的伤害;实验设计的结果将为因果途径和潜在的干预点提供信息，以减少心理健康和随后的健康差距的人口负担。

DESCRIPTION (provided by applicant): Adverse neighborhood contexts predict poor mental health and externalizing behavior among adolescents, and the vast racial inequalities in neighborhood environment may play an important role in creating and maintaining racial disparities in health. However, since most research has been observational rather than experimental, it is potentially biased. Neighborhood-health research typically models point-in-time exposures of neighborhoods, in lieu of understanding neighborhood exposure trajectories, and insufficient attention has been paid to the specific contexts navigated by minority, impoverished, adolescents. Our study proposes a secondary analysis of data from a social experiment of voluntary neighborhood relocation using Section 8 Housing Vouchers in 5 cities (the Moving to Opportunity, MTO, Study), to test how and why random assignment of an offer to move to a low-poverty neighborhood unexpectedly adversely affected behavioral problems for boys over a 4-7 year period, and to inform the program's opposite gender effects on mental health. We will complement the existing data with additional neighborhood-level data collection to enrich the dataset. MTO is the only available large- scale study that has randomly assigned individuals to receive different neighborhood contexts, to support strong causal inferences of how neighborhoods shape mental health. Yet prior MTO analyses have not integrated theoretical understanding of adolescent development to motivate empirical analyses. Nor have prior analyses probed why neighborhood context may increase behavioral problems of boys, whether certain subgroups are more likely to be affected than others by neighborhood relocation, or whether there are important developmentally-sensitive periods when exposure to neighborhood deprivation may be especially influential on youth mental health. Our project proposes 3 aims: Aim 1: To test whether effects of moving to a low-poverty neighborhood on behavioral problems for boys are mediated by neighborhood characteristics, family context, or substance use. Aim 2: To examine, separately among boys and girls, whether the effect of moving to a low-poverty neighborhood on behavioral problems is modified by baseline health status, family/adolescent vulnerability, or program site. Aim 3: To compare the importance of alternative timing or sequencing patterns of exposure to neighborhood poverty on behavioral problems among boys. The project will leverage an interdisciplinary team of investigators, including fields of social epidemiology, psychiatric epidemiology, developmental psychology, demography, public policy, statistics, medicine. This project will capitalize on an experimental design, will innovatively apply causal methods to understand mediation, and will model time-varying neighborhood exposures, which will inform relevant early life course developmental timing of neighborhood exposure periods for adolescent well-being. Because of the rigorous experimental design, this project can provide strong policy-relevant evidence on the mechanisms by which social policies like Section 8 housing vouchers may influence population health and mental health. PUBLIC HEALTH RELEVANCE: Neighborhood context may be an important cause of health disparities, especially taking into account risks which accumulate early in life. The results of this project, leveraging a social experiment of housing relocation, have the potential to inform the literature on why neighborhood context is a cause of behavioral problems among adolescents, including probing more specificity on when and for how long living in low-poverty neighborhoods may be most influential for affecting adolescent mental health. This knowledge will inform the next generation of interventions and policies to ensure that adolescents are not harmed by rental assistance policies; results from the experimental design will inform causal pathways and potential intervention points by which to reduce the population burden of mental health and subsequent health disparities.