Residential trajectories and adolescent health: results from a randomized trial

描述(由申请者提供)：该项目旨在了解邻里居住轨迹在导致青少年心理健康和药物使用问题方面的作用，以提供潜在的早期预防策略。由于大多数成人期的药物使用和精神障碍起源于生命的早期，因此关注童年时期的暴露是非常必要的。 尽管有证据表明不利的邻里环境与发育受损有关，但大多数研究都是观察性和横断性的，限制了因果推理和政策转换。我们建议使用住房代金券实验研究的数据进行严格的二次数据分析，该研究可能会将社区环境作为低收入少数群体健康问题的原因：Moving to Opportunity(MTO)研究。MTO允许强有力的因果推论，尽管这是一个很有希望的政策，可以破坏社区贫困的有毒影响，但卫生研究人员获得数据的机会有限。有必要解开这个昂贵而雄心勃勃的住房实验，以了解非医疗政策可能促进或损害健康的机制。我们提出了新的分析，以回答租赁援助政策的设计和社区健康影响的病因的重要问题。我们将利用MTO的实验设计来了解家庭如何选择并留在社区，居住轨迹如何随着时间的推移受到健康的影响，以及这些居住轨迹反过来又如何影响健康。为了实现高机会社区的运作，我们应用了机会地理框架，这是一个与政策相关的分析工具，强调地区背景和社会不平等对限制住宅选择和影响住宅偏好的持续重要性。我们将对社区的动态性质以及低收入家庭的空间和时间迁移进行建模。为此，我们将通过将46,000多个MTO地理编码地址拼写与零售、调查和行政社区数据的马赛克合并来构建住宅轨迹，以随时间推移运营高机会社区。我们将使用增长曲线和潜在类别分析来检验影响家庭居住轨迹的因素。然后，我们将应用因果中介方法，包括新的基于半参数权重的技术，来测试居住轨迹是否以及何时中介MTO对青少年健康的影响，以告知生命过程的时机和邻里暴露对健康影响的机制。该项目建立在富有成效的持续跨学科合作的基础上，并利用团队在心理健康和物质使用、邻里影响、青少年发展、生命过程和因果方法方面的专业知识。对我们研究问题的回答可能会告诉我们住宅选择的偏见，这反过来可能会告诉我们如何设计更严格的观察性邻里研究。此外，由于住房选择代金券构成了联邦负担得起的住房资金的很大一部分，我们的结果可以为政策提供参考，例如，为住房流动性量身定制 解决客户健康问题的计划，并帮助低收入家庭持续搬到高机会地区。

DESCRIPTION (provided by applicant): This project aims to understand the role of neighborhood residential trajectories for causing adolescent mental health and substance use problems, to inform potential prevention strategies early in life. Since most adulthood substance use and mental disorders originate early in life, it is imperative to focus on childhood exposures. Although evidence links adverse neighborhood contexts to impaired development, most studies are observational and cross sectional, limiting causal inference and policy translation. We propose a rigorous secondary data analysis using data from an experimental study of housing vouchers that may inform neighborhood context as a cause of health problems among low income minority populations: the Moving to Opportunity (MTO) study. MTO allows strong causal inferences, and though it was a promising policy to disrupt the toxic effects of neighborhood poverty, health researchers have had limited access to the data. It is necessary to unpack this expensive, ambitious housing experiment to understand the mechanisms by which non-health policies may promote, or indeed harm, health. We propose new analyses to answer significant questions for the design of rental assistance policy, and for the etiology of neighborhood health effects. We will leverage MTO's experimental design to understand how households select and remain in neighborhoods, how residential trajectories across time are influenced by health, and how these residential trajectories, in turn, influence health. To operationalize high opportunity neighborhoods, we apply a Geography of Opportunity framework - a policy-relevant analytic tool that emphasizes regional context and the continuing significance of social inequality for constraining residential choice, and for influencing residential preferences. We will model the dynamic nature of neighborhoods as well as the spatial, temporal moves of low-income families. To do so, we will construct residential trajectories by merging over 46,000 MTO geocoded address spells with a mosaic of retail, survey, and administrative neighborhood data to operationalize high opportunity neighborhoods across time. We will test for factors that influence household residential trajectories using growth curves and latent class analysis. We will then apply causal mediation methods, including novel semiparametric weight- based techniques, to test whether and when residential trajectories mediate MTO effects on adolescent health, to inform life course timing and mechanisms of neighborhood exposures for health effects. This project builds on a productive ongoing interdisciplinary collaboration, and leverages team expertise in mental health and substance use, neighborhood effects, adolescent development, life course and causal methods. Answers to our research questions may inform residential selection bias, which may, in turn, inform how to design more rigorous observational neighborhood studies. Further, since housing choice vouchers constitute a large portion of federal affordable housing dollars, our results can inform policy, e.g., to tailor housing mobility programs to address client health problems, and help low income families sustain moves to high opportunity areas.