Neighborhood Poverty, Health and Economic Security Over the Adult Lifespan

其他项目信息-项目概要/摘要 该提案寻求支持，以便在长期后续行动中增加详细的健康和经济安全措施， 低收入中老年人参与独特随机邻里流动的研究 这就是所谓的走向机会（MTO）。MTO演示使用随机抽签来提供 一些公共住房居民，而不是其他人，有机会搬迁到不那么不利的社区 使用租房补贴。MTO实验上产生的邻域特性差异很大 低收入、不成比例的少数民族家庭群体。当时， 拟议的调查实地工作（随机分配后10至12年）31%的成人样本年龄在50岁或以上，平均年龄为46.8岁。一项中期研究发现，与对照组相比，治疗组的成年人在随机化后4-7年严重精神疾病的估计患病率显著降低，肥胖的可能性降低20%，并显示出改善饮食和运动的迹象，但在劳动力市场结果方面没有差异。然而，环境毒性、饮食质量、体力活动和心理社会压力负担很难通过调查掌握。MTO对经济安全的影响可能会随着时间的推移而增加，这是由于健康状况的改善，或者如果成年人在社会上更加融入他们的新领域，但随着时间的推移，社区属性中各群体之间趋同的可能性表明，劳动力市场的影响可能会随着时间的推移而减弱。该提案有四个主要目标： “扩大我们的长期数据收集，以管理所有MTO成年人的一套详细的健康评估（包括血液样本，以测量疾病前体，如胆固醇，C反应蛋白和糖化血红蛋白）和DSM-IV精神健康障碍，以及经济安全指标，如收入，储蓄，资产和参与TANF或SSI等计划。中期MTO对饮食，运动和肥胖的影响与公共卫生生活方式干预发现的影响一样大，这已被证明会影响我们建议为MTO收集的生物标志物。 “在总样本和由年龄、性别和其他基线风险因素定义的子样本中估计MTO实验对这些结果的长期影响。 “要分解干预对这些结果的总影响，并缩小发生总影响的行为机制的范围。 “开发一个公共的MTO数据档案，供二次分析使用。 总体目标是更好地了解MTO和社区流动性对成年人长期健康和经济安全的影响，以及影响这些结果的过程。这项研究将有助于揭示种族和阶级之间在健康和经济成果方面的更大差异。NIA的资金对于管理所有MTO成年人的全面成果至关重要。

OTHER PROJECT INFORMATION - Project Summary/Abstract This proposal seeks support to add detailed measures of health and economic security to a long-term follow-up study of low-income middle and older aged adults participating in a unique randomized neighborhood mobility experiment know as Moving to Opportunity (MTO). The MTO demonstration used a randomized lottery to offer some public housing residents but not others the chance to relocate to less disadvantaged neighborhoods using a rental housing subsidy. MTO experimentally generated large difference in neighborhood characteristics for otherwise comparable groups of low-income, disproportionately minority families. At the time of our proposed survey fieldwork (10 to 12 years after random assignment) 31% of the adult sample will be age 50 or older, with a mean age of 46.8. An interim study found that compared to the control group, adults in the treatment groups had substantially lower estimated prevalence of serious mental illness 4-7 years after randomization, were 20% less likely to be obese and showed signs of improved diet and exercise, but had no differences in labor market outcomes. However environmental toxicity, dietary quality, physical activity and the burdens of psychosocial stress are difficult to capture through surveys. The effects of MTO on economic security could potentially increase over time due to health improvements or if adults become more socially integrated into their new areas, but the possibility of convergence across groups in neighborhood attributes over time suggests labor market impacts could instead attenuate over time. This proposal has four main aims: " To expand our long-term data collection to administer to all MTO adults a set of detailed assessments of health (including blood samples to measure disease precursors such as cholesterol, C-reactive protein, and glycosylated hemoglobin)and DSM-IV mental health disorders, and indicators of economic security such as earnings, savings, assets, and participation in programs such as TANF or SSI. The interim MTO impacts on diet, exercise and obesity are about as large as those found with public health lifestyle interventions, which have been shown to impact biomarkers of the sort we propose to collect for MTO. " To estimate long-term effects of the MTO experiment on these outcomes in the total sample and sub- samples defined by age, gender, and other baseline risk factors. " To decompose the total effects of the intervention on these outcomes and narrow down the the set of behavioral mechanisms through which the aggregate effects occurred. " To develop a public MTO data archive that is made available for secondary analysis. The overarching goal is to better understand the effects of MTO and neighborhood mobility on adult long-term health and economic security as well as the processes by which these outcomes are affected. This study will help shed light on larger disparities in health and economic outcomes across race and class lines. NIA funding is essential to administer the full range of outcomes described here to all MTO adults.