Neighborhood Poverty & Mental Health of Low-income Mothers: An Experimental Study

说明(申请人提供)：本提案寻求支持扩大对创新社会政策/实验的评估，以包括考虑干预对参与者心理健康的影响。Moving to Opportunity(MTO)示范使用随机抽签为一些公共住房家庭提供机会，但不是其他家庭，他们有机会通过租赁住房补贴搬迁到条件较差的社区。因此，该计划在实验中为原本可比的低收入家庭群体产生了居住社区特征的巨大差异。随机化后大约5年的一项跟踪研究发现，治疗组的女性严重精神疾病(SMI)的估计患病率明显低于对照组。然而，这些结果并不是基于诊断性访谈，这使得无法区分对特定疾病的发病、持久性和严重性的影响，或者影响发生的途径。这项建议寻求资金，以扩大一项新的跟踪调查，在随机分配后大约10年对4498名MTO母亲进行调查，包括对DSM-IV障碍的明确评估，以解决以下问题：1.在总样本和基线风险因素定义的子样本中，搬到条件较好的社区对DSM-IV精神障碍的发生和持续有什么影响？2.这些累积的心理健康影响是通过什么途径发生的？3.社区流动对心理健康的影响如何具体说明干预对与工作、家庭、教育、犯罪介入、那么基本的决策呢？这项拟议研究的首要目标是尽可能多地了解邻里关系影响心理健康的过程。我们还致力于将我们的数据提供给医学和社会科学的其他研究人员。

DESCRIPTION (provided by applicant): This proposal seeks support for an expansion of the evaluation of an innovative social policy/experiment to include consideration of the impact of the intervention on the mental health of participants. The Moving to Opportunity (MTO) demonstration used a randomized lottery to offer some public housing families but not others the chance to relocate to less disadvantaged neighborhoods using a rental housing subsidy. The program thus experimentally generated large differences in residential neighborhood characteristics for otherwise comparable groups of low-income families. A follow-up study approximately 5 years after randomization found that the women in the treatment groups had a significantly lower estimated prevalence of Serious Mental Illness (SMI) than controls. However these results were not based on a diagnostic interview, which made it impossible to distinguish effects on onset, persistence, and severity of particular disorders or the pathways through which effects occurred. This proposal seeks funding to expand a new follow-up survey of 4498 MTO mothers approximately 10 years after random assignment to include an explicit assessment of DSM-IV disorders, in order to address the following questions: 1. What are the effects of moving to a less disadvantaged neighborhood on the onset and persistence of DSM-IV mental disorders both in the total sample and in sub-samples defined by baseline risk factors? 2. What are the pathways through which these aggregate mental health effects occurred? 3. How do the effects of neighborhood mobility on mental health specify the effects of the intervention on other outcomes related to work, family, schooling, criminal involvement, and basic decision making? The overarching goal of the proposed research is to understand as much as possible about the processes by which neighborhoods affect mental health. We are also committed to making our data available to other researchers in the medical and social sciences.