Project Details
Description
PROJECT SUMMARY/ABSTRACT
The spatial separation of populations along racial-ethnic lines is a fundamental cause of health inequities
across the life course via cascades of interlocking social determinants of health at multiple levels. Although
neighborhood-health multilevel research has proliferated in the past 20 years, it remains weak
methodologically: addressing one point in the life course rather than a long temporal period using prospective
data; failing to integrate social processes and biological data; not attending to heterogeneity or pathways; and
remaining divorced from policy solutions. Our study of place-based inequities in mid-life mortality addresses
these limitations, leveraging data from a promising policy experiment: The Moving to Opportunity (MTO)
Study. The MTO follows 4600 low-income racial minority families, living in public housing at baseline, in five
large US cities, who were randomized to receive one of three treatments: one of two types of housing vouchers
to improve housing affordability and neighborhood opportunity or an in-place control group that remained in
public housing. Evaluation surveys were conducted at baseline (1994), in 2001-02, and in 2008-10. This study
expands and enriches the MTO data by linking it to three administrative datasets across 28 years—(1) NCHS’s
National Death Index, (2) Social Security’s Numident, and (3) the Census Master Address File—allowing us to
analyze the effects of housing mobility on mid-life mortality and long-term residential mobility. An experienced
and productive population health and social epidemiologist scholar leads our accomplished, interdisciplinary
team. Our project has five specific aims: Aim 1: Test if the MTO low-poverty housing voucher treatment
improves neighborhood opportunity in year 2023, versus the in-place public housing or standard voucher
group; Aim 2: Test if the MTO low-poverty housing voucher treatment reduces mortality risk through mid-life
versus in-place public housing or the standard voucher group; Aim 3: Examine subgroups that are more or less
likely to benefit from the MTO housing voucher experiment, i.e., test heterogeneity of MTO effects on mortality
by baseline demographic factors; Aim 4: Test which of many multilevel factors across the life course mediate
the effect of the MTO housing voucher experiment on mortality; Aim 5: Calculate the number of deaths that
would be avoided and how the racial/ethnic mortality gap would be narrower, at the population level, if
voucher-based housing policy were broadly implemented to promote opportunity moves. The proposed project
aligns with NIA Population and Social Processes Branch to elucidate “life course pathways leading to
disparities in health outcomes.” Our study presents a unique and important opportunity for population health: to
understand a long chain of causation from random assignment of a housing voucher to a change in
neighborhood environment and area-based contexts to the biological, physical, mental health, and behavioral
pathways to mortality.
Status | Active |
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Effective start/end date | 8/15/23 → 7/31/24 |
Funding
- National Institute on Aging: $508,090.00
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