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.

Public Health Relevance

This project examines whether disparities in health and other outcomes can be explained in part by the increased likelihood that low-income and minority adults live in high-poverty, highly-disadvantaged neighborhoods. It will draw on biomeasures, surveys and other data from a unique housing-mobility experiment known as Moving to Opportunity (MTO) that helps overcome the self-selection problems that plague most previous research in the area of neighborhoods and health.

National Institute of Health (NIH)
National Institute on Aging (NIA)
High Priority, Short Term Project Award (R56)
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Social Sciences and Population Studies Study Section (SSPS)
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Phillips, John
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National Bureau of Economic Research
United States
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Sciandra, Matthew; Sanbonmatsu, Lisa; Duncan, Greg J et al. (2013) Long-term effects of the Moving to Opportunity residential mobility experiment on crime and delinquency. J Exp Criminol 9:
Ludwig, Jens; Duncan, Greg J; Gennetian, Lisa A et al. (2012) Neighborhood effects on the long-term well-being of low-income adults. Science 337:1505-10
Ludwig, Jens; Sanbonmatsu, Lisa; Gennetian, Lisa et al. (2011) Neighborhoods, obesity, and diabetes--a randomized social experiment. N Engl J Med 365:1509-19