摘要：Objectives. The health consequences of neighborhood poverty are a public health problem. Data were obtained to examine links between neighborhood residence and mental health outcomes. Methods. Moving to Opportunity was a randomized, controlled trial in which families from public housing in high-poverty neighborhoods were moved into private housing in near-poor or nonpoor neighborhoods, with a subset remaining in public housing. At the 3-year follow-up of the New York site, 550 families were reinterviewed. Results. Parents who moved to low-poverty neighborhoods reported significantly less distress than parents who remained in high-poverty neighborhoods. Boys who moved to less poor neighborhoods reported significantly fewer anxious/depressive and dependency problems than did boys who stayed in public housing. Conclusions. This study provides experimental evidence of neighborhood income effects on mental health. During the past few decades, increasing attention has been drawn to the neighborhoods in which families with children live and interact. Policymakers’ concerns have focused on large urban centers where high concentrations of poor families reside; many of these families dwell in public housing. 1, 2 In addition to poverty, these neighborhoods have been marked by high unemployment rates, large numbers of families receiving welfare, and pervasive crime and violence. However, no experimental evidence exists for links between neighborhood residence and health and behavior, because families have some choice, albeit limited in the case of lowincome families, about the neighborhoods in which they live (resulting in problems of selection bias 3– 5 ). In 1994, the US Department of Housing and Urban Development (HUD) launched a novel social experiment, the Moving to Opportunity for Fair Housing Demonstration (MTO), in 5 sites (Baltimore, Boston, Chicago, Los Angeles, and New York City). The MTO is a randomized housing mobility experiment in which families with children who lived in public housing in high-poverty neighborhoods were given the opportunity to move to less poor neighborhoods. This program was motivated by evidence from existing housing relocation programs that rental assistance combined with housing counseling can help low-income families move to private housing in low-minority-concentration or low-poverty neighborhoods and possibly increase their educational and employment opportunities. 6, 7 These studies did not, however, use randomized designs or consider noneconomic outcomes. Beyond possible economic benefits, residential mobility programs such as MTO are likely to have consequences for morbidity. Evidence from nonexperimental studies indicates that residence in a low-income neighborhood is associated with unfavorable physical and mental health. 3 Thus, moving from a high-poverty neighborhood to a less poor neighborhood may improve health. This study focused on the short-term impact of the MTO program in New York City. The consequences of moving from high-rise public housing in high-poverty neighborhoods to either private housing in similar neighborhoods or private housing in lowpoverty neighborhoods for parents’ and children’s mental health were investigated. Outcomes were examined approximately 2 years after families who received vouchers had moved (3 years since baseline and random assignment).
