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Using data from the Moving to Opportunity (MTO) experiment (1994–2002), this study examined how a multidimensional measure of neighborhood quality over time influenced adolescent psychological distress, using instrumental variable (IV) analysis. Neighborhood quality was operationalized with the independently validated 19-indicator Child Opportunity Index (COI), linked to MTO family addresses over 4–7 years. We examined whether being randomized to receive a housing subsidy (versus remaining in public housing) predicted neighborhood quality across time. Using IV analysis, we tested whether experimentally induced differences in COI across time predicted psychological distress on the Kessler Screening Scale for Psychological Distress (n = 2,829; mean β = −0.04 points (standard deviation, 1.12)). The MTO voucher treatment improved neighborhood quality for children as compared with in-place controls. A 1-standard-deviation change in COI since baseline predicted a 0.32-point lower psychological distress score for girls (β = −0.32, 95% confidence interval: −0.61, −0.03). Results were comparable but less precisely estimated when neighborhood quality was operationalized as simply average post–random-assignment COI (β = −0.36, 95% confidence interval: −0.74, 0.02). Effect estimates based on a COI excluding poverty and on the most recent COI measure were slightly larger than other operationalizations of neighborhood quality. Improving a multidimensional measure of neighborhood quality led to reductions in low-income girls’ psychological distress, and this was estimated with high internal validity using IV methods.

american journal of epidemiology

Does the Temporal Pattern of Moving to a Higher-Quality Neighborhood Across a 5-Year Period Predict Psychological Distress Among Adolescents? Results From a Federal Housing Experiment