Neighborhood Environment and Alcohol Health Disparities

社区环境和酒精健康差异

• 批准号: 7056810
• 负责人: RICHARD ALLEN SCRIBNER
• 金额: $ 20.72万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7056810
• 关键词: alcoholic beverage consumption; alcohols; behavior prediction; behavioral /social science research tag; community planning; consumer product; data collection methodology /evaluation; geographic site; health disparity; health services research tag; human data; human mortality; information systems; longitudinal human study; meta analysis; outcomes research; social model; social status; socioeconomics; socioenvironment; statistics /biometry; violence

DESCRIPTION (provided by applicant): Neighborhood Environments and Alcohol Health Disparities A growing literature demonstrates that alcohol health disparities are associated with community level risk factors independent of individual race and SES. While race and individual SES are strongly associated with health disparities, neighborhood level constructs like income inequality, social capital and neighborhood conditions have independent effects on health outcomes. Alcohol outlet density is a neighborhood level condition associated with numerous outcomes responsible for alcohol disparities (e.g., intentional and unintentional injury deaths or alcohol related mortality). However, the two competing models that have been put forward to explain the effects of community level constructs on individual health view the role of alcohol outlet density differently. The psychosocial model views alcohol outlet density as a reflection of low social capital while the environmental model views alcohol outlet density as part of the causal pathway. The 1992 Civil Unrest in South Central Los Angeles resulted in 279 alcohol outlets ceasing operation. A "natural experiment" is proposed. The study area is defined as the 477 census tracts that make of the region of Los Angeles County where the civil unrest took place. Annual mortality rates (i.e. injury mortality, alcohol related mortality, and all cause mortality) and alcohol outlet densities will be generated using a Geographic Information System (GIS) for all years from 1988 to 2000. Additional measures assessing social capital and compositional measures of neighborhood socio-demographics will also be included as study measures. The hierarchical panel analysis with controls for spatial and temporal autocorrelation will test the primary study hypothesis H1: Neighborhoods in which alcohol sales ceased for one or more outlets should have experienced lower rates of alcohol related mortality after their closure if alcohol outlet density is causally linked to outcomes. Additional analysis using the results of a qualitative assessment of the effort of neighborhoods to prevent the rebuilding of outlets will attempt to control for the potential selection bias caused by non randomization. Differentiating between explanatory models accounting for alcohol health disparities is essential for the development of effect preventive interventions since the two models suggest dramatically different approaches in addresses health disparities at the neighborhood level.

描述（由申请人提供）：社区环境和酒精健康差异越来越多的文献表明，酒精健康差异与社区层面的风险因素相关，与个人种族和社会经济地位无关。虽然种族和个人社会经济地位与健康差异密切相关，但收入不平等、社会资本和社区条件等社区层面的结构对健康结果具有独立的影响。酒精出口密度是一种邻里水平状况，与造成酒精差异的多种结果相关（例如，故意和无意伤害死亡或酒精相关死亡率）。然而，为解释社区水平结构对个人健康的影响而提出的两个相互竞争的模型对酒精出口密度的作用有不同的看法。心理社会模型将酒精出口密度视为低社会资本的反映，而环境模型将酒精出口密度视为因果路径的一部分。 1992 年洛杉矶中南部的内乱导致 279 家酒类商店停止营业。提出了“自然实验”。研究区域定义为发生内乱的洛杉矶县地区的 477 个人口普查区域。将使用地理信息系统 (GIS) 生成 1988 年至 2000 年所有年份的年死亡率（即伤害死亡率、酒精相关死亡率和全因死亡率）和酒精出口密度。 评估社会资本和社区构成措施的其他措施社会人口统计数据也将被纳入研究措施。 控制空间和时间自相关的分层面板分析将检验主要研究假设 H1：如果酒精出口密度与以下因素存在因果关系，则一个或多个商店停止销售酒精饮料的社区在关闭后应该经历较低的酒精相关死亡率：结果。使用对社区防止重建商店的努力进行定性评估的结果进行的其他分析将尝试控制非随机化引起的潜在选择偏差。 区分酒精健康差异的解释模型对于制定有效的预防干预措施至关重要，因为这两种模型提出了解决社区层面健康差异的截然不同的方法。