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; 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）：邻里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级别的风险因素与独立种族和SES无关。尽管种族和个人SES与健康差异密切相关，但诸如收入不平等，社会资本和邻里状况等邻里水平结构对健康成果产生了独立的影响。酒精出口密度是与众多造成酒精差异的结果相关的邻里水平状况（例如，故意和无意的损伤死亡或与酒精有关的死亡率）。但是，已经提出的两个竞争模型来解释社区水平结构对个人健康的影响，对酒精出口密度的作用有所不同。社会心理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途径的一部分。 1992年洛杉矶中南部的内乱导致279个酒精渠道停止了行动。提出了“自然实验”。研究区域被定义为对发生内乱发生的洛杉矶县地区的477块人口普查区。从1988年到2000年，全年都将产生年死亡率（即伤害死亡率，与酒精相关的死亡率和所有导致死亡率）和酒精出口密度。评估社会资本和邻里社会人口统计学组成的其他措施也将作为研究措施。 具有空间和时间自相关的对照的分层面板分析将检验主要研究假设H1：如果酒精销售销售停止的酒精销售后，如果酒精出口密度在因果关系上与抗癌结果联系在一起，则应停止饮酒相关的死亡率。使用定性评估社区为防止出口重建的努力的结果的进一步分析将试图控制非随机化引起的潜在选择偏见。 区分解释性模型对酒精健康差异的解释模型对于预防干预措施的发展至关重要，因为这两种模型表明在邻里水平上的健康差异方面存在截然不同的方法。