Effects of Disadvantage and Protective Resources on Alcohol-related Disparities

劣势和保护性资源对酒精相关差异的影响

基本信息

批准号：
8144753
负责人：
NINA MULIA
金额：
$ 20.76万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8144753
关键词：
Accidents Accounting Acculturation Address Adverse effects Age Alcohol abuse Alcohol consumption Alcohol dependence Alcohols American Buffers Cause of Death Censuses Cessation of life Consumption Data Data Analyses Dependence Disadvantaged Discrimination Distress Economics Equation Ethanol Ethnic Origin Ethnic group Exposure to Family Gender Goals Health Heavy Drinking Hispanics Immigrant Individual Injury Intervention Legal Life Measures Mediating Mediation Mediator of activation protein Mental Health Minority Modeling Morbidity - disease rate Neighborhoods Play Policies Prevention Public Health Race Relative (related person)Religion Religion and Spirituality Reporting Research Resources Risk Risk Factors Role Social Network Social support Surveys Symptoms Techniques Testing Work Workplace alcohol related problem density of AOD outlets drinking experience health disparity high risk drinking mortality physical conditioning protective effect psychologic psychological distress public health priorities public health relevance racial and ethnic racial and ethnic disparities residence social stress management

项目摘要

DESCRIPTION (provided by applicant): Project Summary Heavy alcohol use is a leading cause of preventable death in the U.S. Given that rates of alcohol-related morbidity and mortality are elevated among Blacks and Hispanics compared to Whites, reducing racial disparities in heavy drinking and alcohol problems is an important public health goal. At present, however, there is a critical gap in our understanding of alcohol disparities related to race. Prior research has already established higher rates of heavy drinking and alcohol problems among Black and Hispanic (vs. White) drinkers; further, there is some evidence of relatively higher rates of alcohol problems among Blacks and Hispanics even at similar levels of alcohol consumption. Yet, no studies to our knowledge have formally evaluated mediators of these disparities. Further, only a very few studies have examined racial disparities in alcohol problems when controlling for consumption, and those have been limited. The primary objective of this study is thus to describe and explain racial disparities in both heavy drinking and alcohol problems at equivalent levels of consumption. Our conceptual approach recognizes that racial/ethnic groups in the U.S. are differentially exposed to economic, social, and neighborhood disadvantages, and draws upon recent theoretical work suggesting that cumulative exposure to disadvantage may play a significant role in understanding health disparities. Our study also considers alcohol-related factors-such as differences in drink size, drinking contexts, and age at heavy drinking-as potential contributors to disparities in problems at equivalent levels of consumption. The study examines alcohol-related disparities among Whites (as the referent), Blacks, and Hispanics, the three largest racial/ethnic groups in the U.S., and analyzes data from the 2005 and 2010 U.S. National Alcohol Survey (NAS); total N=11,839. The NAS provides a wide array of fine- grained alcohol consumption and problem measures; economic, social and psychological variables; and geolinked Census data on neighborhood SES, alcohol outlet density, and racial/ethnic composition. Advanced statistical techniques such as structural equation modeling, moderated mediation tests, and propensity score matching will be employed in addressing the following Specific Aims: 1) to describe racial disparities in heavy drinking and alcohol problems (i.e., negative drinking consequences and dependence symptoms); 2) to assess the extent to which disadvantage and alcohol-related factors account for these racial disparities; and 3) to identify protective resources (e.g., social support, drinking norms and networks, religiosity) that mitigate the impact of disadvantage on heavy drinking. By identifying the relative contribution of distinct risk factors to racial disparities, this study will help in prioritizing policymaking and prevention efforts, and will inform interventions seeking to address risk factors and build upon the protective resources of each racial/ethnic group. PUBLIC HEALTH RELEVANCE: Public Health Relevance Statement This study describes and explains racial disparities in heavy drinking and alcohol problems, specifically assessing the contribution of economic, social and neighborhood disadvantage and alcohol-related factors. It also examines race-specific protective resources that may buffer the effects of disadvantage on heavy drinking and alcohol problems. Findings will help to prioritize policymaking and inform prevention efforts to reduce racial disparities in heavy drinking and alcohol problems, a leading cause of death among Americans.

描述（由申请人提供）：项目摘要大量饮酒是美国可预防死亡的主要原因。鉴于与白人相比，黑人和西班牙裔与酒精相关的发病率和死亡率较高，因此减少了酗酒和酗酒方面的种族差异问题是一个重要的公共卫生目标。然而，目前我们对与种族相关的酒精差异的理解存在严重差距。先前的研究已经证实，黑人和西班牙裔（与白人）饮酒者的酗酒和酒精问题发生率较高；此外，有一些证据表明，即使在相似的饮酒水平下，黑人和西班牙裔的酒精问题发生率也相对较高。然而，据我们所知，还没有研究正式评估这些差异的中介因素。此外，只有极少数研究在控制饮酒量的情况下调查了酒精问题的种族差异，而且这些研究也是有限的。因此，本研究的主要目的是描述和解释同等消费水平下酗酒和酒精问题的种族差异。我们的概念方法认识到美国的种族/族裔群体在经济、社会和邻里劣势方面的暴露程度不同，并借鉴了最近的理论工作，表明累积的劣势可能在理解健康差异方面发挥重要作用。我们的研究还考虑了与酒精相关的因素，例如饮酒量、饮酒环境和酗酒年龄的差异，这些因素是造成同等消费水平下问题差异的潜在因素。该研究调查了美国三大种族/族裔群体——白人（作为参照物）、黑人和西班牙裔之间与酒精相关的差异，并分析了 2005 年和 2010 年美国国家酒精调查 (NAS) 的数据；总数 N=11,839。 NAS 提供了广泛的细粒度酒精消耗和问题测量；经济、社会和心理变量；以及有关社区社会经济地位、酒精出口密度和种族/民族构成的地理关联人口普查数据。将采用结构方程模型、调节中介测试和倾向评分匹配等先进统计技术来实现以下具体目标： 1) 描述酗酒和酗酒问题中的种族差异（即负面饮酒后果和依赖症状）； 2) 评估不利因素和酒精相关因素在多大程度上造成这些种族差异； 3) 确定减轻酗酒不利影响的保护性资源（例如社会支持、饮酒规范和网络、宗教信仰）。通过确定不同风险因素对种族差异的相对贡献，这项研究将有助于确定政策制定和预防工作的优先顺序，并为寻求解决风险因素和利用每个种族/族裔群体的保护资源的干预措施提供信息。公共卫生相关性：公共卫生相关性声明本研究描述并解释了酗酒和酒精问题中的种族差异，特别评估了经济、社会和邻里劣势以及酒精相关因素的影响。它还研究了特定于种族的保护资源，这些资源可能会缓冲劣势对酗酒和酗酒问题的影响。研究结果将有助于确定政策制定的优先顺序，并为预防工作提供信息，以减少酗酒和酗酒问题上的种族差异，这是美国人死亡的主要原因。