Hotspots: Understanding Areas of Concentrated Alcohol and Drug Problems at the US-Mexico Border

热点：了解美墨边境酒精和毒品问题集中的地区

• 批准号: 9228313
• 负责人: SARAH E. ZEMORE
• 金额: $ 22.05万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9228313
• 关键词: Address; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Area; Automobile Driving; Border Crossings; Buffers; Cities; Crime; Data; Data Set; Development; Disadvantaged; Drug usage; Ecology; Environment; Environmental Risk Factor; Epidemiology; Exposure to; Family; Fibrinogen; Friends; Gender; Grant; Health; Hispanics; Household; Immigrant; Immigration; Individual; Insurance; Intervention; Interview; Language; Latino; Law Enforcement; Light; Location; Mexican; Mexican Americans; Mexico; Modeling; Neighborhoods; Occupations; Outcome; Paper; Pathway interactions; Pattern; Persons; Pharmaceutical Preparations; Play; Population; Privatization; Probability Samples; Process; Psychological Factors; Research; Resources; Risk; Risk Factors; Role; Sampling; Services; Sister; Site; Staging; Surveys; Testing; Texas; Variant; Violence; alcohol epidemiology; alcohol related problem; alcohol risk; base; comparative; density; epidemiology study; family support; geographic difference; improved; knowledge base; migration; programs; socioeconomic disadvantage; substance abuse epidemiology; trafficking

ABSTRACT: Hotspots: Understanding Areas of Concentrated Alcohol and Drug Problems at the US- Mexico Border Millions of Mexican Americans live in the US-Mexico border region, which is both an extremely disadvantaged area and a staging zone for migration to the interior. Thus, the health and substance use patterns of Mexican- origin border residents are of central concern. Nevertheless, despite preliminary evidence of high drug trafficking, drug availability, and substance use problems along the border, very little is known about alcohol and drug problems in this area. Our team recently initiated a large epidemiological study, the US-Mexico Study of Alcohol and Related Conditions, or UMSARC (R01AA018365; PI's Cherpitel and Borges), to address this gap. In addition to being one of only two large-scale epidemiological studies of the border addressing alcohol, UMSARC is the only known such study to survey residents of both the US and Mexico. Data represent 4,796 in-person interviews with a probability sample of Mexican and Mexican-origin individuals interviewed between 2011-2013. Emerging papers based on UMSARC data suggest a heightened risk for alcohol and drug problems, yet substantially lower substance use treatment utilization, at the US border, compared to the interior. Yet, preliminary evidence also suggests dramatic, unexplained variation even among border sites, with alcohol and drug problems being concentrated in a single US hotspot: Laredo, Texas. Preliminary, unpublished analyses also point to Nuevo Laredo, Laredo's sister city, as a hotspot for drug problems. This suggests that the local environment may play a critical role in alcohol and drug outcomes at the border—and perhaps among Latinos generally. A deeper understanding of the role of environmental factors in this apparent concentration of problems in border hotspots would help shed light on core processes in the epidemiology of substance abuse as well as possible points of intervention relevant to Latinos in the border region and more broadly. However, additional research is needed to 1) better characterize and contextualize variation across UMSARC sites in alcohol- and drug-related outcomes; 2) delineate the roles of specific environmental (and other) factors in explaining this variation; and 3) better understand pathways of influence between the US and Mexico, and how US-Mexico interactions may contribute to elevations of problems. The current project proposes to address these gaps. Aim 1 will better characterize the distribution of alcohol use and problems, drug use and problems, and substance use treatment utilization across study sites and relative to regional and national estimates. Aims 2 and 3 will involve geocoding the data to test roles for key neighborhood variables in explaining geographic variation in alcohol- and drug- related outcomes. Aim 4 will directly explore potential pathways of influence between Mexico and the US using existing and geocoded variables. Analyses will leverage a uniquely rich and well-powered dataset to extend the very limited knowledge base on alcohol and drug use and problems at the border, as well as improve understanding of environmental influences on these outcomes among Latino populations.

摘要：热点：了解美国集中酒精和药物问​​题的领域 - 墨西哥边境 数以百万计的墨西哥裔美国人居住在美国 - 墨西哥边境地区，这都是一个极为干扰的 面积和一个登台区，用于迁移到内部。那，墨西哥的健康和物质使用模式 起源边境居民是核心问题。然而，dospite的初步证据 边境贩运，毒品可用性和物质使用问题，对酒精知之甚少 和该领域的毒品问题。我们的团队最近启动了一项大型流行病学研究，即美墨 研究酒精和相关条件，或UMSARC（R01AA018365； PI的Cherpitel和Borges），以解决 这个差距。除了是边境报道的仅有的两个大规模流行病学研究之一 酒精，UMSARC是唯一一项对美国和墨西哥居民进行调查的研究。数据 代表4,796次面对面访谈，墨西哥和墨西哥人的概率样本 在2011年至2013年之间接受了采访。基于UMSARC数据的新兴论文表明， 酒精和药物问​​题，但在美国边境上使用治疗利用的物质大幅降低， 与内部相比。然而，初步证据也表明，即使在 边境站点，酒精和药物问​​题集中在一个美国热点：德克萨斯州拉雷多。 初步未发表的分析也指向拉雷多（Laredo）的姊妹城市Nuevo Laredo，作为毒品的热点 问题。这表明当地环境可能在酒精和药物结局中起关键作用 边界 - 通常在拉丁美洲人之间。对环境的作用有更深入的了解 在边境热点中，这种明显的问题集中的因素将有助于阐明核心过程 在滥用药物的流行病学以及与拉丁裔有关的干预点中 边境地区，更广泛。但是，需要其他研究才能更好地表征和 在酒精和药物相关的结果中，UMSARC部位之间的差异与情境化； 2）描述 解释这种变化的特定环境（和其他）因素； 3）更好地了解 美国和墨西哥之间的影响，以及美国墨西哥互动如何有助于提升 问题。当前的项目建议解决这些差距。 AIM 1将更好地描述分布 饮酒和问题，药物使用和问题以及在整个研究中的药物使用治疗利用 站点以及相对于区域和国家估计的地点。目标2和3将涉及地理编码数据以测试角色 用于解释酒精和药物相关结果的地理变异的关键邻域变量。目的 4将使用现有和地理编码直接探索墨西哥与美国之间的潜在影响途径 变量。分析将利用一个独特的丰富且功能良好的数据集来扩展非常有限的 关于饮酒和吸毒以及边境问题的知识基础，并提高对 环境对拉丁裔人群中这些结果的影响。