Understanding Racial Disparities in Heavy Drinking over the Life Course

了解一生中酗酒的种族差异

基本信息

批准号：
8614984
负责人：
NINA MULIA
金额：
$ 31.29万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-02-15 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8614984
关键词：
Address Adolescence Adult African American Age Alcohol abuse Alcohol dependence Alcohols American Area Attention Cessation of life Chronic Cohort Analysis Cohort Effect Cohort Studies Data Development Disadvantaged Education Equation Ethnic group Exhibits Exposure to Gender Growth Guidelines Health Heavy Drinking Hispanics Income Intervention Latina Life Cycle Stages Longitudinal Surveys Low income Mediating Mediator of activation protein Minority Minority Groups Modeling Morbidity - disease rate National Institute on Alcohol Abuse and Alcoholism Occupational Occupational Status Outcome Pattern Performance Policies Poverty Prevalence Psychopathology Race Relative (related person)Research Risk Risk Factors Sampling Schools Scoring Method Sex Characteristics Social Welfare Socioeconomic Factors Statistical Methods Structural Models Subgroup Suspension substance Suspensions Symptoms Teenagers Ursidae Family Woman Youth alcohol epidemiology alcohol related problem base career cohort drinking emerging adult experience follow-up generation difference improved interest men middle age mortality multidisciplinary population health prospective public health relevance racial and ethnic racial and ethnic disparities racial difference racial/ethnic difference social social health determinants socioeconomics young adult

项目摘要

DESCRIPTION (provided by applicant): Heavy drinking is the third leading cause of preventable death among Americans and strongly associated with alcohol-related morbidity and problems, including negative drinking consequences and alcohol dependence. While racial/ethnic minorities bear a disproportionate burden of alcohol-related problems in the U.S., it is unknown whether this reflects more harmful, long-term patterns of heavy drinking. While some studies suggest that minorities have longer heavy drinking "careers", these have been based on short-term follow-up data, retrospective data, and age-specific prevalence data. Rigorous, prospective cohort studies have rarely examined racial/ethnic differences in heavy drinking trajectories, and those few studies that have shown contradictory findings for racial differences by the mid-to-late 20s, the age when these studies typically end. However, there are important theoretical and empirical reasons to expect that racial/ethnic groups diverge in their heavy drinking patterns as they transition out of early adulthood into middle age. Our central hypothesis is that racial/ethnic minority groups' greater accumulation of disadvantage over the life course will contribute to prolonged heavy drinking beyond the 20s, which could help to explain recent findings of more recurring and persistent alcohol problems among minorities (vs. whites) in mid-life. Responding to PA-11-308 "Secondary Analysis of Existing Alcohol Epidemiology Data", we propose to investigate this in the first, in-depth, prospective analysis of racial/ethnic disparities in heavy drinking trajectories from adolescence to middle age in a nationally-representative U.S. sample (National Longitudinal Surveys of Youth). Our Specific Aims are to: 1) Describe racial/ethnic differences in heavy drinking trajectories from the late teens to middle age, and their association with persistent alcohol problems; 2) Identify predictors of membership in heavy drinking trajectories, and mediators through which they operate to create alcohol problems; and 3) Assess the extent to which lifecourse socioeconomic factors explain racial disparities in prolonged heavy drinking and alcohol problems, and the mechanisms (differential exposure and differential consequences) contributing to these disparities. Our study draws on a social determinants perspective, thus departing somewhat from the dominant approach of developmental psychopathology. Heeding recent, federal calls for multisectoral efforts to address health inequities, we give special attention to the ways in which disparities related to education (parental and personal educational attainment, quality of education, and returns on education) may contribute to racial disparities in prolonged heavy drinking and problems. Our highly multidisciplinary team will utilize growth mixture models, structural equation models, and propensity scoring, and capitalize on data from both the 1979 and 1997 NLSY to examine cohort effects and differences by gender and Hispanic subgroup. This research will identify a range of far-reaching and interim policy targets to address racial disparities in lifecourse heavy drinking which are amenable to intervention in the education, social welfare and labor sectors.

描述（由申请人提供）：大量饮酒是美国人可预防死亡的第三大原因，并且与酒精相关的发病率和问题密切相关，包括饮酒的负面后果和酒精依赖。虽然在美国，少数种族/族裔承受着与酒精相关问题不成比例的负担，但目前尚不清楚这是否反映了更有害的长期酗酒模式。虽然一些研究表明少数族裔的酗酒“职业”较长，但这些研究都是基于短期随访数据、回顾性数据和特定年龄患病率数据。严格的前瞻性队列研究很少考察酗酒轨迹中的种族/民族差异，而少数研究在 20 多岁中后期（这些研究通常结束的年龄）显示了种族差异的矛盾结果。然而，有重要的理论和经验原因表明，种族/族裔群体在从成年早期过渡到中年时，其酗酒模式会出现差异。我们的中心假设是，少数种族/族裔群体在生命历程中更多的劣势积累将导致 20 岁以上长期酗酒，这可能有助于解释最近发现的少数族裔（与白人相比）中更频繁和持续的酒精问题在中年。响应 PA-11-308“现有酒精流行病学数据的二次分析”，我们建议在全国范围内对从青春期到中年的酗酒轨迹中的种族/民族差异进行首次深入的前瞻性分析。美国代表性样本（全国青年纵向调查）。我们的具体目标是： 1) 描述从青少年后期到中年的酗酒轨迹中的种族/民族差异，以及它们与持续性酒精问题的关系； 2) 确定酗酒轨迹的预测因素，以及造成酗酒问题的中介因素； 3) 评估生命周期社会经济因素在多大程度上解释长期酗酒和酗酒问题中的种族差异，以及造成这些差异的机制（不同的暴露和不同的后果）。我们的研究借鉴了社会决定因素的观点，因此在某种程度上偏离了发展精神病理学的主流方法。注意到最近联邦政府呼吁多部门努力解决健康不平等问题，我们特别关注与教育相关的差异（父母和个人的教育程度、教育质量和教育回报）可能会在长期严重的种族不平等中造成种族差异。饮酒和问题。我们高度跨学科的团队将利用增长混合模型、结构方程模型和倾向评分，并利用 1979 年和 1997 年 NLSY 的数据来检查队列效应以及按性别和西班牙裔亚组划分的差异。这项研究将确定一系列影响深远的临时政策目标，以解决生命过程中酗酒的种族差异，这些目标适合教育、社会福利和劳工部门的干预。