Alcohol's Harms to Others among US Adults: Individual and Contextual Effects

美国成年人酒精对他人的危害：个人和环境影响

• 批准号: 8621942
• 负责人: Thomas K Greenfield
• 金额: $ 49.38万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-10 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8621942
• 关键词: Address; Adult; Affect; African American; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; Area; Australia; Automobile Driving; Cellular Phone; Characteristics; Child Abuse; Crime; Data; Development; Disadvantaged; Disease; Economic Conditions; Economic Factors; Environmental Policy; Environmental Tobacco Smoke; Epidemiology; Ethnic Origin; Ethnic group; Family; Family member; Fetal alcohol effects; Friends; Funding; Gender; Goals; Hand; Health; Heavy Drinking; Hispanics; Home environment; Hour; Individual; Individual Differences; Investigation; Mental Health; Meta-Analysis; Metric; Mind; Minority Groups; Modeling; Morbidity - disease rate; Neighborhoods; Outcome; Pathway interactions; Patient Self-Report; Pattern; Policies; Population; Population Study; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Quality of life; Race; Reporting; Research; Research Design; Respondent; Risk; Role; Sales; Sampling; Severities; Social Conditions; Sorting - Cell Movement; Source; Subgroup; Surveys; Taxes; Techniques; Testing; Time; Trust; Victimization; Violence; Woman; Work; alcohol availability; assault; base; burden of illness; child neglect; cohesion; cost; density; density of AOD outlets; design; disability-adjusted life years; drinking; experience; field survey; health related quality of life; high risk; innovation; insight; men; mortality; novel; peace; perpetrators; population survey; prevent; public drinking; public health relevance; public policy on alcohol; racial and ethnic; social; socioeconomics; young adult

In the US and worldwide, the vast majority of studies of alcohol's harms have focused on outcomes experienced by the drinker, given that alcohol use causes significant morbidity and mortality. However, alcohol adversely affects not only individual drinkers, but also other people, including family members, friends, co- workers and strangers. With the exception of a few areas (such as drink driving and fetal alcohol effects), alcohol's harms to others (or externalities), are largely understudied, particularly in the US. Initial studies in Australia and New Zealand suggest excessive drinking can harm families, cause child abuse or neglect, and cost people other than the drinker time, money, and peace of mind, potentially doubling the social costs directly associated with harms to drinkers themselves. There has been a complete absence of US population-wide data of alcohol's harms to others, excepting preliminary work for the present application that uses a brief scale in the National Alcohol Survey (NAS). Responding to PA-11-016 (Epidemiology & Prevention), we propose the first comprehensive investigation of harms due to others' heavy drinking, as experienced by US adults, studying types and sources of such harms, as well as impacts on health-related quality of life, mental health and time and financial burdens. To leverage the already-funded 2014-15 NAS (expected NH5,270) we plan to add 10 minutes of detailed questions for respondents reporting harm from others' drinking (expected nH1,580), as well as to field a parallel, specialized US-wide Alcohol's Harms to Others survey (NH2,250). Both surveys will include common items and scales and use the same sampling design (dual-frame landline/cell phone RDD CATI surveys, oversampling African Americans and Hispanics). This will permit pooling data for certain analyses to achieve greater power and precision. Current aims include to (1) comprehensively estimate the prevalence, sources and seriousness of alcohol's harms to others, and test hypotheses about individual differences in these; (2) test hypotheses regarding environmental influences (drinking contexts and neighborhood context, e.g., urbanicity, socioeconomic disadvantage, disorder and alcohol outlet density) to gain insight about how such harms might be prevented; (3) estimate multi-level models to examine the roles of state alcohol taxes, policies on alcohol availability, and 'wet' to 'dry' drinking cultures. We will investigate the interplay of these levels of influence on the occurrence, sources and severity of the harms. In addition to the novel direction of the research (the first US adult population survey of alcohol's harms to others), an innovation is the proposed use of propensity score matching techniques to contrast outcomes (such as mental health impacts) while addressing the place-based sorting and selection effects common in contextual analysis. As part of this work, we will identify high-risk situations associated with severe harms from others' drinking that may be amenable to preventive interventions, and examine pathways of influence, with a goal of helping to inform prevention strategies and evaluate alcohol policies that may help reduce harms from other drinkers.

在美国和世界范围内，绝大多数关于酒精危害的研究都集中在结果上 鉴于饮酒会导致显着的发病率和死亡率，饮酒者会经历这种情况。然而，酒精 不仅对饮酒者个人产生不利影响，而且对其他人，包括家庭成员、朋友、同事等产生不利影响。 工人和陌生人。除了少数领域（例如酒后驾驶和胎儿酒精影响）之外， 酒精对他人的危害（或外部性）在很大程度上没有得到充分研究，特别是在美国。初步研究于 澳大利亚和新西兰表示，过度饮酒可能会伤害家庭，导致虐待或忽视儿童，并且 花费了饮酒者以外的人的时间、金钱和内心的平静，可能直接使社会成本加倍 与饮酒者自身的危害有关。美国人口范围内完全没有 酒精对他人危害的数据，除了使用简短量表的本申请的初步工作 国家酒精调查（NAS）。响应 PA-11-016（流行病学与预防），我们建议 首次针对美国成年人因他人酗酒造成的危害进行全面调查， 研究此类危害的类型和来源，以及对健康相关生活质量、心理健康的影响 以及时间和经济负担。为了利用已经资助的 2014-15 NAS（预计 NH5,270），我们计划 为报告他人饮酒造成伤害的受访者添加 10 分钟的详细问题（预计 nH1,580）， 以及开展一项平行的、专门的全美范围内酒精对他人危害的调查 (NH2,250)。两项调查 将包括常见的项目和规模，并使用相同的抽样设计（双框固定电话/手机RDD CATI 调查，对非裔美国人和西班牙裔美国人进行过采样）。这将允许汇集某些特定的数据 分析以实现更高的功率和精度。当前的目标包括（1）综合估计 酒精对他人危害的流行程度、来源和严重性，并检验有关个人的假设 这些方面的差异； (2) 检验关于环境影响的假设（饮酒环境和 邻里环境，例如城市化、社会经济劣势、混乱和酒精出口密度） 深入了解如何预防此类伤害； (3) 估计多层次模型来检验 州酒精税、酒精供应政策以及“湿”到“干”饮酒文化。我们将调查 这些影响程度对危害的发生、来源和严重程度的相互作用。除了 研究的新方向（美国第一个关于酒精对他人危害的成年人口调查），一项创新 是建议使用倾向评分匹配技术来对比结果（例如心理健康 影响），同时解决上下文分析中常见的基于地点的排序和选择效应。作为 作为这项工作的一部分，我们将识别与他人饮酒造成的严重伤害相关的高风险情况， 可能会采取预防性干预措施，并检查影响途径，以帮助 告知预防策略并评估可能有助于减少其他饮酒者伤害的酒精政策。