A microsimulation of alcohol control interventions to advance health equity and reverse the current decrease in life expectancy in the US

酒精控制干预措施的微观模拟，以促进健康公平并扭转美国当前预期寿命下降的趋势

• 批准号: 10889432
• 负责人: Charlotte Probst
• 金额: $ 10.69万
• 依托单位: CENTRE FOR ADDICTION AND MENTAL HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-10 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10889432
• 关键词: 18 year old; Accidental Injury; Adult; Affect; Age; Alaska Native; Alcohol consumption; Alcohols; American Indians; Behavioral Risk Factor Surveillance System; Birth; Brain hemorrhage; Cause of Death; Censuses; Cessation of life; Characteristics; Data; Demographic Factors; Demographic Survey; Development; Diabetes Mellitus; Epidemiology; Ethnic Origin; Ethnic Population; Future; General Population; Individual; Inequality; Injury; Intervention; Life; Life Expectancy; Link; Liver Cirrhosis; Liver diseases; Modeling; Modification; Motor Vehicles; Myocardial Ischemia; National Health Interview Survey; Not Hispanic or Latino; Outcome Measure; Pattern; Play; Pneumonia; Poisoning; Population; Poverty; Premature Mortality; Price; Race; Regulation; Research; Risk; Risk Factors; Role; Series; Socioeconomic Status; Specific qualifier value; Subgroup; Suicide; Surveys; System; Taxation; Time; United States; Vital Statistics; Vulnerable Populations; age group; alcohol availability; alcohol effect; alcohol screening and brief intervention; attributable mortality; burden of illness; chronic liver disease; cost effectiveness; drinking; evidence base; experience; health equity; health inequalities; hypertensive heart disease; improved; insight; intervention effect; low socioeconomic status; model design; models and simulation; mortality; mortality risk; population survey; prevent; primary outcome; public policy on alcohol; racial population; scale up; screening and brief intervention; sex; simulation; socioeconomics; trend

PROJECT SUMMARY Until recently, life expectancy in the United States (US) had been increasing. However, in the past couple of years, life expectancy at birth started to decline, following a period of stagnation. Underlying this trend are increases in mortality rates in specific causes of death, with individuals with low socioeconomic status (SES) being disproportionately affected. The specific causes of death for which mortality rates have increased include poisoning, suicide, motor vehicle-related injuries, liver disease and cirrhosis and diabetes mellitus—all of which are causally linked to alcohol use. Alcohol use has also been found to be associated with heightened mortality risk among individuals with a low SES. The proposed project will investigate the role of alcohol use in past and future trends in US life expectancy on both the national and state level. Fifteen states have been selected for the state-level modeling based on relevant characteristics (e.g., high mortality rates), covering all nine census divisions and more than 50% of the population. Years of potential life lost (YLL) will serve as the primary outcome measure, as it is more closely related to life expectancy per se than mortality rates. The project will I) investigate SES and race/ethnicity as effect modifiers on the relationship between alcohol use and YLL using National Health Interview Survey data linked to cause of death data; II) generate a microsimulation model of cause-specific alcohol-attributable YLL by SES, race/ethnicity, age and sex (for years 2002-2017); and III) model gains in YLL for different alcohol control intervention scenarios (for years 2018-2028). The microsimulation model will be based on data from the National Vital Statistics System and Current Population Surveys for the demographic component, the exposure component will be informed by data from the National Epidemiologic Survey on Alcohol and Related Conditions and the Behavioral Risk Factor Surveillance System. YLL from unintentional injuries, suicide, liver disease and cirrhosis, diabetes mellitus, ischemic heart disease, hemorrhagic stroke and hypertensive heart disease will be investigated among the adult (18+ years of age) general population of the US. Cause-specific mortality risks related to alcohol use will account for effect modification by SES and race/ethnicity, if appropriate. The effects of alcohol taxation, minimum unit pricing, regulation of the availability of alcohol and screening and brief intervention on alcohol consumption and alcohol-attributable mortality will be modeled under different scenarios. The findings of the proposed study will directly inform evidence-based alcohol control interventions with the aim of reducing alcohol-attributable mortality, particularly among the most vulnerable groups of the US population. Furthermore, the microsimulation model will have the potential to be expanded in the future in order to include additional states, interventions and/or risk factors.

项目概要 直到最近，美国的预期寿命一直在增加，但在过去的几年里。 多年来，出生预期寿命开始下降，随后出现了一段停滞期。 社会经济地位 (SES) 较低的个体特定死因的死亡率增加 死亡率增加的具体死因包括 中毒、自杀、机动车相关伤害、肝病、肝硬化和糖尿病——所有这些 研究还发现，饮酒与哮喘死亡率存在因果关系。 社会经济地位低的个体面临的风险。 拟议的项目将调查饮酒对美国过去和未来预期寿命趋势的影响 国家级和州级均已选择 15 个州进行州级建模。 相关特征（例如高死亡率），涵盖所有九个人口普查分区和 50% 以上的人口普查分区 人口潜在寿命损失年数（YLL）将作为主要结果指标，因为它更接近。 该项目将 I) 调查社会经济地位和种族/民族。 使用国家健康访谈调查数据对饮酒与 YLL 之间关系的影响修正 与死亡原因数据关联；II) 生成特定原因酒精归因的 YLL 的微观模拟模型 按 SES、种族/民族、年龄和性别（2002-2017 年）和 III) 不同酒精的 YLL 模型增益； 控制干预情景（2018-2028 年）。微观模拟模型将基于来自 国家人口动态统计系统和当前人口调查的人口组成部分、暴露情况 组件将根据国家酒精及相关流行病学调查的数据提供信息 意外伤害、自杀、肝脏的状况和行为危险因素监测系统。 疾病和肝硬化、糖尿病、缺血性心脏病、出血性中风和高血压性心脏病 将对美国成年人（18 岁以上）普通人群进行疾病调查。 与饮酒相关的死亡风险将解释社会经济地位和种族/民族的影响修改，如果 酒精税、最低单位定价、酒精供应监管的影响。 将模拟对饮酒和酒精造成的死亡率的筛查和简短干预 不同场景下。 拟议研究的结果将直接为基于证据的酒精控制干预措施提供信息 旨在降低酒精造成的死亡率，特别是美国最弱势群体的死亡率 此外，微观模拟模型未来还将有扩展的潜力。 包括其他状态、干预措施和/或风险因素。

项目成果

The dose-response relationship between socioeconomic deprivation and alcohol-attributable mortality risk-a systematic review and meta-analysis.

社会经济剥夺与酒精所致死亡风险之间的剂量反应关系——系统评价和荟萃分析。

• 发表时间: 2021-11-05
• 影响因子: 9.3
• 作者: Probst, Charlotte;Lange, Shannon;Kilian, Carolin;Saul, Celine;Rehm, Jürgen
• 通讯作者: Rehm, Jürgen

Can lifestyle factors explain racial and ethnic inequalities in all-cause mortality among US adults?

生活方式因素可以解释美国成年人全因死亡率的种族和民族不平等吗？

• 发表时间: 2023-04-14
• 作者: Puka, Klajdi;Kilian, Carolin;Zhu, Yachen;Mulia, Nina;Buckley, Charlotte;Lasserre, Aurélie M;Rehm, Jürgen;Probst, Charlotte
• 通讯作者: Probst, Charlotte

Employment Status and Alcohol-Attributable Mortality Risk-A Systematic Review and Meta-Analysis.

就业状况和酒精所致死亡风险——系统回顾和荟萃分析。

• 发表时间: 2022-06-15
• 作者: Saul, Celine;Lange, Shannon;Probst, Charlotte
• 通讯作者: Probst, Charlotte

Trends in mortality from alcohol, opioid, and combined alcohol and opioid poisonings by sex, educational attainment, and race and ethnicity for the United States 2000-2019.

2000-2019 年美国按性别、教育程度、种族和族裔划分的酒精、阿片类药物以及酒精和阿片类药物混合中毒死亡率趋势。

• 发表时间: 2022-10-24
• 影响因子: 9.3
• 作者: Buckley, Charlotte;Ye, Yu;Kerr, William C;Mulia, Nina;Puka, Klajdi;Rehm, Jürgen;Probst, Charlotte
• 通讯作者: Probst, Charlotte

Simulation of Alcohol Control Policies for Health Equity (SIMAH) Project: Study Design and First Results.

健康公平酒精控制政策模拟 (SIMAH) 项目：研究设计和初步结果。

• 发表时间: 2023-05-05
• 影响因子: 5
• 作者: Probst, Charlotte;Buckley, Charlotte;Lasserre, Aurélie M;Kerr, William C;Mulia, Nina;Puka, Klajdi;Purshouse, Robin C;Ye, Yu;Rehm, Jürgen
• 通讯作者: Rehm, Jürgen