Discrimination and Racial Inequalities in Drug Use in U.S. Adults: Associations and Mechanisms

美国成年人吸毒中的歧视和种族不平等：关联和机制

基本信息

批准号：
10739180
负责人：
Hongying Daisy Dai
金额：
$ 38.5万
依托单位：
UNIVERSITY OF NEBRASKA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-15 至 2027-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10739180
关键词：
Address Adult Alcohol consumption Alcohols Amplifiers Anxiety Asian population Behavioral Black Populations Buffers COVID-19 COVID-19 pandemic COVID-19 vaccination Cannabis Characteristics Cigarette Climate Coping Behavior Coping Skills Coronavirus Crime Data Data Reporting Data Set Discrimination Disease Drug usage Economics Electronic cigarette Employment Employment Status Environment Ethnic Origin Event Exercise Exposure to Food Frequencies Friends Hispanic Populations Household Housing Incidence Internet Intervention Life Link Measures Mediating Mediation Mental Depression Methods Modernization Nature Not Hispanic or Latino Outcome Outcome Study Patient Self-Report Persons Pharmaceutical Preparations Police Policy Maker Probability Public Health Race Research Risk Factors Sampling Science Surveys Techniques Testing Time Unemployment United States Vaccination Volatilization Vulnerable Populations addiction anti-Asian anti-racism anxiety symptoms binge drinking data modeling depressive symptoms ethnic difference ethnic disparity ethnic minority ethnic minority population experience follow-up hate crimes health equity killings minority communities multi-racial multilevel analysis pandemic impact people of color perceived discrimination polysubstance use prospective racial difference racial discrimination racial disparity racial minority racial minority population racial population racism recruit resilience secondary analysis social social determinants social health determinants substance use theories

项目摘要

Project Summary Exposure to racial discrimination has long been identified as a key social determinant of substance use that stratifies by race/ethnicity. Starting in 2020, displays of racism and their impacts have intensified, and the recent volatile climate during the COVID-19 pandemic provides a unique opportunity to assess mechanisms that link discrimination and other social determinants of health with racial/ethnic disparities in drug use, but there has not been the requisite science on this topic as it deserves. Existing research on the discrimination-substance use association is plagued by both external validity (i.e., non-representative sampling with low generalizability to overall U.S.) and internal validity (i.e., low temporal precision from annual inter-survey intervals to detect prospective, potentially causal association). Additionally, there is little evidence to guide clinicians and policymakers on interventions that can disrupt discrimination’s impact on substance use in the modern social, economic, and public health context. This secondary analysis of the nationally-representative Understanding America Study (UAS, n~9,000 U.S. adults) aims to elucidate the nature and mechanisms of the association of discrimination with race/ethnicity inequalities in substance use. To chart the broad effects of the pandemic, this study will harmonize longitudinally bi-weekly (March 2020-July 2021) and monthly (August/September 2021- June 2022) survey waves with a total of 38 timepoints. Time-varying measures include 1) frequency of discrimination experience, racism, and COVID-19 related discrimination, and 2) substance use (past-week use of alcohol, cigarettes, e-cigarettes, cannabis, and other drugs, poly-substance use, and binge drinking) along with key public health (e.g., COVID-19 illness and vaccination), economic (e.g., economic insecurity, housing insecurity, and employment instability), and behavioral factors (e.g., resilience and coping strategies). We will combine person-level data (38 survey waves) with state-level geocoded data on hate crime incidence, statutory provisions, and other public health or economic context. Intensive longitudinal multi-level modeling will be conducted to partition between- and within-subject variance and address between-person confounds, thus overcoming the biases inherent in other annual-interval national substance use surveillance with low temporal precision and recall errors. Through three inter-related aims and theory-driven hypothesis testing, we will 1) examine whether within-person changes in discrimination are associated with substance use and if associations are moderated by race and ethnicity (Aim 1), 2) determine person- and environment-level factors that exacerbate or buffer against the association of discrimination with substance use (Aim 2), and 3) assess mechanisms that explain race/ethnicity differences in the association of discrimination with substance use (Aim 3). Findings from this study will provide timely evidence to guide clinicians and policymakers on interventions that can disrupt discrimination’s impact on substance use in the modern social, economic, and public health context.

项目摘要长期以来，暴露于种族歧视已被确定为使用物质使用的关键社会决定者按种族/种族分层。从2020年开始，种族主义及其影响的展示受到了启发，最近在Covid-19大流行期间的挥发性气候为评估连接的机制提供了独特的机会歧视和其他具有种族/种族差异的毒品/种族差异的歧视和其他社会决定者，但没有我们是应得的关于这个主题的必要科学。现有关于歧视固定使用的研究缔合受到外部有效性的困扰（即，非代表性采样，概括性较低美国总体上）和内部有效性（即，从年度调查间隔到检测到的低临时精度潜在的，潜在的因果关系）。此外，几乎没有证据可以指导临床医生和政策制定者对可能破坏歧视对现代社会物质使用的影响的干预措施经济和公共卫生环境。对全国代表性理解的次要分析美国研究（UAS，N〜9,000名美国成年人）旨在阐明协会的性质和机制对种族/种族不平等的歧视。为了绘制大流行的广泛影响，这研究将每周（2020年3月至2021年7月）和每月（2021年8月/9月 - 2022年6月）调查浪，总计38个时间点。时间变化的措施包括1）歧视经验，种族主义和共同19相关歧视和2）使用物质（过去一周使用沿着酒精，香烟，电子烟，大麻和其他药物，多余的使用以及暴饮暴食）具有关键的公共卫生（例如Covid-19疾病和疫苗接种），经济（例如，经济不安全，住房不安全感，就业不稳定）和行为因素（例如，弹性和应对策略）。我们将将人级数据（38个调查浪）与州级地理编码数据相结合有关仇恨犯罪事件，法定的数据规定以及其他公共卫生或经济环境。密集的纵向多层建模将是进行分配 - 主题内和受试者之间的差异和地址之间的混淆，因此克服其他年度Interval National Substrate使用监视中固有的偏见，临时性低精确和回忆错误。通过三个相互关联的目的和理论驱动的假设检验，我们将1）检查歧视的人内变化是否与物质使用和是否关联有关受种族和种族的调节（目标1），2）确定加剧的人和环境级别的因素或反对歧视与物质使用的关联（目标2）和3）评估机制的缓冲解释歧视与物质使用的关联的种族/民族差异（AIM 3）。来自这项研究将提供及时的证据，以指导临床医生和政策制定者有关可能中断的干预措施歧视对现代社会，经济和公共卫生环境中物质使用的影响。