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

对酒精控制干预措施微观模拟的补充，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: 10665343
• 负责人: Charlotte Probst
• 金额: $ 10.94万
• 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/10665343
• 关键词: Accidental Injury; Adult; Affect; Age; Alcohol consumption; Alcoholic Liver Cirrhosis; Alcohols; Area; Behavioral; Birth; Black Populations; COVID-19; COVID-19 mortality; COVID-19 pandemic; COVID-19 pandemic effects; Cardiovascular Diseases; Cause of Death; Cessation of life; Characteristics; Complex; Data; Development; Diabetes Mellitus; Distress; Economics; Educational Background; Ensure; Epidemic; Ethnic Origin; Excess Mortality; Foundations; Frequencies; General Population; Health behavior; Hispanic; Hispanic Populations; Individual; Inequality; Intentional injury; Intervention; Life; Life Expectancy; Literature; Liver Cirrhosis; Liver diseases; Long-Term Effects; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Not Hispanic or Latino; Pattern; Pharmaceutical Preparations; Poisoning; Policies; Population; Population Statistics; Probability; Public Health; Race; Regulation; Report (document); Request for Applications; Restaurants; Risk Factors; Role; Shock; Socioeconomic Status; Subgroup; Suicide; Taxation; Time; United States; Update; Variant; Woman; alcohol measurement; alcohol use disorder; attributable mortality; base; black subgroup; drinking; health equity; insight; low socioeconomic status; markov model; men; mortality; mortality statistics; multilevel analysis; pandemic disease; parent grant; population based; psychological distress; racial and ethnic; screening and brief intervention; sex; social; social health determinants; sociodemographics; socioeconomics; trend

PROJECT SUMMARY The COVID-19 pandemic has led to drastic declines in life expectancy in the United States (US), disproportionately affecting individuals with low socioeconomic status (SES) as well as Black and Hispanic populations. Mortality from non-COVID-related causes has also shown meaningful increases that contributed to the losses in life expectancy, including a striking 27% increase in age-adjusted mortality rates from alcohol- related causes from 2019 to 2020. The current application requests a supplement to the parent grant (R01AA028009) to account for the social, demographic, economic, and behavioral changes induced by the COVID-19 pandemic. Under the parent grant, a microsimulation of the adult (18+) general population is being developed to model years of potential life lost (YLL) from alcohol-attributable causes of death between 2000 and 2017 with a forward modeling time horizon until 2028. This supplement aims to augment the microsimulation model by incorporating the role and effects of the COVID-19 pandemic. Specifically, the role of alcohol use in excess mortality during the COVID-19 pandemic will be investigated among different population subgroups. Changes in psychological distress and alcohol-related policies during the pandemic will be investigated as potential drivers of changes in alcohol use. Current population-based data on alcohol use, psychological distress, alcohol-related policy changes, mortality, and population statistics will be used. Linear spline multilevel models, stratified by sex, will be used to investigate trends in alcohol use, conditional on SES and race/ethnicity. Age, individual-level psychological distress, and state-level alcohol-related policies, along with their interaction with year, will be introduced as covariates. Cause-specific contributions to changes in life expectancy will be calculated using a decomposition method. Transition probabilities between i) drinking patterns and ii) levels of education before and during the COVID-19 pandemic will be estimated using continuous-time Markov models. Findings will be integrated into an augmented microsimulation model. YLL from nine selected causes of death including alcohol use disorders, intentional and unintentional injuries, liver disease and cirrhosis, diabetes mellitus, and several cardiovascular diseases will be modeled. Counterfactual scenarios will be used to estimate i) excess alcohol-attributable YLL by population subgroup during the COVID-19 pandemic compared to a scenario without pandemic; ii) potential long-term effects on alcohol-attributable mortality assuming sustained compared to temporary changes in transition probabilities; and iii) alcohol-attributable YLL under different scenarios of long- and short-term implementation of restrictive and permissive alcohol-related policies during the pandemic and beyond. The findings will provide unique insights into the impact of the COVID-19 pandemic on alcohol use and alcohol-attributable mortality in different population subgroups. Furthermore, the augmented microsimulation model will constitute a robust foundation for policy and intervention modeling performed under the parent grant.

项目概要 COVID-19 大流行导致美国 (US) 的预期寿命急剧下降， 对社会经济地位 (SES) 较低的个人以及黑人和西班牙裔的影响尤为严重 人口。非新冠肺炎相关原因造成的死亡率也显着增加，这导致 预期寿命的缩短，包括酒精导致的按年龄调整的死亡率显着增加 27% 2019年至2020年的相关原因。 当前申请要求对家长补助金 (R01AA028009) 进行补充，以考虑社会、 COVID-19 大流行引发的人口、经济和行为变化。在家长的资助下， 正在开发对成年人（18 岁以上）一般人群的微观模拟，以模拟潜在寿命损失的年数 (YLL) 来自 2000 年至 2017 年间酒精导致的死亡原因，并采用正向建模时间范围 直到 2028 年。本补充旨在通过纳入以下因素的作用和效果来增强微观模拟模型： COVID-19 大流行。具体来说，在 COVID-19 期间饮酒对死亡率过高的影响 将在不同的人口亚组中调查流行病。心理困扰和变化 将调查大流行期间与酒精相关的政策，将其作为酒精使用变化的潜在驱动因素。 当前基于人口的饮酒数据、心理困扰、与酒精相关的政策变化、 将使用死亡率和人口统计数据。按性别分层的线性样条多级模型将用于 调查饮酒趋势，以社会经济地位和种族/民族为条件。年龄、个人心理 困境和州级酒精相关政策及其与年份的相互作用将被引入 协变量。将使用分解来计算特定原因对预期寿命变化的贡献 方法。之前和期间 i) 饮酒模式和 ii) 教育水平之间的转变概率 将使用连续时间马尔可夫模型来估计 COVID-19 大流行。调查结果将被纳入 增强的微观模拟模型。九种选定死因（包括酒精使用障碍）的 YLL， 有意和无意的伤害、肝病和肝硬化、糖尿病和一些心血管疾病 疾病将被建模。反事实情景将用于估计 i) 过量饮酒造成的 YLL 与没有大流行的情况相比，在 COVID-19 大流行期间按人口亚组划分； ii) 潜力 假设与暂时变化相比，酒精所致死亡率的长期影响是持续的 转移概率； iii) 不同长期和短期情景下酒精造成的 YLL 在大流行期间及之后实施与酒精相关的限制性和允许性政策。 研究结果将为了解 COVID-19 大流行对饮酒和饮酒的影响提供独特的见解。 不同人群中酒精造成的死亡率。此外，增强微观模拟 模型将为在母基金资助下进行的政策和干预建模奠定坚实的基础。