Comparing the Effectiveness of City Policy and Structure in Health Disparities

比较城市政策和结构在健康差异方面的有效性

• 批准号: 7937085
• 负责人: RICHARD ALLEN SCRIBNER
• 金额: $ 33.17万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7937085
• 关键词: AODR mortality; Address; Adopted; Alcohol abuse; Alcohols; Area; Censuses; Cities; Data; Databases; Fees; Goals; Growth; Health; Injury; Intervention; Licensing; Literature; Longitudinal Studies; Louisiana; Measures; Minority; Modeling; Neighborhoods; Outcome; Policies; Population; Public Health; Risk; Series; Social Problems; Source; Structure; Violence; comparative effectiveness; compare effectiveness; density of AOD outlets; design; effectiveness research; health disparity; health inequalities; mortality; public policy on alcohol; social; social health determinants; social inequality; trend

DESCRIPTION (provided by applicant): This application addresses the broad Challenge Area (05) Comparative Effectiveness Research. Within this Challenge Area the specific Challenge Topic is 05-MD-101: Social Determinants of Health. This study's goal is to compare the effectiveness of a city level policy in New Orleans to control problem alcohol outlets that contribute to health inequalities among poor and minority populations. In 1997 the City of New Orleans adopted a series of policies that in effect represent a societal intervention to address the social determinants of health disparities in poor and minority neighborhoods, where problem alcohol outlet proliferation is a major problem. The policies were specifically enacted to address the proliferation of problem alcohol outlets believed to be the source of a variety of social problems including assaultive violence as well as adverse health effects. To accomplish this goal a longitudinal study of the effect of changes in alcohol outlet exposure on assaultive violence as well as alcohol related mortality is proposed. The study will span ten years (i.e., 1994 through 2004). It will be organized at the census tract level, the unit of analysis most strongly associated with structural effects associated with alcohol outlet exposure. The study will be conducted in two Louisiana cities: New Orleans and Baton Rouge. Since the policies were enacted in New Orleans, census tracts there will serve as "intervention" tracts while census tracts in Baton Rouge serve as the "control" tracts. Study Hypothesis 1: Among census tracts in New Orleans the trend in assaultive violence and alcohol-related mortality outcomes over the study period will demonstrate a significantly more negative slope than occurs among census tracts in Baton Rouge. Study Hypothesis 2: Decreases in alcohol outlet density at the census tract level will explain a significant amount of the trend in assaultive violence and alcohol-related mortality over the study period. Demonstrating that policy change at the city level designed to remedy a social inequality will result in a corresponding reduction is health disparities would represent a major contribution to the public health literature. The proposed project is designed to do just that. Compare the effectiveness of an alcohol control policy on rates of assaultive violence and alcohol related mortality across neighborhoods in two cities, one where the policy was enacted and one where it was not.

描述（由申请人提供）：本申请介绍了广泛的挑战领域（05）比较有效性研究。在这个挑战领域内，具体挑战主题是05-MD-101：健康的社会决定因素。这项研究的目标是比较新奥尔良的城市级别政策的有效性，以控制有助于贫困人口和少数民族人口健康不平等的问题酒精渠道。 1997年，新奥尔良市采用了一系列政策，这些政策实际上代表了一种社会干预措施，以解决贫困和少数民族社区中健康差异的社会决定因素，在这种问题上，问题是酗酒渠道增殖是一个主要问题。这些政策是专门制定的，以解决问题的酒精渠道的扩散，这些问题被认为是各种社会问题的根源，包括攻击性暴力和不利的健康影响。为了实现这一目标，提出了提出纵向研究酒精出口暴露对攻击性暴力以及与酒精相关的死亡率的影响的纵向研究。该研究将跨越十年（即1994年至2004年）。它将在人口普查水平上组织，这是与酒精出口暴露有关的结构效应最密切相关的分析单位。该研究将在路易斯安那州的两个城市进行：新奥尔良和巴吞鲁日。由于政策是在新奥尔良制定的，因此人口普查区将用作“干预”区，而在巴吞胭脂中的人口普查区则是“控制”区。研究假设1：在新奥尔良的人口普查区中，在研究期间，攻击性暴力和与酒精相关的死亡率结果的趋势将表明，与巴吞胭脂中的人口普查区中的发生相比，负斜率要大得多。研究假设2：在人口普查水平下，酒精出口密度的降低将解释研究期间大量攻击性暴力和与酒精有关的死亡率的趋势。证明旨在纠正社会不平等的城市层面的政策变化将导致相应的降低是健康差异将代表对公共卫生文献的重大贡献。拟议的项目旨在做到这一点。将酒精控制政策的有效性在两个城市的攻击性暴力和与酒精相关的死亡率上的有效性进行比较，一个城市是制定该政策的，而不是该政策。