Racial/ethnic Disparities in Alcohol Outcomes and Health Service

酒精结果和健康服务方面的种族/民族差异

• 批准号: 9340854
• 负责人: Joseph Edwin Glass
• 金额: $ 8万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-03 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9340854
• 关键词: Address; Affect; African American; Alaska Native; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; American Indians; Asians; Attention; Caring; Cause of Death; Data; Disadvantaged; Discrimination; Economics; Epidemiology; Equation; Ethnic Origin; Ethnic group; Exposure to; Face; Foundations; Frequencies; Goals; Health; Health Services; Heavy Drinking; Hispanic Americans; Hispanics; Individual; Interview; Investigation; Literature; Liver diseases; Medical; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Native Americans; Nature; Outcome; Persons; Population; Poverty; Race; Research; Risk; Risk Factors; Sex Discrimination; Source; Specialist; Surveys; Symptoms; Time; Treatment outcome; United States; addiction; adverse outcome; alcohol abstinence; alcohol abuse therapy; alcohol availability; alcohol related problem; alcohol use disorder; drinking; ethnic difference; ethnic discrimination; ethnic minority population; experience; follow-up; health disparity; help-seeking behavior; improved; informal care; innovation; medical specialties; minority health; population health; preference; psychosocial; public health intervention; racial and ethnic; racial and ethnic disparities; social; social stigma; stressor; treatment disparity

 DESCRIPTION (provided by applicant): Alcohol use disorders (AUDs) are the third leading cause of death in the United States. Profound disparities exist in the consequences of AUDs for racial/ethnic minorities when compared to Whites. African Americans and Hispanics have a greater risk of developing alcohol-related liver disease, experience more social consequences related to drinking when controlling for alcohol consumption, and are less likely to recover from alcohol problems when compared to whites. Identifying the sources of these disparities is critical to improving population health. Recent studies in the alcohol literature have considered the accumulation of multiple psychosocial stressors as a framework to investigate racial/ethnic disparities. For instance, poverty and perceived racial/ethnic discrimination have been identified as multiplicative stressors when experienced in combination, which exacerbates the adverse outcomes of drinking. More research is needed to determine if commons stressors pertinent to health disparity populations, such as the perceived stigma of alcohol addiction and perceived gender discrimination, may be multiplicative in nature when influencing the experience of alcohol outcomes. Moreover, racial/ethnic minorities in need of care for alcohol-related problems also utilize different forms of treatment than Whites. In particular, racial/ethnic minorities often receive alcohol-related care from informal sources as opposed to addiction treatment specialists. It is unknown if these differences can be attributed to health disparities. goal of the proposed research is to use longitudinal analyses to estimate the unique and multiplicative influences of poverty and race/ethnicity when predicting alcohol outcomes and treatment utilization over time. We will also investigate the potential multiplicative nature of common psychosocial stressors (perceived alcohol stigma, perceived racial/ethnic discrimination, and perceived gender discrimination) when predicting AUD symptoms and alcohol treatment utilization using structural equation models. An intersectionality framework provides an innovative method to investigate alcohol outcome and treatment utilization differences. We will apply rigorous analyses to Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Our longitudinal analyses will overcome limitations of the current literature on intersecting risk factors and alcohol outcomes. Moreover, the examination of the potential sources of racial/ethnic differences in obtaining specific alcohol treatments has received almost no empirical attention, which we address in this application. In addition to gaining a better understanding of why Black, Hispanic, and Native Americans tend to have worse alcohol outcomes than whites when controlling for alcohol consumption, the proposed analyses could inform whether public health interventions to reduce alcohol consumption and improve treatment utilization should increasingly target racial/ethnic minorities, address economic disparities, and/or attempt to reduce discrimination and alcohol-related stigma.

 描述（由适用提供）：酒精使用障碍（AUD）是美国第三大死亡原因。与白人相比，与种族/族裔少数群体的后果存在严重的差距。非洲裔美国人和西班牙裔人物患与酒精相关的肝脏疾病的风险更大，在控制饮酒时会遇到更多与饮酒有关的社会后果，与白人相比，从酒精问题中康复的可能性较小。确定这些差异的来源对于改善人口健康至关重要。酒精文献的最新研究认为，多种社会心理压力源的积累是研究种族/族裔分布的框架。例如，在合并经历时，贫穷和感知的种族/族裔歧视已被确定为乘法源，这加剧了饮酒的不利结果。需要进行更多的研究来确定与健康差异人群相关的公共压力，例如，当酗酒成瘾的污名和感知的性别歧视时，当影响酒精结果的经验时，本质上可能是倍数的。此外，与白人相比，需要照顾与酒精有关的问题的种族/族裔少数民族也使用不同形式的治疗。特别是，种族/族裔少数民族通常会从非正式来源获得与饮酒有关的护理，而不是成瘾治疗专家。未知这些差异是否可以归因于健康分布。拟议的研究的目标是使用纵向分析来估计贫困和种族/种族的独特和乘法影响，以预测随着时间的推移酒精结果和治疗利用。当使用结构当量模型预测AUD症状和酒精治疗时，我们还将研究常见的社会心理压力源（感知到的酒精污名，感知的种族/种族歧视以及感知的性别歧视）的潜在乘法性质。相交性框架提供了一种创新的方法来研究酒精结果和治疗利用差异。我们将对酒精和相关条件的国家流行病学调查（NESARC）进行严格的分析。我们的纵向分析将克服当前文献对相交风险因素和酒精结果的局限性。此外，在获得特定酒精治疗方面的种族/族裔差异来源的检查几乎没有得到经验的关注，我们在本申请中解决了这一点。除了更好地了解为什么黑人，西班牙裔和美洲原住民在控制饮酒时倾向于与白人更差的酒精结果外，拟议的分析还可以告知降低酒精消耗和改善治疗方法的公共卫生干预措施是否应增加目标种族/族裔少数民族的少数族裔，并解决经济差异，解决歧视和饮酒的疾病和酒精含量和酒精含量。