Rural Southern Contexts, COVID-19, and Black Men'Âs Alcohol Misuse

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Project Summary/Abstract The young Black men who are the focus of the proposed Urgent Competitive Revision to R01AA026623 are from small towns and rural communities in Georgia, an area of persistent poverty for Black residents that coincides with the nation’s worst educational, economic, and health disparities by race. Black residents account for more than 50% of Georgia’s COVID-19 deaths, despite comprising less than 1/3 of the state’s population; the state’s rural areas have a death rate 1.5 times that of its large cities. NIAAA reports that alcohol use has increased since pandemic precautions (e.g., shelter in home, social distancing) have been implemented. Among rural Black men, we hypothesize that alcohol use may accelerate the spread of SARS CoV-2. In addition to effects on immune function, alcohol misuse undermines the judgement, self-regulation, and motivation to practice recommended disease mitigation behaviors (e.g., physical distancing, self- quarantine, hand washing). Alcohol misuse also encourages young adults’ presence in settings and interactions in which they may be likely to become infected or to infect others. We also propose to examine the predictors of alcohol use. Many low-income Black men live below or near the federal poverty level and have few financial resources, including economic assets to use during a protracted pandemic. Economic hardship is exacerbated by racial discrimination, family stress and conflict, fears of exposure to unsafe working conditions when work is available, and the greater likelihood that they, their families, or their friends will be affected directly by SARS Cov-2 infection. Pandemic-related stressors are expected to foster the onset of alcohol use problems and the amplification of existing problems. Importantly, many men will cope well, avoiding alcohol misuse by drawing on both personal and social coping resources to deal with stress without alcohol use. We propose to conduct 3 remote surveys at 3-month intervals with a subsample (N = 242) of rural Black men from an ongoing study who provided past year, pre-pandemic data for the parent study. We will document men’s face-to-face social network contacts, COVID-19 mitigation behaviors, pandemic-related stressors and coping resources, and alcohol use. Our aims are to (a) model alcohol misuse trajectories among rural Black men during the course of the pandemic, (b) investigate the influence of alcohol misuse, over time, on men’s SARS CoV-2 transmission risk, and (c) investigate risk and protective processes associated with change in alcohol use during the pandemic.