The Influence of Multilevel Minority Stress on Hazardous Drinking among Sexual Minority Women

性少数妇女（法定最低工资;例如，女同性恋者、双性恋者）代表了危险性最高的群体之一， 饮酒（HD;使个人处于有害风险的酒精消费量或模式） 后果，包括严重的间歇性饮酒，不良饮酒后果，中毒， 依赖症状）。法定最低工资妇女比异性恋妇女更有可能报告有亨廷顿病的迹象; 例如，他们去年酒精依赖症状的几率高出3-7倍。主要解释 因为这种差异是法定最低工资对少数压力源的暴露（例如，歧视）。然而，研究 主要集中在个人（例如，污名意识）或人际关系-（例如，鉴别）水平 因素相对较少的研究考虑了结构层面的少数族裔压力源（例如，歧视性法律或 政策），甚至更少的同时审查了多层次的少数民族压力对HD的影响， SMW。更好地了解少数群体的多层次动态、背景和相互关联的影响 压力源可以为预防和干预战略提供信息。在拟议的博士前奖学金，我将 通过结合21年纵向芝加哥健康与生活的数据来研究这些关系 女性研究经验（CHLEW; R 01 AA 013328 -14; T.休斯，PI [主要导师]）和公开 现有数据涉及结构层面的少数民族压力，使用先前验证的国家LGBT政策指数 环境在社会生态模型和少数民族压力模型相结合的指导下， （1）研究个人层面的少数民族压力源（即，污名意识， （2）检查人际层面的关联， 少数压力源（即，性身份歧视，家庭对性身份披露的反应）与过去 年HD，同时考虑个人层面的少数民族压力源;（3）检查结构性- 水平的少数族裔压力源（即，国家LGBT政策环境）与过去一年的HD，同时考虑到个人 和人际层面的少数民族压力源。认识到法定最低工资的多样性，对于三个目标中的每一个， 还将探索性别认同的潜在差异（即，女同性恋、双性恋）和种族/民族（即，黑人 白色，拉丁裔）。拟议的目标与国家酒精滥用和酒精中毒研究所（NIAAA）保持一致 研究目标和优先事项，以告知预防战略，酒精滥用和疾病， 在整个生命周期中的个人，并调查酒精使用的社会文化根源。处理一个 在哥伦比亚资源丰富的环境中， 大学，我将发展酒精流行病学，少数民族压力的多个层次， 先进的定量方法。我将获得经验和专业技能，在负责任的行为， 研究，多学科合作，granimate，和学术写作。这将有助于建立一个强大的 我的独立研究事业的发展基金会专注于减少法定最低工资中的HD。

Sexual minority women (SMW; e.g., lesbian, bisexual) represent one of the highest-risk groups for hazardous drinking (HD; a quantity or pattern of alcohol consumption that places individuals at risk for harmful consequences that includes heavy episodic drinking, adverse drinking consequences, intoxication, and dependence symptoms). SMW are much more likely than heterosexual women to report indicators of HD; for example, they have 3-7 times higher odds of past-year alcohol dependence symptoms. The major explanation for this disparity is SMW’s exposure to minority stressors (e.g., stigma, discrimination). However, research has been largely focused on individual- (e.g., stigma consciousness) or interpersonal- (e.g., discrimination) level factors. Relatively little research has considered structural-level minority stressors (e.g., discriminatory laws or policies) and even less has simultaneously examined the impact of multiple levels of minority stress on HD in SMW. Greater understanding of the dynamic, contextual, interrelated impact of multiple levels of minority stressors can inform prevention and intervention strategies. In the proposed predoctoral fellowship, I will investigate these relationships by combining data from the 21-year longitudinal Chicago Health and Life Experiences of Women study (CHLEW; R01AA013328-14; T. Hughes, PI [primary mentor]) and publicly available data related to structural level minority stress, using a previously validated index of state LGBT policy environment. Guided by an integration of the Social Ecological and Minority Stress Models, the specific aims are to: (1) Examine the associations of individual-level minority stressors (i.e., stigma consciousness, internalized stigma/homophobia) with past year HD; (2) Examine the associations of interpersonal-level minority stressors (i.e., sexual identity discrimination, family reactions to sexual identity disclosure) with past year HD while accounting for individual-level minority stressors; and (3) Examine the association of structural- level minority stressors (i.e., state LGBT policy environment) with past year HD while accounting for individual and interpersonal-level minority stressors. Recognizing the diversity among SMW, for each of the three aims I will also explore potential differences by sexual identity (i.e., lesbian, bisexual) and race/ethnicity (i.e., Black, White, Latina). The proposed aims align with the National Institute on Alcohol Abuse and Alcoholism (NIAAA) research goals and priorities to inform prevention strategies for alcohol misuse and disorders among individuals across the lifespan and to investigate socio-cultural origins of alcohol use. Working with a mentorship team of prominent researchers, and within the highly resourced environment of Columbia University, I will develop expertise and skills in alcohol epidemiology, multiple levels of minority stress, and advanced quantitative methods. I will gain experience and professional skills in the responsible conduct of research, multidisciplinary collaboration, grantsmanship, and academic writing. This will serve to build a strong foundation for the development of my independent research career focused on reducing HD among SMW.