Childhood Origin of Disparities in Alcohol Use Disorders

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DESCRIPTION (provided by applicant): There is compelling evidence that alcohol abuse and dependence are concentrated among individuals of disadvantaged socioeconomic status. However, the origins of socioeconomic disparities in alcohol use disorders remain poorly understood. While emerging data on health disparities point to the importance of childhood conditions in shaping individuals' long-term risk for health problems, the childhood origins of disparities in alcohol use disorders have been difficult to study due to the lack of prospective data needed to link childhood conditions with subsequent alcohol abuse and dependence. Moreover, previous research on this subject has often focused on socioeconomic differences in the level of alcohol consumption rather than alcohol use disorders. This proposal is submitted by a new investigator to study the childhood origins of socioeconomic disparities in alcohol abuse and dependence using a longitudinal design and with reliable measures of alcohol use disorders. We hypothesize that adult disparities in alcohol use disorders originate early in life, and that childhood conditions pose long-term consequences for the development and continuation of alcohol abuse and dependence. This proposal overcomes the limitations of prior studies by 1) investigating risks for alcohol use disorders in a longitudinal study of 1,267 individuals who were enrolled at birth and systematically followed for an average of 27.8 years, and 2) utilizing diagnostic criteria to define alcohol abuse and dependence. These investigations will be based on secondary analyses of the Providence, Rhode Island cohort of the National Collaborative Perinatal Project, initiated in 1959. Comprehensive assessment of socioeconomic and environmental conditions was obtained at multiple points in early childhood and in adulthood; adult psychiatric diagnoses were obtained using structured diagnostic interviews. The major aims of this study are: 1) to investigate the prospective relation between socioeconomic status, family disruption, and residential stability in childhood and the long-term risk for the onset and persistence of alcohol abuse and dependence; 2) to investigate adult socioecononomic disparities in alcohol use disorders; and 3) to investigate the childhood origins of the comorbidity between alcohol use disorders, other substance use disorders, and major depression.