Race, Stressors, and Alcohol-related Health Disparities

描述（由申请人提供）：虽然先前的流行病学研究揭示了饮酒和酒精问题中重要的种族/民族模式，但对为什么存在与酒精有关的健康差异的理解有限。目前，需要对酒精进行研究，阐明病因，以帮助了解和确定公共卫生预防、治疗和社区干预的目标。我们建议分析2005年全国酒精调查中现有的具有全国代表性的横断面数据，以检查少数民族地位、社会压力因素（如贫困、种族耻辱和感知歧视）、酗酒以及与酒精相关的健康和社会问题之间的关系。在此过程中，我们将利用现有的国家数据集，其中包括大量黑人和西班牙裔美国人的超样本，提供了酒精消费和问题的细粒度测量，并允许我们探索社会，经济，心理和文化因素与黑人，西班牙裔和白人的独立亚组中大量饮酒和酒精问题的相互作用。我们的概念方法是基于越来越多关于种族偏见和经济劣势对健康影响的工作，并认识到种族/族裔的社会结构和文化方面的重要性。我们的具体目标是：(1)研究少数民族身份、社会压力源暴露和心理困扰之间的关系；(2)探讨社会压力源与重度饮酒的关系，并考虑心理困扰和情境饮酒规范和态度的干预作用；(3)探讨少数民族身份、社会压力源和酒精相关问题之间的关系；导致酗酒和酗酒问题的途径的种族/族裔差异；以及麦芽白酒的作用。这项重新分析将为未来对酒精相关差异的多方法研究提供信息，以便使用更全面和多层次的措施，更仔细地检查这里出现的关系。

DESCRIPTION (provided by applicant): While prior epidemiological research has revealed important racial/ethnic patterns in drinking and alcohol problems, there is limited understanding of why alcohol-related health disparities exist. At present, alcohol studies that illuminate causal factors are needed to help inform and target public health prevention, treatment, and community interventions. We propose to analyze existing, nationally representative, cross-sectional data from the 2005 National Alcohol Survey to examine associations between minority status, social stressors such as poverty, racial stigma, and perceived discrimination, heavy drinking, and alcohol-related health and social problems. In so doing, we will capitalize on the existence of a national data set that includes large oversamples of black and Hispanic Americans, that provides fine-grained measures of alcohol consumption and problems, and that allows us to explore the interplay of social, economic, psychological, and cultural factors with heavy drinking and alcohol problems in separate subgroups of blacks, Hispanics, and whites. Our conceptual approach is informed by a growing body of work on the health impacts of racial bias and economic disadvantage, and recognizes the importance of both social structural and cultural aspects of race/ethnicity. Our specific aims are: (1) to examine associations between minority status, exposure to social stressors, and psychological distress; (2) to explore relationships between social stressors and heavy drinking, and consider the intervening roles of psychological distress and situational drinking norms and attitudes; and (3) to explore associations between minority status, social stressors, and alcohol-related problems; racial/ethnic differences in pathways leading to heavy drinking and alcohol problems; and the role of malt liquor. This re-analysis will inform the development of a future multi-method study of alcohol-related disparities to more closely examine the relationships that emerge here, with the use of more comprehensive and multi-level measures.