Neighborhood Socioeconomic Status and Alcohol Outcomes: Moderators and Mediators

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DESCRIPTION (provided by applicant): This grant application responds to the program announcements for the Secondary Analysis of Existing Epidemiology Data (PA-08-168) and for studies of Epidemiology and Prevention in Alcohol Research (PA-07-449) calling for exploratory and developmental research issued by the National Institute on Alcohol Abuse and Alcoholism. The application proposes a secondary analysis of data from the 2000 and 2005 National Alcohol Surveys (conducted by the Alcohol Research Group) linked with data from the 2000 US Decennial Census to examine whether, for whom and how neighborhood socioeconomic status is associated with alcohol use and alcohol problems. First, the study will investigate whether there are direct effects of neighborhood SES on alcohol use, high-risk drinking and alcohol problems in a nationally-representative sample of US adults. To determine the groups for whom the neighborhood socioeconomic context matters, we will examine whether the associations between neighborhood SES and the outcomes vary by demographic group. Analyses using linear and logistic regression will examine the relevance of the neighborhood environment for residents of different races/ethnicities and socioeconomic backgrounds, as well as for young, midlife and senior adults. Additional analyses focusing on high-risk drinking and alcohol problems will examine whether early-life risk factors moderate the effects of exposure to neighborhood risk later in life. This innovative approach is informed by developmental psychopathology and a life-course perspective in examining alcohol use and alcohol problems among a general population sample of adults. The final analyses will address how the neighborhood socioeconomic context may impact behavior by ascertaining whether psychosocial mediating factors help explain the influence of neighborhood SES on the alcohol outcomes. The mediation analysis will involve preliminary linear and logistic regression to inform overall path analysis models. The objectives of this project are directly relevant to the mission of the NIH to explain and reduce health disparities related to alcohol. This exploratory epidemiologic study will inform prevention science by permitting the identification of groups of neighborhood residents at increased risk for heavy alcohol use and alcohol problems. The study also will extend prior research by exploring the pathways through which neighborhoods contribute to alcohol outcomes. As noted in the program announcements, multi-level prevention initiatives are of great interest. This study identifies risk and protective factors at the individual, familial, and neighborhood levels and explores their interrelationships using a socioecological perspective. Future projects will be designed to help translate the study findings into community-focused, multi-level prevention interventions for at-risk individuals living in high-risk neighborhoods, including mental health support services for people most in need, targeted public education campaigns in affluent and disadvantaged neighborhoods, and environmental change to reduce the burden of alcohol problems in disadvantaged communities. PUBLIC HEALTH RELEVANCE: Our health and behavior are influenced by where we live. This study explores whether neighborhoods are related to alcohol use and alcohol problems. It focuses on neighborhood socioeconomic status (both affluence and disadvantage) and whether some groups (such as racial minority group members, people with low incomes, young adults, or formerly heavy drinkers) are more at risk if they live in disadvantaged neighborhoods. The study also examines how neighborhoods are related to expression of alcohol problems, such as by heavier drinking, depression or reasons for drinking. The results from this study will help develop prevention programs for people and neighborhoods at risk.