Neighborhood interventions in alcohol-related homicide: a systems approach

描述(由申请人提供)：黑人和西班牙裔美国人比非西班牙裔白人(NHW)更有可能死于与酒精有关的杀人案，尽管与NHW相比，他们不太可能大量饮酒。几乎没有进行流行病学研究来确定可以做些什么来减少这种差异。我们认为，少数族裔发生与酒精有关的凶杀案的不成比例风险可能与少数族裔有系统地居住在经济条件较差的社区有关，这些社区的酒精出口密度高，优质医疗保健机会减少。我们建议使用基于代理的模型(ABM)来模拟嵌入社区的代理中的酒精使用、暴力实施和受害的经历，并检查对社区酒精出口密度和医疗保健获取的干预是否可以减少与酒精相关的杀人案中的种族差异。通过允许我们模拟反事实情况，ABM克服了在观察性邻域研究中将卫生工作者、西班牙裔和黑人单独选择到不可比较的邻域中对因果推理的限制。在研究和测试这些干预措施时，我们还将纳入有关社会关系的信息，因为与酒类销售点集中相关的街头和酒吧消费模式可能会鼓励与也表现出暴力行为的高风险饮酒者形成社会联系。具体地说，我们将研究社会关系的广度和强度是否影响邻里干预在减少种族/民族差距方面的有效性。 与酒精有关的杀人案。ABM将包括与纽约市的人口构成相匹配的代理人，并将其安排在一个划分为社区的网格中，通过20多个基于经验的参数来了解情况，这些参数评估了一个复杂的网络，包括社会关系、社区特征、酒精使用和滥用，以及受害和犯罪。本项目的重点是模拟纽约市社区；该项目将为NIH R01提案的准备工作提供信息，该提案将使用复杂的系统方法来调查不同形式酒精相关伤害的国家种族/族裔差异。

DESCRIPTION (provided by applicant): Blacks and Hispanics are more likely to die from alcohol-related homicides than non-Hispanic Whites (NHWs), despite being less likely to drink heavily compared to NHWs. Little epidemiologic research has been conducted to determine what can be done to reduce such disparities. We propose that the disproportionate risk for alcohol-related homicide among racial/ethnic minorities may be related to the systematic residential segregation of racial/ethnic minorities into economically disadvantaged neighborhoods with high alcohol outlet density and reduced quality health care access. We propose to use agent-based models (ABM) to simulate experiences of alcohol use, violent perpetration and victimization in agents embedded in neighborhoods, and to examine whether interventions on neighborhood alcohol outlet density and health care access could reduce racial disparities in alcohol-related homicide. By allowing us to simulate counterfactual situations, ABMs overcome the limitations that individual selection of NHWs, Hispanics and Blacks into non-comparable neighborhoods place on causal inference in observational neighborhood studies. In examining and testing these interventions, we will also incorporate information on social ties, as the patterns of street and bar consumption associated with concentration of alcohol outlets may encourage the formation of social ties with high-risk drinkers who also exhibit violent behavior. Specifically, we will examine whether the breadth and strength of social ties influences the efficacy of neighborhood interventions in reducing racial/ethnic disparities in alcohol-related homicides. The ABM will include agents matched to the demographic composition of New York City and arranged in a grid divided into neighborhoods, informed by more than 20 empirically-based parameters assessing a complex network of social ties, neighborhood characteristics, alcohol use and misuse, and victimization and perpetration. The present project focuses on simulating NYC neighborhoods; this project will inform the preparation of an NIH R01 proposal to use complex systems approaches to investigate national racial/ethnic disparities in different forms of alcohol-related injury.