Race, alcohol consumption and vehicle crashes: an epidemiologic paradox

种族、饮酒和车祸：流行病学悖论

• 批准号: 8688740
• 负责人: KATHERINE MARGARET KEYES
• 金额: $ 17.76万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-23 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8688740
• 关键词: Accident and Emergency department; Adolescence; Adolescent; Adolescent and Young Adult; Adult; African American; Alcohol abuse; Alcohol consumption; Alcohols; American; Applications Grants; Area; Attitude; Automobile Driving; Award; Blood alcohol level measurement; Cause of Death; Censuses; Cessation of life; Characteristics; Communities; Consumption; Data; Data Collection; Data Set; Development; Disease; Drug usage; Elderly; Environment; Epidemiologic Studies; Epidemiology; Ethnic Origin; Ethnic group; Event; Exposure to; Face; Funding; Genetic Crossing Over; Geographic Locations; Health; Hispanics; Individual; Injury; Latino; Life; Life Cycle Stages; Link; Longitudinal Studies; Low Prevalence; Measurement; Measures; Mediating; Mentored Research Scientist Development Award; Methods; Mexican; Minority; Minority Groups; Modeling; New York; New York City; Not Hispanic or Latino; Pattern; Persons; Pharmaceutical Preparations; Population Density; Preparation; Public Health; Puerto Rican; Race; Records; Reporting; Research; Research Project Grants; Research Training; Risk; Risk Factors; Role; Rural Population; Safety; Sampling; Shapes; Social Environment; Subgroup; Surveys; System; Testing; Time; Training; United States; Ursidae Family; Vehicle crash; Work; age related; alcohol epidemiology; alcohol use disorder; base; binge drinking; drinking; emerging adult; epidemiologic data; ethnic difference; experience; high risk; high risk drinking; injured; low socioeconomic status; mortality; neglect; novel; professor; public health relevance; racial and ethnic; racial/ethnic difference; sex; skills; social; social norm; young adult

DESCRIPTION (provided by applicant): Despite a greater accumulation of risk factors for at-risk drinking and alcohol use disorders, national epidemiological surveys consistently report that Blacks and Hispanics in the United States (US) have an comparable or lower prevalence of binge drinking and alcohol disorders compared to non-Hispanic Whites. However, mortality data indicate that they have higher rates of alcohol-attributable motor vehicle crash fatality (MVCF). These seemingly divergent patterns indicate an epidemiologic paradox, the consequences of which are important for public health: MVCF is a leading cause of death among young adults, Blacks and Hispanics experience substantial inequities in MVCF compared to non-Hispanic Whites, and approximately 30% of all MVCFs are alcohol-related. In the present application for a Mentored Research Scientist Development Award (K01), I propose to develop expertise in four areas that will allow me to develop a line of research into the racial/ethnic paradox in alcohol-related health: 1) Built environment effects on alcohol-related health; 2) Conceptualization and measurement of cultural and social norms regarding alcohol use; 3) Analysis of repeated measures data; and 4) Field methods in epidemiologic data collection. I will use the skills obtained in these training areas to begin to fill outstanding gaps in our understanding of racial/ethnic differences in alcohol- related health with three research projects, for which the K01 will allow me protected research time that would otherwise not be possible as a new assistant professor. First, I will probe the validity of the racial/ethnic paradox itself. I ill explore whether lower rates of problem drinking among racial/ethnic minorities are limited to adolescents and young adults, and whether rates of problem drinking among older adults are higher among Blacks and Hispanics compared to non-Hispanic Whites. This work will utilize a national longitudinal dataset and incorporate information on trajectories within Blacks and Latino subgroups, which have never been characterized. Second, I will determine if alcohol-related social norms mediate overall differences in alcohol use and MVC risk, adding to our knowledge of how the paradox arises. I will use data from the New York Social Environment Survey, an epidemiologic study in New York City with rich racial and ethnic diversity and one of the only community-based samples to measure alcohol norms. Third, I will test a potential mechanism to explain the racial/ethnic paradox: that Black and Hispanic individuals experience more alcohol-attributable MVCF because the built environment in which they consume alcohol is more dangerous (e.g., worse road conditions). To test this hypothesis I propose a novel study linking records from the Fatality Analysis Reporting System on a national level with census and land usage information. In addition to these research aims, my K01 award period will focus on preparation of an R01 grant proposal to collect original data on racial/ethnic differences in alcohol-related health that builds on and extends the research proposed here. These projects are feasible only if I have protected time for new training and research, which K01 funding will provide.

描述（由申请方提供）：尽管存在风险的饮酒和酒精使用障碍的风险因素积累较多，但国家流行病学调查一致报告称，与非西班牙裔白人相比，美国（US）黑人和西班牙裔的酗酒和酒精障碍患病率相当或较低。然而，死亡率数据表明，他们有较高的酒精归因于机动车碰撞死亡率（MVCF）。这些看似不同的模式表明了一个流行病学悖论，其后果对公共卫生很重要：MVCF是年轻人死亡的主要原因，黑人和西班牙裔人与非西班牙裔白人相比，MVCF存在很大的不平等，大约30%的MVCF与酒精有关。在本申请辅导研究科学家发展奖（K 01），我建议在四个领域发展专业知识，使我能够发展一系列研究酒精相关健康的种族/民族悖论：1）建筑环境对酒精相关健康的影响; 2）关于酒精使用的文化和社会规范的概念化和测量; 3）重复测量数据的分析;（4）流行病学资料收集的现场方法。我将利用在这些培训领域获得的技能，开始用三个研究项目来填补我们对酒精相关健康的种族/民族差异的理解中的突出空白， K 01将使我有受保护的研究时间，否则作为一个新的助理教授是不可能的。首先，我将探讨种族/民族悖论本身的有效性。我将探讨少数种族/族裔中较低的问题饮酒率是否仅限于青少年和年轻人，以及黑人和西班牙裔老年人的问题饮酒率是否高于非西班牙裔白人。这项工作将利用一个国家纵向数据集，并纳入关于黑人和拉丁美洲人亚群内轨迹的信息，这些信息从未被定性。其次，我将确定是否与酒精相关的社会规范介导了酒精使用和MVC风险的总体差异，增加了我们对悖论如何产生的知识。我将使用来自纽约社会环境调查的数据，这是一项在纽约市进行的流行病学研究，具有丰富的种族和民族多样性，也是唯一一个以社区为基础的样本来衡量酒精规范。第三，我将测试一种潜在的机制来解释种族/民族悖论：黑人和西班牙裔个体经历更多的酒精归因于MVCF，因为他们饮酒的建筑环境更危险（例如，路况较差）。为了验证这一假设，我提出了一个新的研究链接记录从死亡分析报告系统在国家一级的人口普查和土地使用信息。除了这些研究目标，我的K 01奖期间将专注于准备R 01赠款提案，以收集关于酒精相关健康的种族/民族差异的原始数据，该数据建立在这里提出的研究的基础上并扩展了该研究。只有当我有时间进行新的培训和研究时，这些项目才是可行的，K 01基金将提供这些时间。