Inter-Relationships Between Life-Course Alcohol Patterns and Health Conditions

生命历程酒精模式与健康状况之间的相互关系

• 批准号: 8513747
• 负责人: William C Kerr
• 金额: $ 36.7万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8513747
• 关键词: Abstinence; Address; Adult; Affect; African American; Alcohol abuse; Alcohol consumption; Alcohols; Area; Attention; Characteristics; Childhood; Data; Diabetes Mellitus; Diagnosis; Drug usage; Economic Recession; Economics; Ethnic Origin; Exercise; Future; Growth; Health; Health Services; Health Status; Health behavior; Health education; Heart; Heart Diseases; Hispanics; Hypertension; Individual; Knowledge; Life Cycle Stages; Life Style; Link; Literature; Longitudinal Surveys; Malignant Neoplasms; Measurement; Measures; Modeling; Obesity; Outcome; Patient Self-Report; Pattern; Prevalence; Prevention program; Preventive Intervention; Race; Regulation; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Scoring Method; Severities; Sexual abuse; Shapes; Statistical Methods; Stroke; Structural Models; Surveys; Time; Tobacco; Tobacco use; Youth; alcohol epidemiology; cohort; cost; design; drinking; economic impact; ethnic difference; hazard; health disparity; improved; innovation; insight; parental alcoholism; physical abuse; public health relevance; public policy on alcohol; racial and ethnic disparities; racial/ethnic difference; sedentary

DESCRIPTION (provided by applicant): Establishing causal relationships between alcohol consumption, drinking patterns and common health problems is important for health education of consumers, alcohol policy and regulation, prevention programming and cost estimates for health services. While a large body of literature has addressed this topic, the conclusions that can be drawn have been limited by shortcomings in three important and inter- related areas: poor measurement of alcohol intake and limited assessment of life-course drinking and abstention; lack of attention to the influence of health problems on subsequent alcohol patterns; and inadequate treatment of potentially confounding health risk factors, such as childhood adversity and economic hardship, and health behaviors such as tobacco use, drug use, and exercise. Moreover, there has been limited attention to racial/ethnic differences in the inter-relationships of alcohol and health, despite suggestive evidence of such. To address these issues and gaps in the extant literature, the proposed study would conduct new analyses of the National Longitudinal Survey of Youth (NLSY) 1979 and 1997 cohorts and of the 2010 National Alcohol Survey (NAS). We will examine: (1) effects of specific prevalent health conditions (heart disease/heart problems, hypertension, diabetes, cancers and stroke), alcohol-attributable health problems and self-reported health status on alcohol consumption over the life course, (2) influences of life-course alcohol use and childhood adversity (physical abuse, sexual abuse, parental alcoholism, economic hardship and serious illnesses) on the onset of specific health conditions, and (3) effects of life-course alcohol use patterns, childhood and adult adversity and economic impacts of the 2008-09 recession on self-reported general health status. The proposed study is informed by a life- course perspective, focusing on both the influences of drinking on health and the influences of health on drinking while attending to important alternative health risk factors. Both the NLSY and 2010 NAS studies over-sampled Hispanics and African Americans, allowing consideration of factors that may contribute to racial and ethnic disparities in health conditions and problems. This project uses innovative statistical methods for longitudinal data including marginal structural Cox proportional hazards survival models and latent class growth curve models as well as retrospective cohort design survival models and propensity score matching. Results will provide new insights into inter-relationships between alcohol use and heath by avoiding common misclassification problems that undermine the validity of most previous research linking alcohol with health outcomes. Study findings will document the prevalence, severity and impact on future drinking of general and alcohol attributed health problems, provide estimates of alcohol pattern risks for specific health conditions and overall health status, and will provide estimates of impacts of childhood adversity and economic losses in the recent recession on these health outcomes.

描述（由申请人提供）：建立饮酒，饮酒模式和常见健康问题之间的因果关系对于消费者的健康教育，酒精政策和监管，预防计划以及对卫生服务的成本估算至关重要。尽管大量文献已经解决了这个主题，但可以得出的结论受到三个重要和相关领域的缺点的限制：衡量酒精摄入量的不良测量以及对生命过程饮酒和戒烟的评估有限；缺乏关注健康问题对随后酒精模式的影响；以及对可能混淆的健康危险因素（例如儿童逆境和经济困难，以及烟草使用，吸毒和运动等健康行为）的治疗不足。此外，尽管有暗示性的证据，但人们对酒精与健康之间的种族/种族差异的关注有限。为了解决现有文献中的这些问题和差距，拟议的研究将对1979年和1997年的《青年纵向调查》（NLSY）和2010年国家酒精调查（NAS）进行新的分析。 We will examine: (1) effects of specific prevalent health conditions (heart disease/heart problems, hypertension, diabetes, cancers and stroke), alcohol-attributable health problems and self-reported health status on alcohol consumption over the life course, (2) influences of life-course alcohol use and childhood adversity (physical abuse, sexual abuse, parental alcoholism, economic hardship and serious illnesses) on the onset of specific health conditions, and (3) effects of寿命饮酒模式，童年和成人逆境以及2008 - 09年经济衰退对自我报告的一般健康状况的经济影响。拟议的研究以生命课程的观点为启示，重点是饮酒对健康的影响以及健康对饮酒的影响，同时参与重要的替代健康危险因素。 NLSY和2010年NAS研究都过度采样了西班牙裔和非洲裔美国人，允许考虑可能导致健康状况和问题中种族和种族差异的因素。该项目使用创新的统计方法 纵向数据包括边缘结构COX比例危害存活模型和潜在类增长曲线模型以及回顾性队列设计生存模型和倾向得分匹配。结果将通过避免常见的错误分类问题，破坏了大多数先前的研究与健康结果的有效性，从而为酒精使用和荒地之间的相互关系提供新的见解。研究结果将记录对普通和酒精饮酒的普遍性，严重性和影响，归因于健康问题，为特定健康状况和整体健康状况提供酒精模式风险的估计，并将估计最近经济衰退对这些健康成果的儿童逆境和经济损失的影响。