Understanding Racial Disparities in Heavy Drinking over the Life Course

了解一生中酗酒的种族差异

• 批准号: 8614984
• 负责人: NINA MULIA
• 金额: $ 31.29万
• 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: 2014-02-15 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8614984
• 关键词: Address; Adolescence; Adult; African American; Age; Alcohol abuse; Alcohol dependence; Alcohols; American; Area; Attention; Cessation of life; Chronic; Cohort Analysis; Cohort Effect; Cohort Studies; Data; Development; Disadvantaged; Education; Equation; Ethnic group; Exhibits; Exposure to; Gender; Growth; Guidelines; Health; Heavy Drinking; Hispanics; Income; Intervention; Latina; Life Cycle Stages; Longitudinal Surveys; Low income; Mediating; Mediator of activation protein; Minority; Minority Groups; Modeling; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Occupational; Occupational Status; Outcome; Pattern; Performance; Policies; Poverty; Prevalence; Psychopathology; Race; Relative (related person); Research; Risk; Risk Factors; Sampling; Schools; Scoring Method; Sex Characteristics; Social Welfare; Socioeconomic Factors; Statistical Methods; Structural Models; Subgroup; Suspension substance; Suspensions; Symptoms; Teenagers; Ursidae Family; Woman; Youth; alcohol epidemiology; alcohol related problem; base; career; cohort; drinking; emerging adult; experience; follow-up; generation difference; improved; interest; men; middle age; mortality; multidisciplinary; population health; prospective; public health relevance; racial and ethnic; racial and ethnic disparities; racial difference; racial/ethnic difference; social; social health determinants; socioeconomics; young adult

DESCRIPTION (provided by applicant): Heavy drinking is the third leading cause of preventable death among Americans and strongly associated with alcohol-related morbidity and problems, including negative drinking consequences and alcohol dependence. While racial/ethnic minorities bear a disproportionate burden of alcohol-related problems in the U.S., it is unknown whether this reflects more harmful, long-term patterns of heavy drinking. While some studies suggest that minorities have longer heavy drinking "careers", these have been based on short-term follow-up data, retrospective data, and age-specific prevalence data. Rigorous, prospective cohort studies have rarely examined racial/ethnic differences in heavy drinking trajectories, and those few studies that have shown contradictory findings for racial differences by the mid-to-late 20s, the age when these studies typically end. However, there are important theoretical and empirical reasons to expect that racial/ethnic groups diverge in their heavy drinking patterns as they transition out of early adulthood into middle age. Our central hypothesis is that racial/ethnic minority groups' greater accumulation of disadvantage over the life course will contribute to prolonged heavy drinking beyond the 20s, which could help to explain recent findings of more recurring and persistent alcohol problems among minorities (vs. whites) in mid-life. Responding to PA-11-308 "Secondary Analysis of Existing Alcohol Epidemiology Data", we propose to investigate this in the first, in-depth, prospective analysis of racial/ethnic disparities in heavy drinking trajectories from adolescence to middle age in a nationally-representative U.S. sample (National Longitudinal Surveys of Youth). Our Specific Aims are to: 1) Describe racial/ethnic differences in heavy drinking trajectories from the late teens to middle age, and their association with persistent alcohol problems; 2) Identify predictors of membership in heavy drinking trajectories, and mediators through which they operate to create alcohol problems; and 3) Assess the extent to which lifecourse socioeconomic factors explain racial disparities in prolonged heavy drinking and alcohol problems, and the mechanisms (differential exposure and differential consequences) contributing to these disparities. Our study draws on a social determinants perspective, thus departing somewhat from the dominant approach of developmental psychopathology. Heeding recent, federal calls for multisectoral efforts to address health inequities, we give special attention to the ways in which disparities related to education (parental and personal educational attainment, quality of education, and returns on education) may contribute to racial disparities in prolonged heavy drinking and problems. Our highly multidisciplinary team will utilize growth mixture models, structural equation models, and propensity scoring, and capitalize on data from both the 1979 and 1997 NLSY to examine cohort effects and differences by gender and Hispanic subgroup. This research will identify a range of far-reaching and interim policy targets to address racial disparities in lifecourse heavy drinking which are amenable to intervention in the education, social welfare and labor sectors.

描述(申请人提供)：大量饮酒是美国人可预防的死亡的第三大原因，与酒精相关的发病率和问题密切相关，包括负面饮酒后果和酒精依赖。虽然在美国，种族/少数民族承受着与酒精相关的问题的不成比例的负担，但它 目前尚不清楚这是否反映了长期酗酒的更有害模式。虽然一些研究表明，少数族裔有更长的酗酒“职业生涯”，但这些研究是基于短期随访数据、回顾数据和特定年龄段的患病率数据。严格的前瞻性队列研究很少考察大量饮酒轨迹中的种族/民族差异，以及那些在25岁中后期发现种族差异的少数研究，这些研究通常会在25岁左右结束。然而，有重要的理论和经验理由可以预期，随着种族/民族从成年早期过渡到中年，他们的酗酒模式会有所不同。我们的中心假设是，种族/少数民族群体在一生中积累的更多劣势将导致20多岁后长期大量饮酒，这可能有助于解释最近的发现，即少数族裔(相对于白人)在中年更频繁和持续地存在酒精问题。作为对PA-11-308“现有酒精流行病学数据的二次分析”的回应，我们建议在具有全国代表性的美国样本(全国青年纵向调查)中对从青春期到中年的重度饮酒轨迹中的种族/民族差异进行第一次深入的前瞻性分析。我们的具体目标是：1)描述从青少年后期到中年的重度饮酒轨迹的种族/民族差异，以及它们与持续性酒精问题的关联；2)确定重度饮酒轨迹成员的预测因素，以及它们通过哪些因素造成酒精问题；以及3)评估生活过程中的社会经济因素在多大程度上解释了长期大量饮酒和酒精问题的种族差异，以及导致这些差异的机制(不同的暴露和不同的后果)。我们的研究借鉴了社会决定因素的观点，因此有点背离了发展精神病理学的主导方法。注意到最近联邦呼吁多部门努力解决健康不平等问题，我们特别关注与教育有关的差异(父母和个人教育程度、教育质量和教育回报)可能导致长期大量饮酒的种族差异和问题的方式。我们高度多学科的团队将利用增长混合模型、结构方程模型和倾向评分，并利用1979年和1997年NLSY的数据来检查按性别和西班牙裔亚群划分的队列效应和差异。这项研究将确定一系列影响深远的临时政策目标，以解决终生酗酒方面的种族差异，这些差异适合于对教育、社会福利和劳动力部门进行干预。