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: 8918392
• 负责人: William C Kerr
• 金额: $ 39.48万
• 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/8918392
• 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; 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 policy on alcohol; racial and ethnic disparities; racial/ethnic difference; sedentary lifestyle

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.

说明（由申请人提供）：确定酒精消费、饮酒方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、酒精政策和法规、预防方案和保健服务成本估算都很重要。虽然大量文献已经讨论了这一主题，但可以得出的结论受到三个重要且相互关联领域的缺陷的限制：对酒精摄入量的测量不准确，对一生中饮酒和戒酒的评估有限；缺乏对健康问题对随后饮酒模式的影响的关注；对潜在的混杂健康风险因素的治疗不足，如童年逆境和经济困难，以及吸烟、吸毒和锻炼等健康行为。此外，对酒精与健康之间相互关系中的种族/族裔差异的关注有限，尽管有暗示的证据表明这一点。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年全国青年纵向调查（NLSY）和2010年全国酒精调查（NAS）进行新的分析。我们将研究：(1)特定的普遍健康状况（心脏病/心脏病、高血压、糖尿病、癌症和中风）、酒精导致的健康问题和自我报告的健康状况对一生中酒精消费的影响；(2)一生中酒精使用和童年逆境（身体虐待、性虐待、父母酗酒、经济困难和严重疾病）对特定健康状况发生的影响；(3)一生中酒精使用模式的影响。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。本研究从生命历程的角度出发，既关注饮酒对健康的影响，也关注健康对饮酒的影响，同时关注重要的其他健康风险因素。NLSY和2010 NAS的研究都对西班牙裔和非裔美国人进行了过度抽样，从而考虑到可能导致健康状况和问题中种族和民族差异的因素。本项目采用创新的统计方法