Hotspots: Understanding Areas of Concentrated Alcohol and Drug Problems at the US-Mexico Border

热点：了解美墨边境酒精和毒品问题集中的地区

• 批准号: 9228313
• 负责人: SARAH E. ZEMORE
• 金额: $ 22.05万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9228313
• 关键词: Address; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Area; Automobile Driving; Border Crossings; Buffers; Cities; Crime; Data; Data Set; Development; Disadvantaged; Drug usage; Ecology; Environment; Environmental Risk Factor; Epidemiology; Exposure to; Family; Fibrinogen; Friends; Gender; Grant; Health; Hispanics; Household; Immigrant; Immigration; Individual; Insurance; Intervention; Interview; Language; Latino; Law Enforcement; Light; Location; Mexican; Mexican Americans; Mexico; Modeling; Neighborhoods; Occupations; Outcome; Paper; Pathway interactions; Pattern; Persons; Pharmaceutical Preparations; Play; Population; Privatization; Probability Samples; Process; Psychological Factors; Research; Resources; Risk; Risk Factors; Role; Sampling; Services; Sister; Site; Staging; Surveys; Testing; Texas; Variant; Violence; alcohol epidemiology; alcohol related problem; alcohol risk; base; comparative; density; epidemiology study; family support; geographic difference; improved; knowledge base; migration; programs; socioeconomic disadvantage; substance abuse epidemiology; trafficking

ABSTRACT: Hotspots: Understanding Areas of Concentrated Alcohol and Drug Problems at the US- Mexico Border Millions of Mexican Americans live in the US-Mexico border region, which is both an extremely disadvantaged area and a staging zone for migration to the interior. Thus, the health and substance use patterns of Mexican- origin border residents are of central concern. Nevertheless, despite preliminary evidence of high drug trafficking, drug availability, and substance use problems along the border, very little is known about alcohol and drug problems in this area. Our team recently initiated a large epidemiological study, the US-Mexico Study of Alcohol and Related Conditions, or UMSARC (R01AA018365; PI's Cherpitel and Borges), to address this gap. In addition to being one of only two large-scale epidemiological studies of the border addressing alcohol, UMSARC is the only known such study to survey residents of both the US and Mexico. Data represent 4,796 in-person interviews with a probability sample of Mexican and Mexican-origin individuals interviewed between 2011-2013. Emerging papers based on UMSARC data suggest a heightened risk for alcohol and drug problems, yet substantially lower substance use treatment utilization, at the US border, compared to the interior. Yet, preliminary evidence also suggests dramatic, unexplained variation even among border sites, with alcohol and drug problems being concentrated in a single US hotspot: Laredo, Texas. Preliminary, unpublished analyses also point to Nuevo Laredo, Laredo's sister city, as a hotspot for drug problems. This suggests that the local environment may play a critical role in alcohol and drug outcomes at the border—and perhaps among Latinos generally. A deeper understanding of the role of environmental factors in this apparent concentration of problems in border hotspots would help shed light on core processes in the epidemiology of substance abuse as well as possible points of intervention relevant to Latinos in the border region and more broadly. However, additional research is needed to 1) better characterize and contextualize variation across UMSARC sites in alcohol- and drug-related outcomes; 2) delineate the roles of specific environmental (and other) factors in explaining this variation; and 3) better understand pathways of influence between the US and Mexico, and how US-Mexico interactions may contribute to elevations of problems. The current project proposes to address these gaps. Aim 1 will better characterize the distribution of alcohol use and problems, drug use and problems, and substance use treatment utilization across study sites and relative to regional and national estimates. Aims 2 and 3 will involve geocoding the data to test roles for key neighborhood variables in explaining geographic variation in alcohol- and drug- related outcomes. Aim 4 will directly explore potential pathways of influence between Mexico and the US using existing and geocoded variables. Analyses will leverage a uniquely rich and well-powered dataset to extend the very limited knowledge base on alcohol and drug use and problems at the border, as well as improve understanding of environmental influences on these outcomes among Latino populations.

摘要：热点：了解美国的酒精和毒品问题领域 墨西哥边境 数以百万计的墨西哥裔美国人生活在美墨边境地区，该地区是一个极其弱势的地区 区和向内陆迁移的中转区。因此，墨西哥人的健康和物质使用模式 原籍边境居民是人们最关心的问题。尽管如此，尽管初步证据表明药物浓度较高 边境地区的贩运、毒品供应和药物使用问题，但人们对酒精知之甚少 以及该领域的毒品问题。我们的团队最近发起了一项大型流行病学研究，美国-墨西哥 酒精和相关病症研究，或 UMSARC（R01AA018365；PI 的 Cherpitel 和 Borges），以解决 这个差距。除了是仅有的两项针对边境问题的大规模流行病学研究之一之外 UMSARC 是唯一已知的对美国和墨西哥居民进行调查的此类研究。数据 代表对墨西哥人和墨西哥裔个人的概率样本进行的 4,796 次面对面访谈 2011-2013年间接受采访。基于 UMSARC 数据的新论文表明， 酒精和毒品问题，但在美国边境的药物使用治疗利用率大幅降低， 与室内相比。然而，初步证据也表明，即使在不同群体之间也存在巨大的、无法解释的差异。 边境地区，酒精和毒品问题集中在美国的一个热点地区：德克萨斯州拉雷多。 初步未发表的分析还指出，拉雷多的姐妹城市新拉雷多是毒品的热点地区。 问题。这表明当地环境可能在酒精和药物结果中发挥关键作用 边境——或许还有整个拉丁裔。更深入地了解环境的作用 问题明显集中在边境热点地区的因素将有助于揭示核心进程 药物滥用流行病学以及与拉丁裔相关的可能干预点 边境地区以及更广泛的地区。然而，还需要进行额外的研究来 1）更好地表征和 将 UMSARC 站点之间酒精和毒品相关结果的差异纳入背景； 2) 界定角色 解释这种变化的具体环境（和其他）因素； 3）更好地理解途径 美国和墨西哥之间的影响，以及美国和墨西哥的互动如何可能导致 问题。当前的项目建议解决这些差距。目标 1 将更好地表征分布 整个研究中的酒精使用和问题、药物使用和问题以及物质使用治疗利用情况 地点以及相对于区域和国家的估计。目标 2 和 3 将涉及对数据进行地理编码以测试角色 用于解释酒精和毒品相关结果的地理差异的关键社区变量。目的 4 将使用现有的和地理编码直接探索墨西哥和美国之间的潜在影响途径 变量。分析将利用独特的丰富且功能强大的数据集来扩展非常有限的 关于酒精和毒品使用以及边境问题的知识库，并提高对 环境对拉丁裔人群中这些结果的影响。