Understanding Racial Disparities in Heavy Drinking over the Life Course

了解一生中酗酒的种族差异

基本信息

批准号：
9000089
负责人：
NINA MULIA
金额：
$ 34.76万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-02-15 至 2018-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9000089
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 Research Risk Risk Factors Sampling Schools Scoring Method 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 ethnic difference ethnic minority population experience follow-up gender difference generation difference improved interest men middle age mortality multidisciplinary population health prospective racial and ethnic racial and ethnic disparities racial difference racial disparity social social health determinants socioeconomics young adult

项目摘要

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（由申请人提供）：大量饮酒是美国人可预防死亡的第三大主要原因，并且与酒精有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。尽管在美国，种族/少数民族承担着与酒精有关的问题的负担，但尚不清楚这是否反映了更有害的长期饮酒模式。尽管一些研究表明，少数族裔的饮酒“职业”较长，但这些研究基于短期随访数据，回顾性数据和特定年龄的患病率数据。严格的前瞻性队列研究很少研究重度饮酒轨迹中的种族/种族差异，而这些研究表明，在20年代中期20年代，这些研究的年龄通常结束了，这些研究表明了种族差异的矛盾发现。但是，有重要的理论和经验原因可以期望种族/族裔群体从成年早期转变为中年时的饮酒方式有所不同。我们的核心假设是，种族/族裔少数群体在生活过程中更大的劣势积累将有助于长时间的大量饮酒，这可能有助于解释中期中少数群体中更多的经常性和持续性酒精问题的发现。为了回应PA-11-308“现有酒精流行病学数据的次要分析”，我们建议在第一次，深入的，深入的，前瞻性分析中对从青春期到中年的重度饮酒轨迹中的种族/族裔差异进行的，在全国范围内的美国样本中（全国性的年轻人纵向探测）。我们的具体目的是：1）描述从青少年晚期到中年的重型饮酒轨迹中的种族/种族差异，以及它们与持续的酒精问题的联系； 2）确定重度饮酒轨迹的会员资格和探索者的培训者的预测因素； 3）评估生命力的社会经济因素在多大程度上解释了长期繁重的饮酒和酒精问题的种族差异，以及导致这些差异的机制（差异暴露和差异后果）。我们的研究借鉴了社会决定因素的观点，因此与发展心理病理学的主要方法不同。我们注意最近的联邦呼吁要解决健康不平等的众多努力，我们特别注意与教育有关的差异（父母和个人教育成就，教育质量和教育回报）可能会导致长期繁重饮酒和问题的种族歧视。我们高度的多学科团队将利用增长混合模型，结构方程模型以及倾向评分，并利用1979年和1997年NLSY的数据来检查性别和西班牙裔亚组的同伙效应和差异。这项研究将确定一系列深远和临时政策目标，以解决生命性大量饮酒中种族差异，这可以很好地干预教育，社会福利和劳动力部门。