Health Disparities in Alcohol Use and Other Risk Behaviors after the Onset of Cancers and Cardiovascular Disease-Related Conditions

摘要：癌症发病后饮酒和其他危险行为的健康差异 和心血管疾病相关的情况 癌症和癌症发作后饮酒和其他危险行为的健康差异 心血管疾病相关疾病是2016-2020年健康差距项目的延续 关注酒精在健康结果中的作用。我们将注意力转移到饮酒和其他健康模式上 被诊断为有糖尿病、高血压、 心脏/冠状动脉问题、癌症以及这些疾病中的多发病。如上所述 这些情况下大量饮酒有增加发病率和死亡率的风险，这很可能是 当与其他健康危险行为(如肥胖、缺乏运动和吸烟)相结合时，进一步升高 和其他药物使用)，迫切需要多方面的干预措施来解决这些问题。然而，很少有研究 针对特定健康状况进行诊断或治疗后的健康行为调查主要集中在 酗酒或危险饮酒与其他危险行为的聚集性。此外，几乎没有记录在案 关于人群关于酒精在疾病风险中的作用的知识，这也可能影响关于 喝酒。为了增加改善干预措施的知识库，拟议的研究将涉及三个问题 明确的目标。首先，分析诊断为癌症、高血压、糖尿病、 使用2015、2020和2024年NAS将评估心脏问题和酒精导致的健康损害 病情开始对饮酒模式的影响以及持续危险饮酒的相关因素。第二, 检查当前饮酒模式、其他生活方式风险因素(体力活动和 超重/肥胖)和物质使用(烟草、大麻和非法药物)- 陈述的条件和其中的多个发病率将识别这些行为之间的聚集 注意不同性别、年龄、种族/族裔和社会经济地位界定的群体的差异。这些 分析将利用2010-2020年NAS和2015-2020年全国药物使用和健康调查。第三, 关于酒精在癌症和其他健康状况中的作用的知识预测因子的评估 以及这些方面的差异，利用2020年的NAS和国家癌症研究所的2017年健康信息 全国趋势调查，将确定与准确的酒精知识相关的群体和特征 作为每种情况的风险因素，以及与准确知识相关的信息来源。每个目标 将评估种族/族裔和社会经济地位差异以及与性别和年龄有关的差异。 高级流行病学模型，包括广义估计方程模型、倾向评分 将酌情利用加权和潜在分类分析。 。

ABSTRACT: Health Disparities in Alcohol Use and Other Risk Behaviors after the Onset of Cancers and Cardiovascular Disease-Related Condition The proposed Health Disparities in Alcohol Use and Other Risk Behaviors after the Onset of Cancers and Cardiovascular Disease-Related Condition is a continuation of the 2016-2020 Health Disparities Project focusing on alcohol's role in health outcomes. We shift our attention to patterns of drinking and other health risk behaviors among individuals with diagnosed health conditions focusing on diabetes, hypertension, heart/coronary problem, and cancer as well as multimorbidity among these conditions. As continued heavy drinking with these conditions carries risks for increased morbidity and mortality, which are likely to be further elevated when combined with other health risk behaviors (such as obesity, physical inactivity and tobacco and other drug use), there is a critical need for multifaceted interventions to address these. However, few studies investigating health behaviors following diagnosis or treatment for specific health conditions have focused on alcohol use or the clustering of risky drinking with other risk behaviors. Furthermore, little has been documented regarding population knowledge of alcohol's role in disease risk, which may also influence decisions about drinking. To increase the knowledge base for improved interventions, the proposed research will address three specific aims. First, analyses of drinking patterns after diagnosis of cancers, hypertension, diabetes, heart problems, and alcohol-attributed health harms using the 2015, 2020 and 2024 NAS will evaluate the impacts of condition onset on drinking patterns and the correlates of continued risky drinking. Second, examination of current drinking patterns, other lifestyle risk factors (physical activity and overweight/obesity), and substance use (tobacco, marijuana, and illicit drugs) in individuals with above- stated conditions and multi-morbidity among them will identify the clustering among these behaviors with attention to differences across gender, age, race/ethnicity and socioeconomic status defined groups. These analyses will utilize the 2010-2020 NAS and 2015-2020 National Surveys on Drug Use and Health. Third, evaluation of the predictors of knowledge regarding alcohol's role in cancers and other health conditions and disparities in these, utilizing the 2020 NAS and the National Cancer Institute's 2017 Health Information National Trends Survey, will identify groups and characteristics associated with accurate knowledge of alcohol as a risk factor for each condition and the sources of information associated with accurate knowledge. Each Aim will evaluate racial/ethnic and socioeconomic status disparities as well as gender and age-related differences. Advanced epidemiologic models including generalized estimating equation modeling, propensity score weighting, and latent class analysis will be utilized as appropriate. .