Hitting Close to Home: A Multi-Method Investigation of Neighborhood Characteristics and Drinking Motives on Alcohol-Related Health Disparities

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PROJECT SUMMARY/ABSTRACT Black Americans bear a disproportionately greater burden of alcohol-related health problems when compared to their White counterparts,1 representing a significant public health concern. Accordingly, eliminating health disparities and achieving health equity is one of the leading goals of the NIH Healthy People Initiative.2 Although existing research has made progress in understanding broad contributors to health inequities, existing models of substance use fail to adequately explain disparities in alcohol-related consequences among Black adults.3 One promising approach to explaining these disparities is the examination of one’s neighborhood environment and its relation to alcohol use and related consequences.4,5 Extant literature has linked specific neighborhood characteristics (e.g., alcohol outlet and liquor store density6,7 and neighborhood disadvantage5) as important contributors to alcohol use. Yet, existing research on the relationship between neighborhood context and substance use among Black adults provides conflicting evidence on which neighborhood characteristics are most important,8,9 highlighting the necessity of using novel approaches to identify salient factors within individuals’ environments that may contribute to differential alcohol-related outcomes. Moreover, more research is needed to identify mechanisms of action that associate environmental characteristics with alcohol outcomes, and drinking motives are often theorized as a potential pathway. Adults living in different neighborhoods may drink for different reasons, which may differentially influence their alcohol consumption and consequences experienced. Thus, the current proposal seeks to use both qualitative and quantitative approaches to identify neighborhood- and community-level factors that may influence alcohol outcomes among Black adults. Specific aims include (1) identifying neighborhood characteristics (e.g., neighborhood disorganization and deprivation) that serve as protective or risk factors for alcohol outcomes (i.e., alcohol consumption and alcohol-related consequences) among Black adults and (2) investigating the association between neighborhood characteristics and alcohol use outcomes and how alcohol motives may explain this relationship. Study findings will have important implications for future health disparities research and are crucial for the development of effective, mechanistically driven public health strategies, prevention and intervention efforts, and policy implications. The applicant will gain training in (1) understanding the etiology of and treatment approaches for race-related disparities for alcohol and substance use, (2) qualitative, quantitative, and analytical methodology, (3) scientific writing and research dissemination, and (4) community-engaged and interdisciplinary approaches. Ultimately, through the proposed research and training plan, the applicant will develop the skills and expertise necessary to make a substantive contribution to the field of racial health disparities, aligning with the applicant’s strong desire to become an independent clinical scientist addressing health inequities in the substance use field.