Comparing the Effectiveness of City Policy and Structure in Health Disparities

比较城市政策和结构在健康差异方面的有效性

• 批准号: 7937085
• 负责人: RICHARD ALLEN SCRIBNER
• 金额: $ 33.17万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7937085
• 关键词: AODR mortality; Address; Adopted; Alcohol abuse; Alcohols; Area; Censuses; Cities; Data; Databases; Fees; Goals; Growth; Health; Injury; Intervention; Licensing; Literature; Longitudinal Studies; Louisiana; Measures; Minority; Modeling; Neighborhoods; Outcome; Policies; Population; Public Health; Risk; Series; Social Problems; Source; Structure; Violence; comparative effectiveness; compare effectiveness; density of AOD outlets; design; effectiveness research; health disparity; health inequalities; mortality; public policy on alcohol; social; social health determinants; social inequality; trend

DESCRIPTION (provided by applicant): This application addresses the broad Challenge Area (05) Comparative Effectiveness Research. Within this Challenge Area the specific Challenge Topic is 05-MD-101: Social Determinants of Health. This study's goal is to compare the effectiveness of a city level policy in New Orleans to control problem alcohol outlets that contribute to health inequalities among poor and minority populations. In 1997 the City of New Orleans adopted a series of policies that in effect represent a societal intervention to address the social determinants of health disparities in poor and minority neighborhoods, where problem alcohol outlet proliferation is a major problem. The policies were specifically enacted to address the proliferation of problem alcohol outlets believed to be the source of a variety of social problems including assaultive violence as well as adverse health effects. To accomplish this goal a longitudinal study of the effect of changes in alcohol outlet exposure on assaultive violence as well as alcohol related mortality is proposed. The study will span ten years (i.e., 1994 through 2004). It will be organized at the census tract level, the unit of analysis most strongly associated with structural effects associated with alcohol outlet exposure. The study will be conducted in two Louisiana cities: New Orleans and Baton Rouge. Since the policies were enacted in New Orleans, census tracts there will serve as "intervention" tracts while census tracts in Baton Rouge serve as the "control" tracts. Study Hypothesis 1: Among census tracts in New Orleans the trend in assaultive violence and alcohol-related mortality outcomes over the study period will demonstrate a significantly more negative slope than occurs among census tracts in Baton Rouge. Study Hypothesis 2: Decreases in alcohol outlet density at the census tract level will explain a significant amount of the trend in assaultive violence and alcohol-related mortality over the study period. Demonstrating that policy change at the city level designed to remedy a social inequality will result in a corresponding reduction is health disparities would represent a major contribution to the public health literature. The proposed project is designed to do just that. Compare the effectiveness of an alcohol control policy on rates of assaultive violence and alcohol related mortality across neighborhoods in two cities, one where the policy was enacted and one where it was not.

描述（由申请人提供）：本申请涉及广泛的挑战领域（05）比较有效性研究。在此挑战领域中，具体的挑战主题是05-MD-101：健康的社会决定因素。这项研究的目的是比较新奥尔良市一级政策的有效性，以控制问题酒精出口，导致穷人和少数民族人口之间的健康不平等。1997年，新奥尔良市采取了一系列政策，实际上是一种社会干预措施，以解决贫困和少数民族社区健康差异的社会决定因素，在这些社区，问题酒精出口扩散是一个主要问题。这些政策是专门为解决问题酒类销售点的扩散而制定的，这些销售点被认为是各种社会问题的根源，包括攻击性暴力以及对健康的不利影响。为了实现这一目标的纵向研究的影响，酒精出口暴露的攻击性暴力以及酒精相关的死亡率。该研究将持续十年（即，1994年至2004年）。它将在人口普查区一级组织，这是与酒精出口接触相关的结构性影响最密切相关的分析单位。这项研究将在路易斯安那州的两个城市进行：新奥尔良和巴吞鲁日。由于这些政策是在新奥尔良颁布的，那里的人口普查区将作为“干预”区，而巴吞鲁日的人口普查区则作为“控制”区。研究假设1：在新奥尔良的人口普查区中，研究期间攻击性暴力和与酒精有关的死亡率结果的趋势将显示出比巴吞鲁日人口普查区更明显的负斜率。研究假设2：在人口普查区一级，酒精出口密度的下降将解释研究期间攻击性暴力和酒精相关死亡率趋势的显著原因。证明旨在纠正社会不平等的城市一级的政策变化将导致相应的减少健康差距将是对公共卫生文献的重大贡献。拟议中的项目正是为了做到这一点。比较酒精控制政策对两个城市社区的攻击性暴力和酒精相关死亡率的有效性，一个是制定政策的地方，另一个是没有制定政策的地方。