Impact of supportive policies on minority stress, drinking and health among women

 描述(由申请人提供)：这项竞争性更新将建立在PI为期15年的前瞻性研究芝加哥妇女的健康和生活经历(CHLEW)(K01 AA00266和R01 AA013328-09)的基础上，该研究侧重于了解少数性取向与危险饮酒(HD)之间的联系机制。HD是一个可操作的指数，包括大量饮酒、醉酒、不良饮酒后果和潜在的酒精依赖症状。CHLEW研究的前一阶段(W3)的参与者是来自3波纵向样本的354名性少数女性(SMW：女同性恋者，双性恋者)和373名新参与者，其中包括更年轻的(18-25岁)，以及额外的黑人、拉丁裔和双性恋者SMW(总N=727)。该研究收集了大量/有害饮酒和与酒精相关问题的个人和人际(微观)风险和保护因素的丰富数据，迄今已发表45篇期刊论文或书籍章节(已发表、正在出版或正在审查中)和6篇完整的博士论文。在少数群体压力理论的基础上，我们建议通过研究社会背景(结构水平)风险和保护因素来扩展我们以前的工作，从而在SMW中产生HD和饮酒相关的健康后果。具体地说，我们将利用两个历史性的机会：1)进行自然实验，以评估2014年6月1日伊利诺伊州婚姻公平法案对SMW饮酒和健康的影响；以及2)利用独特的纵向数据集-将包括SMW跨越近20年的饮酒数据-来检查长期饮酒轨迹与SMW健康的关联。我们预计，这一支持性的政策变化将对所有法定最低工资妇女产生有利影响，而选择结婚的法定最低工资妇女将证明在一般人口中观察到的婚姻对健康的许多益处。因此，我们计划使用3波现有数据(2000-01、2004-05、2010-12)和2个拟议的新波(2016-17、2017-18)来(1)检验法律承认同性婚姻对饮酒结果(饮酒量和HD)的总体影响以及SMW之间这种变化的潜在调节因素；(2)检验法律承认同性婚姻与饮酒结果之间关系的潜在调节因素；(3)比较与同性伴侣结婚的SMW和其他同性关系(民事结合、同居、承诺/不住在一起)的SMW的饮酒结果；以及(4)确定长期饮酒和HD与SMW身心健康之间的联系，以及这些联系的调节因素。CHLEW是美国或其他地方关于SMW饮酒与健康的持续时间最长、最全面的研究。它的大量亚样本包括25岁以下和50岁以上的女性，以及黑人、拉丁裔和双性恋女性，这增加了它的价值，因为它提供了一个难得的机会来检查婚姻承认与饮酒之间以及饮酒与健康之间的关系中的年龄、种族/族裔和性别认同差异。

 DESCRIPTION (provided by applicant): This competitive renewal will build on the PI's 15-year prospective study, the Chicago Health and Life Experiences of Women (CHLEW) (K01 AA00266 & R01 AA013328-09), that focuses on understanding the mechanisms linking minority sexual orientation and hazardous drinking (HD). HD is operationalized as an index that includes heavy episodic drinking, intoxication, adverse drinking consequences and symptoms of potential alcohol dependence. Participants in the previous phase (W3) of the CHLEW study were 354 sexual minority women (SMW: lesbian, bisexual) from the 3-wave longitudinal sample (79% retention at 10-year follow-up) and 373 new participants including younger (age 18-25), and additional Black, Latina, and bisexual SMW (total N=727). The study has collected rich data on individual and interpersonal (micro-level) risk and protective factors for heavy/hazardous alcohol use and alcohol-related problems and has to date produced 45 journal articles or book chapters (published, in press, or under review) and 6 completed doctoral dissertations. Building on minority stress theory we propose to expand on our previous work by examining social- contextual (structural-level) risk and protective factors for HD and drinking-related health consequences among SMW. Specifically, we will capitalize on 2 historic opportunities to: 1) conduct a natural experiment to evaluate the impact of the June 1, 2014 Illinois Marriage Fairness Act on SMW's drinking and health; and 2) take advantage of a unique longitudinal dataset-that will include data on SMW's drinking spanning nearly 20 years-to examine the associations of long-term drinking trajectories with SMW's health. We expect that this supportive policy change will have beneficial effects for all SMW and that SMW who choose to marry will demonstrate many of the health benefits of marriage observed among women in the general population. Thus, we plan to use 3 waves of existing data (2000-01, 2004-05, 2010-12) and 2 proposed new waves (2016-17, 2017-18) to (1) examine the overall effect of legal recognition of same-sex marriage on drinking outcomes (volume of alcohol consumption and HD) and potential mediators of such changes among SMW; (2) examine potential moderators of the relationship between legal recognition of same-sex marriage and drinking outcomes; (3) compare drinking outcomes among SMW who marry their same-sex partner and those of SMW in other same-sex relationships (civil unions, cohabiting, committed/not living together); and (4) identify associations between long-term trajectories of alcohol consumption and HD and SMW's physical and mental health, as well as moderators of these associations. The CHLEW is the longest running and most comprehensive study of SMW's drinking and health in the U.S. or elsewhere. Its large subsamples of women fewer than 25 and over 50, and of Black, Latina, and bisexual women, add to its value by providing a rare opportunity to examine age, race/ethnicity and sexual identity differences in the relationships between marriage recognition and drinking, and between drinking and health.