Race, Socioeconomic Status, and Trajectories of Substance Use Disorders

描述（由申请人提供）：研究表明，不同种族/民族和社会经济地位（SES）的物质使用障碍风险存在一致且广泛的差异。到目前为止，少数群体的样本不足，无法详细调查亚组在疾病发生、进展和维持方面的差异。酒精和相关疾病的全国流行病学调查（NESARC），其大样本量和少数民族的样本，提供了一个独特的机会，以检查在物质使用障碍的轨迹不太了解亚组的差异。该提案的目的是通过使用NESARC的数据来描述物质使用障碍轨迹中的社会经济和种族/民族分布，并分别对男性和女性进行描述，从而推进物质使用障碍的社会流行病学。我们还建议评估精神疾病和家庭物质问题的贡献，物质障碍的轨迹社会不平等。这一应用符合国家药物滥用问题研究所关于减少健康差距的战略计划重点领域1的方案目标，该计划要求开展更多的研究，以“改进关于所有种族/族裔人口药物滥用和吸毒成瘾模式的知识库”，并符合关于妇女、性别和药物滥用以及药物滥用流行病学的方案倡议。《2010年健康人》的两个目标之一是消除人口各阶层之间的健康差距，“包括因性别、种族或族裔、教育或收入而产生的差异。“描述性的、以人口为基础的研究可以提供关于在疾病的自然史中出现健康差异的有效信息，这是朝着有意义地减少差异迈出的关键的第一步。本申请的主要目的是使用国家酒精及相关疾病流行病学调查（NESARC）的数据，调查物质使用障碍的发生、进展和维持方面的社会经济和种族/民族差异。

DESCRIPTION (provided by applicant): Research has demonstrated consistent and wide variation in risk for substance use disorder by race/ethnicity, and socioeconomic status (SES). Until now insufficient samples of minority groups have made detailed investigations of subgroup differences in the initiation, progression, and maintenance of disorders impossible. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), with its large sample size and over sample of minorities, offers a unique opportunity to examine poorly understood subgroup differences in substance use disorder trajectories. The objective of this proposal is to advance the social epidemiology of substance use disorders by using data from the NESARC to describe the socioeconomic and racial/ethnic distribution in trajectories of substance use disorders, and to do so separately for males and females. We further propose to evaluate the contributions of psychiatric disorders and familial substance problems to social inequalities in substance disorder trajectories. This application is responsive to the programmatic objectives of focus area #1 of the National Institute on Drug Abuse Strategic Plan on Reducing Health Disparities, which called for additional research to "improve the knowledge base on the patterns of drug abuse and addiction in all racial/ethnic populations," and to programmatic initiative on women, gender, and drug abuse, and the epidemiology of drug abuse. 1 of the 2 goals of Healthy People 2010 is to eliminate health disparities among segments of the population, "including differences that occur by gender, race or ethnicity, and education or income." Descriptive, population-based research that can provide valid information on the emergence of health disparities throughout the natural history of disorders represents a critical first step towards achieving meaningful reductions in disparities. The primary objective of this application is to use data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to investigate socioeconomic and racial/ethnic differences in the initiation, progression, and maintenance of substance use disorders.