Disparities in Alcohol Problems and Access to Care: Environmental Contributors

描述（由申请人提供）：这个关于酒精相关问题的流行病学的项目将整合来自多个来源的数据，以调查未成年人饮酒和成年人问题饮酒的环境相关性。由于人类受试者的约束限制了地理标识符的发布和使用，因此难以使用个体水平的人口数据来确定酒精结果与社区环境之间的关系。如果在较大的数据集中有位置代码，它们可能会像州或大都市区标识符一样粗糙。拟议的分析工具和数据在这一领域也是新的。我们的目标与现有酒精流行病学数据集的二次分析（PA-06-557）在两个方面的目标一致：（a）分析以前收集的数据，以推进酒精相关流行病学的科学知识和（B）应用新方法分析现有数据。我们的具体目标是：1.将2001年、2003年和2005年加州健康访谈调查（CHIS）的个人水平数据与受访者的环境数据相结合。我们将从小于人口普查区的区域开始，为各个地理单元的每个受访者得出环境特征。2.研究邻里特征与a）未成年人饮酒和B）成年人问题饮酒之间的关系。我们特别感兴趣的是，估计什么样的地理单元最能预测酒精滥用。3.记录环境特征的差异，这些差异可能影响社会人口群体的酒精结果并与之相互作用。4.检查在何种程度上上下文的保护因素，如集体效能和学校环境温和的问题饮酒。 公共卫生相关性：该项目分析了酒精研究和政策的四个重要问题：哪些环境和邻里特征预测问题饮酒？影响酒精结果的相关社区有多窄或多大？成年人和青少年有什么不同？这些环境特征是否主要使某些人口亚群处于不利地位？

DESCRIPTION (provided by applicant): This project on the epidemiology of alcohol-related problems will integrate data from multiple sources to investigate environmental correlates of underage drinking and adult problem drinking. The relationship between alcohol outcomes and neighborhood environments has been difficult to determine using individual- level population data because human subjects constraints restrict the release and use of geographic identifiers. If location codes are available at all in larger data sets, they may be as crude as a state or metropolitan area identifier. The proposed analytic tools and data are also new in this field. Our objectives coincide with the objectives of Secondary Analysis of Existing Alcohol Epidemiology Data Sets (PA-06-557) in two dimensions: (a) analyzing previously collected data to advance scientific knowledge of alcohol-related epidemiology and (b) applying new approaches to analyze existing data. Our specific aims are to: 1. Integrate individual-level data from the 2001, 2003, and 2005 waves of the California Health Interview Survey (CHIS) with data on the respondents' environment. We will derive environmental characteristics for each respondent for various geographic units, beginning with areas smaller than census tracts. 2. Study the relationship between neighborhood characteristics and a) underage drinking and b) problem drinking among adults. We are particularly interested in estimating what size geographic unit is most predictive of alcohol misuse. 3. Document disparities in environmental characteristics that may affect and interact with alcohol outcomes across sociodemographic groups. 4. Examine the extent to which contextual protective factors such as collective efficacy and school environments moderate problem drinking. Public Health Relevance: The project analyzes four important questions for alcohol research and policy: Which environmental and neighborhood characteristics predict problem drinking? How narrow or large is the relevant neighborhood that affects alcohol outcomes? How does that differ for adults versus adolescents? Do these environmental characteristics predominantly disadvantage certain population subgroups?