Neighborhood interventions in alcohol-related homicide: a systems approach

描述（由申请人提供）：黑人和西班牙裔比非西班牙裔白人（NHWs）更容易死于与酒精有关的凶杀案，尽管与NHWs相比，他们不太可能大量饮酒。很少进行流行病学研究，以确定可以做些什么来减少这种差距。我们认为，少数民族中与酒精相关的杀人事件的不成比例的风险可能与种族/少数民族在经济上处于不利地位的社区中有系统的居住隔离有关，这些社区的酒精出口密度高，卫生保健质量低。我们建议使用基于agent的模型（ABM）来模拟嵌入在社区中的agent的酒精使用，暴力犯罪和受害经历，并检查对社区酒精出口密度和医疗保健获取的干预是否可以减少酒精相关杀人的种族差异。通过允许我们模拟反事实情况，ABMs克服了在观察性社区研究中，nhw、西班牙裔和黑人进入不可比较社区的个人选择对因果推理的限制。在检查和测试这些干预措施时，我们还将纳入有关社会关系的信息，因为街头和酒吧的消费模式与酒精销售点的集中有关，可能会鼓励与表现出暴力行为的高风险饮酒者形成社会关系。具体而言，我们将研究社会关系的广度和强度是否会影响社区干预在减少种族/民族差异方面的效果

DESCRIPTION (provided by applicant): Blacks and Hispanics are more likely to die from alcohol-related homicides than non-Hispanic Whites (NHWs), despite being less likely to drink heavily compared to NHWs. Little epidemiologic research has been conducted to determine what can be done to reduce such disparities. We propose that the disproportionate risk for alcohol-related homicide among racial/ethnic minorities may be related to the systematic residential segregation of racial/ethnic minorities into economically disadvantaged neighborhoods with high alcohol outlet density and reduced quality health care access. We propose to use agent-based models (ABM) to simulate experiences of alcohol use, violent perpetration and victimization in agents embedded in neighborhoods, and to examine whether interventions on neighborhood alcohol outlet density and health care access could reduce racial disparities in alcohol-related homicide. By allowing us to simulate counterfactual situations, ABMs overcome the limitations that individual selection of NHWs, Hispanics and Blacks into non-comparable neighborhoods place on causal inference in observational neighborhood studies. In examining and testing these interventions, we will also incorporate information on social ties, as the patterns of street and bar consumption associated with concentration of alcohol outlets may encourage the formation of social ties with high-risk drinkers who also exhibit violent behavior. Specifically, we will examine whether the breadth and strength of social ties influences the efficacy of neighborhood interventions in reducing racial/ethnic disparities in alcohol-related homicides. The ABM will include agents matched to the demographic composition of New York City and arranged in a grid divided into neighborhoods, informed by more than 20 empirically-based parameters assessing a complex network of social ties, neighborhood characteristics, alcohol use and misuse, and victimization and perpetration. The present project focuses on simulating NYC neighborhoods; this project will inform the preparation of an NIH R01 proposal to use complex systems approaches to investigate national racial/ethnic disparities in different forms of alcohol-related injury.