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

 描述（由申请人提供）：这一竞争性的续期申请将建立在PI的15年前瞻性研究，芝加哥妇女健康和生活经验（CHLEW）（K 01 AA 00266和R 01 AA 013328 -09），重点是了解少数性取向和危险饮酒（HD）的机制。HD作为一个指数，包括重度间歇性饮酒，中毒，不良饮酒后果和潜在的酒精依赖症状。CHLEW研究前一阶段（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，双性恋）（10年随访时保留率为79%）和373名新参与者，包括年轻人（18-25岁）和其他黑人，拉丁裔和双性恋SMW（总N=727）。该研究收集了大量/危险饮酒和酒精相关问题的个人和人际（微观层面）风险和保护因素的丰富数据，迄今已发表了50多篇期刊文章和书籍章节以及6篇已完成的博士论文。 基于少数人压力理论，我们建议通过研究法定最低工资中HD和饮酒相关健康后果的社会背景（结构水平）风险和保护因素来扩展我们以前的工作。具体而言，我们将利用两个历史性机遇：1）进行自然实验， 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; 2）利用独特的纵向调查表--其中包括SMW近20年的饮酒数据--研究长期饮酒轨迹与SMW健康的关联。我们预期这项支援性的政策改变会对所有法定最低工资产生有利的影响，而选择结婚的法定最低工资人士亦会像一般女性一样，在健康方面获得不少裨益。因此，我们计划使用3波现有数据（2000-01、2004-05、2010-12）及两次建议的新浪潮（2016-17，2017-18）以（1）检查法律的承认同性婚姻对饮酒结果的总体影响（2）研究同性婚姻的法律的承认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法定最低工资与其他同性关系（民事结合、同居、承诺/不同居）中的法定最低工资的饮酒结果;及（4）找出长期饮酒轨迹与HD和法定最低工资的身心健康之间的关系，以及这些关系的调节因素。 CHLEW是美国或其他地方对SMW饮酒和健康进行的时间最长、最全面的研究。它对25岁以下和50岁以上的妇女以及黑人、拉丁裔和双性恋妇女进行了大量的子样本，通过提供一个难得的机会来研究婚姻认可与饮酒之间以及饮酒与健康之间关系中的年龄、种族/民族和性别认同差异，增加了它的价值。

 DESCRIPTION (provided by applicant): This competing renewal application will build on the PI's 15-year prospective study, the Chicago Health and Life Experiences of Women (CHLEW) (K01 AA00266 & R01 AA013328-09), which 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 more than 50 journal articles and book chapters 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 US or elsewhere. Its large subsamples of women under 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.