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人问题饮酒的环境相关性。由于人类受试者的限制限制了地理标识符的释放和使用，使用个体水平的人口数据很难确定酒精结果与社区环境之间的关系。如果位置代码在更大的数据集中是可用的，它们可能像州或大都市区标识符一样粗糙。所提出的分析工具和数据在该领域也是新的。我们的目标与现有酒精流行病学数据集二次分析（PA-06-557）的目标在两个方面是一致的：(a)分析以前收集的数据，以推进与酒精有关的流行病学的科学知识；(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）的个人层面数据与受访者的环境数据相结合。我们将从比人口普查区小的地区开始，得出每个受访者在不同地理单位的环境特征。2. 研究邻里特征与a)未成年人饮酒和b)成人问题饮酒的关系。我们特别感兴趣的是估计什么大小的地理单位最能预测酒精滥用。3. 记录不同社会人口统计学群体中可能影响酒精后果并与之相互作用的环境特征差异。4. 检查环境保护因素如集体效能和学校环境在多大程度上缓和了饮酒问题。

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?