Drinking Patterns & Ethnicity: Impact on Mortality Risks

描述（由研究者提供）：此修订后的应用程序响应PA-05-088，对现有数据进行二次分析，以增强对饮酒模式和酒精相关问题（此处为死亡率）流行病学的理解。PA的目标将通过解决美国人群和白色、黑人和西班牙裔两种性别亚群中的风险和保护因素（帮助阐明酒精相关死亡率的差异）、饮酒史对死亡率的影响以及模式测量和分析中的方法学问题（包括倾向评分策略）来实现。最近的酒精死亡率研究，包括成功的R 01（AA 10960，T.K.格林菲尔德，主要研究者）发现了饮酒模式作用的初步证据，即，低至中等量饮酒者的大量饮酒，有全因死亡的风险。早期的分析受到缺乏功效、测量不充分或两者兼而有之的限制。该应用程序使用了两波全国酒精调查（NAS），对饮酒模式、终生大量饮酒和酒精相关问题进行了异常彻底的测量。它将把1984年NAS的国家死亡指数（NDI）随访从11年延长到21年（如果可能的话，22年）（n = 5，221，应答率为74%），增加了1995年NAS的新的11年或12年随访（n = 4，950，应答率= 79%）。这两项调查（18岁及以上）都是由坦普尔大学ISR面对面进行的，使用了大量黑人和西班牙裔过度样本的概率抽样，并评估了许多相关的相同项目和量表。饮酒模式的措施包括12个月的数量/频率的啤酒，葡萄酒，白酒和整体饮酒，大多数饮料/天，以前的饮酒和最大数量，以往5+每周，发病年龄等吸烟，药物使用，抑郁/士气低落，和许多其他风险因素进行评估。通用设计允许合并NAS，预期死亡人数超过三倍（与早期R 01的532例死亡相比，超过1，800例），产生比迄今为止更大的功效来检验关于全因缺血性心脏病（IHD）和癌症死亡率的假设，并对损伤和肝硬化死亡率进行探索性分析。分析将按性别分类，并在可能的情况下按性别和族裔/种族群体分类。将对酒精消费和种族之间的相互作用进行建模;将在一系列计划分析中添加理论上重要的协变量及其与酒精测量的相互作用，例如，CES-D抑郁症、社会孤立和其他风险因素，如酗酒和酒精问题史、因健康问题戒烟、酒精治疗、药物使用和其他变量。研究结果将为公共卫生战略，酒精政策的制定提供信息，并有助于解开模式对死亡率的影响。

DESCRIPTION (provided by investigator): This revised application responds to PA-05-088 for secondary analysis of existing data to enhance understanding of drinking patterns and the epidemiology of alcohol-related problems-here, mortality. The PA's objectives will be met by aims addressing risk and protective factors in the US population and in white, black and Hispanic subpopulations of both genders (helping elucidate disparities in alcohol-related mortality), impact of drinking history on mortality, and methodological issues in pattern measurement and analysis including propensity score strategies. Recent alcohol mortality studies, including a successful R01 (AA10960, T.K. Greenfield, Principal Investigator), have found preliminary evidence of the role of drinking pattern, i.e., heavy drinking among low to mid-volume drinkers, in risk of all-cause mortality. Earlier analyses have been limited by lack of power, inadequate measurement, or both. This application uses two waves of the National Alcohol Survey (NAS) with unusually thorough measurement of drinking pattern, lifetime heavy drinking, and alcohol-related problems. It will extend from 11 to 21 (or if possible 22) years the National Death Index (NDI) follow up of the 1984 NAS (n = 5,221, response rate of 74 percent) adding a new 11- or 12-year follow up of the 1995 NAS (n = 4,950, response rate = 79 percent). Both surveys (ages 18 and older) were conducted face-to-face by Temple University ISR, used probability sampling with large black and Hispanic over-samples, and assessed many relevant identical items and scales. Drinking pattern measures include 12-month quantity/frequency of beer, wine, liquor and overall drinking, most drinks/day, former drinking and largest quantity, ever 5+ weekly, age of onset, etc. Smoking, drug use, depression/ demoralization, and many other risk factors are assessed. The common design permits pooling NASs, more than tripling number of expected deaths (to over 1,800 compared to the earlier R01's 532 deaths), yielding considerably greater power than heretofore for testing hypotheses about all-cause, ischemic heart disease (IHD) and cancer mortality, with exploratory analyses on injury and liver cirrhosis mortality. Analyses will disaggregate by gender and, where possible, by this and ethnic/racial group. Interactions between alcohol consumption and ethnicity will be modeled; theoretically important covariates and their interactions with alcohol measures will be added in a series of planned analyses, e.g., CES-D depression, social isolation, and other risk factors such as history of heavy drinking and alcohol problems, quitting because of health problems, alcohol treatment, drug use, and other variables. Results will inform public health strategies, alcohol policy development, and help disentangle pattern effects on mortality.