Neighborhood Effects on Drug Use Among African American Adults

描述（由申请人提供）：邻里的结构特征，物理基础设施和社会进程越来越多地被认为是健康的显着决定因素。虽然健康状况在很大程度上取决于个人行为，但人们居住的地方可能会影响个人行为之外的健康结果。具体来说，我们建议调查邻里环境在多大程度上损害或促进其居民的健康。这项拟议中的研究重点是格鲁吉亚亚特兰大的非裔美国成年人，同时比较使用者和非使用者、男性和女性、年轻人和老年人。毒品使用的定义是使用可卡因、海洛因和/或甲基苯丙胺。拟议的研究目标是：（1）社区背景、个体特征和社区感知与吸毒的关系：（2）在吸毒人群中，社区背景、个体特征（包括情境性吸毒相关属性）和社区感知与吸毒频率的关系;以及（3）识别空间模式并调查与这些空间模式相关的邻域特征和个体水平特征。指导概念模型建立在邻里社会和生态组织理论，特别是社会解体理论。该项目包括四个不同的数据源，即1,600个个人访谈，2000年美国人口普查的数据，第1部分犯罪数据和亚特兰大警察局的毒品逮捕数据，这些数据将结合到对社区结构特征的评估中，并对社区的物理基础设施和社会进程进行系统观察。人口普查街区组将被用作社区的代理。研究区域将涵盖100个人口普查区块组，我们的试点数据显示，这些区块组根据关键结构特征而有所不同。我们的分析方法将结合联合收割机分层线性模型（HLM）和空间“热点”分析，以探讨关键的假设。拟议的研究之所以意义重大，是因为其重点是非洲裔美国人，这一人口被证明受到非法药物使用及其社会和健康后果，包括艾滋病毒/艾滋病的不成比例的影响。它的意义是通过应用一个多层次的，分层的方法，扩大了对药物使用的个人层面的因素的影响，邻里的影响的重点。此外，该研究具有理论和研究意义，因为其研究结果将为政策制定者、城市设计者、社会和卫生服务提供者以及更广泛的研究界提供有用的信息。最重要的是，这些发现有可能为未来针对非法药物使用及其社会和健康后果的多层次干预做出重大贡献，这些干预受到个人和社区背景因素的影响。公共卫生相关性：本研究旨在调查非裔美国成年人在个人层面上对药物使用的邻里影响。尽管对影响药物使用的个人层面特征有重要的见解，但我们对背景因素及其影响的了解有限。这项研究的结果可能对许多其他健康挑战产生影响，包括性传播感染，包括艾滋病毒/艾滋病，肥胖，癌症和心血管疾病。

DESCRIPTION (provided by applicant): The structural characteristics, physical infrastructure, and social processes of a neighborhood increasingly are recognized as salient determinants of health. Although health conditions largely depend on individual behaviors, the place where people live may impact health outcomes over and beyond individual actions. Specifically we propose to investigate the extent to which the neighborhood context harms or promotes the health of its residents. The proposed study focuses on African American adults in Atlanta, Georgia, while comparing users and non-users, men and women, and younger and older persons. Drug use is defined as the use of cocaine, heroin and/or methamphetamine. The proposed study aims are: (1) to investigate the association between neighborhood context, individual characteristics and neighborhood perceptions with drug use; (2) among drug users, to examine the association between neighborhood context, individual characteristics, including situational use-related attributes, and neighborhood perceptions with the frequency of drug use; and (3) to identify the spatial patterns and to investigate neighborhood characteristics and individual-level characteristics associated with these spatial patterns. The guiding conceptual model builds on theories of neighborhood social and ecological organization, specifically social disorganization theory. This project comprises four distinct data sources, namely 1,600 individual interviews, data from the 2000 U.S. Census, Part 1 crime data and drug arrest data from the Atlanta Police Department which will be combined into an assessment of neighborhood structural characteristics, and systematic observations of neighborhood physical infrastructure and social processes. Census block groups will be used as proxy for neighborhoods. The study area will cover 100 census block groups and our pilot data show these to vary according to key structural characteristics. Our analytical approach will combine hierarchical linear modeling (HLM) and spatial "hot spot" analyses to explore the key hypotheses. The proposed study is significant because of its focus on African Americans, a population that is shown to be disproportionately impacted by illicit drug use and its social and health consequences, including HIV/AIDS. Its significance is enhanced by applying a multilevel, hierarchical approach that expands the focus from individual-level factors on drug use to the impact of neighborhood influences. In addition, the study has theoretical and research significance as its findings will provide useful information for policy-makers, urban designers, social and health service providers and the wider research community. Most importantly, the findings have the potential to make major contributions to future multi-level interventions targeting illicit drug use and its social and health consequences that are impacted by a mix of individual-level and neighborhood contextual factors. PUBLIC HEALTH RELEVANCE: This study proposes to investigate the neighborhood effects on drug use among African American adults over and beyond those at the individual level. Despite significant insights about individual-level characteristics found to influence drug use, our knowledge regarding contextual factors and their impact is limited. The findings from the study can have implications for many other health challenges including sexually transmitted infections, including HIV/AIDS, obesity, cancer, and cardiovascular disease.