Disparities in Alcohol-related Risks for Injury, Diabetes and Cardiovascular Morbidity and Mortality: William C. Kerr, Component Director
This new project looks at health disparities in major alcohol-related injuries and chronic conditions. Analysis of alcohol’s role in risks for these health issues among disparate populations will help our understanding of how to reduce alcohol-related disparities through policy, prevention efforts and treatment. Data from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Alcohol Surveys (NAS) will be used to assess major causes of illness, injury, disability and death in areas of the US where significant alcohol-related racial/ethnic and socioeconomic disparities occur.
For people under the age of 40, unintentional injuries often result in high mortality rates across all racial/ethnic groups while hypertension and diabetes are more prevalent for people over 40 years old with significant racial/ethnic and socioeconomic disparities. Mortality analyses focuses on major acute and chronic causes and varying patterns of racial/ethnic disparities, including unintentional injuries, diabetes, cardiovascular-related areas of ischemic heart disease (IHD), and hypertension.
Results will inform efforts to reduce health disparities through targeted and general policies and interventions aimed at reducing alcohol use and problems in disadvantaged populations.
Hotspots: Understanding Areas of Concentrated Alcohol and Drug Problems at the US-Mexico Border. Sarah E. Zemore, Component Director
With millions of Mexican Americans living in the extremely disadvantaged US-Mexico border region, their health and substance use are a critical concern. Even though this area experiences high drug trafficking, drug availability and substance use problems, very little is known about alcohol and drug use among its residents. To address this knowledge gap, our team recently initiated the US-Mexico Study of Alcohol and Related Conditions, or UMSARC, which, in addition to being one of only two large-scale epidemiological studies of the border addressing alcohol, it is also the only known study to survey residents of both the US and Mexico.
UMSARC findings suggest a heightened risk for alcohol and drug problems at the US border, yet substantially lower substance use treatment utilization compared with participants living in the interior. Such variations also occur among border sites, suggesting that the local environment may play a critical role in alcohol and drug outcomes. A deeper understanding of environmental factors that may contribute to this apparent concentration of problems in border hotspots would increase our understanding of processes that lead to substance abuse and help to identify potential interventions.
This study seeks to better characterize the distribution of alcohol use and problems, drug use and problems, and substance use treatment utilization across study sites and relative to regional and national estimates. Geocoding the data enables testing of neighborhood variables that may help explain these variations in alcohol- and drug- related outcomes. The study also explores potential influential pathways between Mexico and the US using existing and geocoded variables.
Analyses will leverage a uniquely rich and well-powered dataset to extend the very limited knowledge base on alcohol and drug use and problems at the border, as well as improve understanding of environmental influences on these outcomes among Latino populations.
Differential Effects of Alcohol-related Policy Across U.S. Population Subgroups: Nina Mulia, Component Director
It is known that broad, evidence-based public health interventions do not always benefit all segments of the population. In some cases, such interventions result in unintended consequences, creating even greater health disparities. While alcohol policy interventions are a vital tool for reducing excessive drinking and alcohol problems, they have not often been used to mitigate alcohol-related disparities. To use policy interventions to address such disparities, policymakers first need to know whether and which alcohol policies have the effect of both increasing population health and health equity.
Focusing on important upstream and downstream policies that seek to transform the alcohol environment and access to treatment services, this research component aims to determine which policies are most and least effective for different populations. It also aims to estimate the reduction in disparities associated with hypothetical policy changes implemented across the U.S. The resulting information will help policymakers weigh specific policy interventions and combinations of interventions to improve population health and reduce disparities.