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Singichetti B, Wang YC, Golightly YM, Marshall SW, Naumann RB. Trends and disparities in alcohol-DWI license suspensions by suspension duration, North Carolina, 2007-2016. PLoS One 2024; 19:e0310270. [PMID: 39302993 DOI: 10.1371/journal.pone.0310270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 08/22/2024] [Indexed: 09/22/2024] Open
Abstract
PURPOSE To examine trends and potential disparities in North Carolina (NC) driving while impaired by alcohol (alcohol-DWI) license suspensions from 2007-2016. Specific objectives included: 1) examining personal (e.g., race/ethnicity) and contextual (e.g., residential segregation) characteristics of alcohol-DWI license suspensions by suspension duration; and 2) examining trends in annual suspension rates by race/ethnicity, sex, and duration. METHODS We linked NC administrative licensing and county-level survey data from several sources from 2007-2016. Suspensions were categorized by duration: 1 to <4 years and 4 years or longer (proxies for initial and repeat suspensions, respectively). We calculated counts, percentages, and suspensions rates (per 1,000 person-years) with 95% confidence intervals, examined trends in annual suspension rates by race/ethnicity, sex, and suspension duration. RESULTS We identified 220,471 initial and 41,526 repeat license suspensions. Rates among males were three times that of females. 21-24-year-old (rates: 6.9 per 1,000 person-years for initial; 1.5 for repeat) and Black (4.1 for initial; 1.0 for repeat) individuals had the highest suspension rates. We observed decreases in annual initial and repeat suspension rates among males, but only in repeat suspensions for females during the study period. A substantial decrease in annual initial suspension rates was observed among Hispanic individuals relative to other racial/ethnic groups, while annual repeat suspension rates exhibited large decreases for most racial/ethnic groups. The highest overall suspension rates occurred in counties with higher proportions of the population without health insurance and with the highest levels of Black/White residential segregation. CONCLUSIONS Potential disparities by race/ethnicity and sex existed by alcohol-DWI license suspension duration (i.e., initial vs. repeat suspensions) in NC. Contextual characteristics associated with suspensions, including a high degree of residential segregation, may provide indications of underlying structures and mechanisms driving potential disparities in alcohol-DWI outcomes.
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Affiliation(s)
- Bhavna Singichetti
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yudan Chen Wang
- Department of Counseling, North Carolina A&T State University, Greensboro, North Carolina, United States of America
- Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yvonne M Golightly
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Stephen W Marshall
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Rebecca B Naumann
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Butano VW, Phillips MC, Wells AB, Strand MS, McKillop IH, Baker EH, Martinie JB, Iannitti DA. Analysis of technical failure after 1,613 surgical microwave ablations: A propensity score-matched analysis. Surgery 2024; 176:775-784. [PMID: 38971698 DOI: 10.1016/j.surg.2024.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/29/2024] [Accepted: 05/19/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Microwave ablation is becoming increasingly common for the treatment of liver tumors. Despite numerous studies aimed at identifying risk factors for local recurrence after microwave ablation, a consensus on modifiable risk factors for failure remains elusive, partly because of the limited statistical power of these studies. This study investigated the incidence of technical failure after microwave ablation, encompassing both incomplete ablation and local recurrence, and aimed to identify modifiable factors that reduce technical failure. METHODS This retrospective review included patients who underwent surgical microwave ablation at a high-volume institution between October 2006 and March 2023. Univariate analysis, multivariate analysis, and propensity score matching were performed to identify risk factors for technical failure. RESULTS A total of 1,613 surgical microwave ablations were performed on 3,035 tumors, with 226 instances (14% per procedure, 7.4% per tumor) of technical failure. Incomplete ablation occurred at a rate of 1.7% per tumor, whereas local recurrence was identified in 6.5% of ablations in per-tumor analysis. Body mass index >25 was significant for failure (odds ratio, 1.50; 95% confidence interval, 1.07-2.11; P < .05), suggesting that more difficult targeting may lead to increased technical failure rates. African American race (odds ratio, 1.62; 95% confidence interval, 1.16-2.27; P < .05), pre-microwave ablation transarterial chemoembolization (odds ratio, 1.54; 95% confidence interval, 1.08-2.21; P < .05), and previous ablation (odds ratio, 1.58; 95% confidence interval, 1.09-2.29; P < .05) were found to be statistically significant. CONCLUSION On the basis of the largest microwave ablation database available to date, this study identified novel modifiable and nonmodifiable risk factors of microwave ablation failure. These results can lead to decreasing technical failure rates after microwave ablation.
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Affiliation(s)
- Vincent W Butano
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - Michael C Phillips
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - Alexandra B Wells
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - Matthew S Strand
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - Iain H McKillop
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - Erin H Baker
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - John B Martinie
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC
| | - David A Iannitti
- Division of HPB Surgery, Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, NC.
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Barro Lugo S, Flamarich Gol C, González Martínez MÁ, Sampedro Elvira Á, Saperas Pérez C, Sánchez Collado C. [Chronic communicable and non-communicable pathology and skin pathology of the migrant patient]. Aten Primaria 2024; 56:102922. [PMID: 38583414 PMCID: PMC11002854 DOI: 10.1016/j.aprim.2024.102922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 04/09/2024] Open
Abstract
The care of migrant patients includes initial screening and lifelong monitoring, highlighting the importance of preventing and tracking chronic, communicable and non-communicable diseases. The prevalence of hypertension, diabetes mellitus, dyslipidemia, and obesity varies by ethnicity, influenced by genetic factors, lifestyle, and socio-economic status. Preventive measures, health promotion, and risk factor identification are crucial. Chronic communicable diseases may manifest years after transmission, underscoring the necessity of primary care screening, especially for populations from endemic or high-risk areas. Imported skin lesions are a common reason for consultation among migrant and traveller patients. Their ethiology is varied, ranging from common conditions such as scabies, mycoses, and urticaria to tropical dermatoses like filariasis and leprosy.
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Affiliation(s)
- Silvia Barro Lugo
- Centro de Atención Primaria Larrard, Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria.
| | - Clara Flamarich Gol
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Equipo de Atención Primaria Sant Roc, Institut Català de la Salut, IDIAP Jordi Gol Gorina, Badalona, Barcelona, España
| | - M Ángeles González Martínez
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Trinitat Vella, Institut Català de la Salut, Sant Andreu, Barcelona, España
| | - Ángela Sampedro Elvira
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Gornal, L'Hospitalet de Llobregat, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España
| | - Carme Saperas Pérez
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Plana Lledó, Mollet del Vallès, Institut Català de la Salut, Metropolitana Nord, Mollet del Vallès, Barcelona, España
| | - Consuelo Sánchez Collado
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Garrotxa-Olot Nord, Institut Català de la Salut, Girona, Olot, Girona, España
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Zhang H, Ruan WJ, Chou SP, Saha TD, Fan AZ, Huang B, White AM. Exploring patterns of alcohol use and alcohol use disorder among Asian Americans with a finer lens. Drug Alcohol Depend 2024; 257:111120. [PMID: 38402754 DOI: 10.1016/j.drugalcdep.2024.111120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND National survey data suggest Asian Americans (AA) are less likely to consume alcohol and develop AUD than Americans in other groups. However, it is common for AA to be born outside of the US and carry gene variants that alter alcohol metabolism, both of which can lead to lower levels of alcohol involvement. The current study examined differences in alcohol use and AUD between AA and other groups before and after controlling for birth location and gene variants. DESIGN Past year alcohol measures were examined from adults 18+ (N=22,848) in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III before and after controlling for birth location (inside or outside of the US) and gene variants (ALDH2*2 and ADH1B*2/ADH1B*3). Gender gaps in alcohol measures also were assessed. RESULTS Before adjustments, AA were less likely than White Americans to drink in the previous year (OR=0.50, 95% CI 0.41-0.62), binge (OR=0.68, 95% CI 0.52-0.88), engage in frequent heavy drinking (OR=0.55, 95% CI 0.42-0.73), and reach criteria for AUD (OR=0.71, 95% CI 0.53-0.94). After controlling for birth location and gene variants, AA remained less likely to drink in the past year (OR=0.54, 95% CI 0.41-0.70) but all other differences disappeared. Gender gaps were only observed for AA born outside of the US, highlighting the importance of experience rather than racial category per se. CONCLUSIONS Findings indicate that heterogeneity among AA leads to spurious generalizations regarding alcohol use and AUD and challenge the model minority myth.
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Affiliation(s)
- Haitao Zhang
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA
| | - W June Ruan
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA
| | - S Patricia Chou
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA
| | - Tulshi D Saha
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA
| | - Amy Z Fan
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA
| | - Boji Huang
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA
| | - Aaron M White
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA.
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Bedi NS, Tsering D, Raubenhold R, Allee L, Mahoney EJ, Wurcel A, Byhoff E. Analysis of bias in toxicology screening of patients in serious motor vehicle collisions. Acad Emerg Med 2024; 31:185-186. [PMID: 37606997 DOI: 10.1111/acem.14793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Neil Singh Bedi
- Boston Trauma, Division of Trauma & Acute Care Surgery & Surgical Critical Care, Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Dolma Tsering
- Yale University School of Public Health, New Haven, Connecticut, USA
| | - Rachel Raubenhold
- Boston Trauma, Division of Trauma & Acute Care Surgery & Surgical Critical Care, Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Lisa Allee
- Boston Trauma, Division of Trauma & Acute Care Surgery & Surgical Critical Care, Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Eric J Mahoney
- Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Alysse Wurcel
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Elena Byhoff
- Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts, USA
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Moskal D, Bennett ME, Marks RM, Roche DJO. Associations among Trauma Exposure, Post-Traumatic Stress Symptoms and Alcohol Use in Black/African American Treatment-Seeking Adults. J Dual Diagn 2024; 20:5-15. [PMID: 38113919 PMCID: PMC10842739 DOI: 10.1080/15504263.2023.2286025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Black/African American (AA) individuals are a group at risk for co-occurring posttraumatic stress disorder (PTSD) symptoms and alcohol use due to unique cultural and system-level barriers. Although associations between trauma exposure, PTSD symptoms, and alcohol use are well established across various populations, Black/AA individuals are underrepresented in this literature, and related findings in this population are inconclusive. Thus, the goal of this study was to examine the associations among trauma exposure, PTSD symptoms, and alcohol use in a sample of treatment-seeking, Black/AA adults. We hypothesized that trauma exposure and alcohol use would be positively associated and that this relationship would be mediated by PTSD symptoms. METHODS This study conducted secondary analysis of screening data from a PTSD and alcohol use disorder clinical trial. Participants were 96 Black/AA adults (57.3% male; 2.0% Hispanic; M age = 44.73, SD = 11.83) who were seeking treatment for alcohol use and endorsed trauma exposure. Associations between trauma exposure, PTSD symptom severity, and quantity and frequency of alcohol use were tested using bivariate correlations and linear regressions. Hypothesized indirect effects were tested using IBM SPSS Statistics Version 27 PROCESS model 4 with bootstrapping. RESULTS Findings illustrated a significant positive association between trauma exposure and PTSD symptoms and between PTSD symptoms and drinks per typical drinking day. PTSD symptoms were not significantly associated with number of drinking days. Tests of indirect effects were significant for trauma exposure on drinks per typical drinking day through PTSD symptoms. CONCLUSIONS Results from the test of indirect effects suggest that among Black/AA adults with heavy alcohol use and trauma exposure, trauma exposure is associated with PTSD symptoms, which in turn is associated with quantity of alcohol use. These findings are consistent with research conducted with White/mixed groups and align with tenets of the self-medication model of PTSD-AUD comorbidity. These findings support current practices that highlight the importance of screening for and addressing PTSD and alcohol use in individuals exposed to trauma. Findings from this paper provide initial data on understudied relationships in an underserved sample and several suggestions are made to generate future research and improve clinical care for Black/AA adults. CLINICAL TRIALS REGISTRY NAME Pharmacogenetic Treatment With Anti-Glutaminergic Agents for Comorbid PTSD & AUD; ClinicalTrials.gov Identifier: NCT02884908.
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Affiliation(s)
- Dezarie Moskal
- VA Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, New York, USA
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Melanie E Bennett
- VA VISN 5 Mental Illness Research, Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland, USA
- Department of Psychiatry, University of Maryland, Baltimore, Baltimore, Maryland, USA
| | - Russell M Marks
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Daniel J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, Baltimore, Maryland, USA
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Javadi D, Murchland AR, Rushovich T, Wright E, Shchetinina A, Siefkas AC, Todd KP, Gitelman J, Hall E, Wynne JO, Zewge-Abubaker N, Krieger N. Systematic review of how racialized health inequities are addressed in Epidemiologic Reviews articles (1979-2021): a critical conceptual and empirical content analysis and recommendations for best practices. Epidemiol Rev 2023; 45:1-14. [PMID: 37386694 DOI: 10.1093/epirev/mxad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 04/25/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023] Open
Abstract
Critical analysis of the determinants of current and changing racialized health inequities, including the central role of racism, is an urgent priority for epidemiology, for both original research studies and epidemiologic review articles. Motivating our systematic overview review of Epidemiologic Reviews articles is the critical role of epidemiologic reviews in shaping discourse, research priorities, and policy relevant to the social patterning of population health. Our approach was first to document the number of articles published in Epidemiologic Reviews (1979-2021; n = 685) that either: (1) focused the review on racism and health, racial discrimination and health, or racialized health inequities (n = 27; 4%); (2) mentioned racialized groups but did not focus on racism or racialized health inequities (n = 399; 59%); or (3) included no mention of racialized groups or racialized health inequities (n = 250; 37%). We then conducted a critical content analysis of the 27 review articles that focused on racialized health inequities and assessed key characteristics, including (1) concepts, terms, and metrics used regarding racism and racialized groups (notably only 26% addressed the use or nonuse of measures explicitly linked to racism; 15% provided explicit definitions of racialized groups); (2) theories of disease distribution guiding (explicitly or implicitly) the review's approach; (3) interpretation of findings; and (4) recommendations offered. Guided by our results, we offer recommendations for best practices for epidemiologic review articles for addressing how epidemiologic research does or does not address ubiquitous racialized health inequities.
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Affiliation(s)
- Dena Javadi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Audrey R Murchland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Tamara Rushovich
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Emily Wright
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Anna Shchetinina
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Anna C Siefkas
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Kieran P Todd
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Julian Gitelman
- Postgraduate Medical Education, University of Toronto, Toronto, Ontario M5R 0A3, Canada
| | - Enjoli Hall
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Jhordan O Wynne
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Nishan Zewge-Abubaker
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
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Greenberg J, Penn T, Doorley JD, Grunberg VA, Duarte BA, Fishbein NS, Bakhshaie J, Vranceanu AM. Pain catastrophizing, pain anxiety, and substance use among Black individuals with chronic pain who use opioids. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:977-984. [PMID: 36107640 PMCID: PMC10878305 DOI: 10.1037/adb0000881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVE Substance use is the leading cause of preventable deaths in the U.S. Chronic pain is associated with risky substance use. Black individuals experience substantial disparities in pain and substance use outcomes and treatment. Maladaptive psychological reactions to chronic pain, such as pain catastrophizing and pain anxiety, can increase substance use among White individuals. However, no research to date has tested this among Black individuals. This study is the first to test the relationships between pain catastrophizing, pain anxiety, and substance use among Black individuals with chronic pain who use opioid medications. METHOD Black adults with chronic pain who use opioids (N = 401) completed online measures of pain catastrophizing (Brief Pain Catastrophizing Scale); pain anxiety (Pain Anxiety Symptom Scale Short Form-20); risky use of alcohol, tobacco, e-cigarettes, cannabis and opioids (Alcohol, Smoking and Substance Involvement Screening Test); and opioid dependence (Severity of Dependence Scale). We conducted zero-inflated and hierarchical regressions to test associations between pain catastrophizing, pain anxiety and substance use (risky use; general use vs. nonuse) above that of demographics, pain intensity and pain interference. RESULTS Pain catastrophizing was uniquely associated with risky use of all substances (βs = .03-.09, ps < .001-.02), opioid dependence (β = .13, SE = .05, p = .01), and use (vs. nonuse) of tobacco, alcohol and opioids (βs = .07-.11, ps < .001-.02). Pain anxiety was uniquely associated with tobacco use (vs. nonuse; β = -.02, SE = .01, p = .04) and severity of opioid dependence (β = .21, SE = .01, p < .001). CONCLUSION Pain catastrophizing and, to a lesser degree, pain anxiety may be useful intervention targets for this underserved and understudied population. Addressing them may help reduce additional health complications and costs associated with substance use-related risk and dependence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | - Terence Penn
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | - James D. Doorley
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | - Victoria A. Grunberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | - Brooke A. Duarte
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Nathan S. Fishbein
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | - Jafar Bakhshaie
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
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Hai AH, Lee CS, Zhou C, Delva J. Culturally adapted motivational interviewing's effects on drinking in response to immigration and acculturation stressors among Latinx adults with heavy drinking problems. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 150:209061. [PMID: 37156426 PMCID: PMC10353888 DOI: 10.1016/j.josat.2023.209061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/13/2022] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Culturally adapted motivational interviewing (CAMI) is a form of motivational interviewing that was adapted to address immigration- and acculturation-related stressors among Latinx adults who met criteria for hazardous drinking. This study hypothesized that (1) receiving CAMI was associated with reduced immigration/acculturation stress and related drinking and that (2) these associations differed by participants' acculturation and perceived discrimination levels. METHODS This study employed a single group pre-post study design using data from a randomized controlled trial. Participants were Latinx adults who received CAMI (N = 149). The study assessed immigration/acculturation stress with the Measure of Immigration and Acculturation Stressors (MIAS) and measured related drinking with the Measure of Drinking Related to Immigration and Acculturation Stressors (MDRIAS). The study team conducted linear mixed modeling for repeated measures to examine outcome changes between the baseline and the 6-month and 12-month follow-ups and moderation effects. RESULTS Compared to baseline, the study found significant decreases in the total MIAS and MDRIAS scores and subscale scores at 6- and 12-month follow-ups. Moderation analysis results showed that lower acculturation levels and higher levels of perceived discrimination were significantly associated with larger decreases at follow-up in total MIAS and MDRIAS scores and several subscale scores. CONCLUSIONS Findings provide preliminary support for CAMI's efficacy in reducing immigration and acculturation stress and related drinking among Latinx adults with heavy drinking problems. The study observed more improvements among the less acculturated and more discriminated participants. Larger studies with more rigorous designs are needed.
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Affiliation(s)
- Audrey Hang Hai
- School of Social Work, Tulane University, 127 Elk Place, New Orleans, LA 70112, USA.
| | - Christina S Lee
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, USA.
| | - Carmen Zhou
- School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118, USA.
| | - Jorge Delva
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, USA.
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Kilian C, Lemp JM, Llamosas-Falcón L, Carr T, Ye Y, Kerr WC, Mulia N, Puka K, Lasserre AM, Bright S, Rehm J, Probst C. Reducing alcohol use through alcohol control policies in the general population and population subgroups: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101996. [PMID: 37256096 PMCID: PMC10225668 DOI: 10.1016/j.eclinm.2023.101996] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 06/01/2023] Open
Abstract
We estimate the effects of alcohol taxation, minimum unit pricing (MUP), and restricted temporal availability on overall alcohol consumption and review their differential impact across sociodemographic groups. Web of Science, Medline, PsycInfo, Embase, and EconLit were searched on 08/12/2022 and 09/26/2022 for studies on newly introduced or changed alcohol policies published between 2000 and 2022 (Prospero registration: CRD42022339791). We combined data using random-effects meta-analyses. Risk of bias was assessed using the Newcastle-Ottawa Scale. Of 1887 reports, 36 were eligible. Doubling alcohol taxes or introducing MUP (Int$ 0.90/10 g of pure alcohol) reduced consumption by 10% (for taxation: 95% prediction intervals [PI]: -18.5%, -1.2%; for MUP: 95% PI: -28.2%, 5.8%), restricting alcohol sales by one day a week reduced consumption by 3.6% (95% PI: -7.2%, -0.1%). Substantial between-study heterogeneity contributes to high levels of uncertainty and must be considered in interpretation. Pricing policies resulted in greater consumption changes among low-income alcohol users, while results were inconclusive for other socioeconomic indicators, gender, and racial and ethnic groups. Research is needed on the differential impact of alcohol policies, particularly for groups bearing a disproportionate alcohol-attributable health burden. Funding Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Number R01AA028009.
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Affiliation(s)
- Carolin Kilian
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Julia M. Lemp
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Laura Llamosas-Falcón
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tessa Carr
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, CA, United States
| | - William C. Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, CA, United States
| | - Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, CA, United States
| | - Klajdi Puka
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Aurélie M. Lasserre
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Sophie Bright
- School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, England, UK
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Program on Substance Abuse & WHO Collaborating Centre, Public Health Agency of Catalonia, Barcelona, Spain
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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11
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Karaye IM, Maleki N, Yunusa I. Racial and Ethnic Disparities in Alcohol-Attributed Deaths in the United States, 1999-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5587. [PMID: 37107870 PMCID: PMC10138663 DOI: 10.3390/ijerph20085587] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
The disparities in alcohol-attributed death rates among different racial and ethnic groups in the United States (US) have received limited research attention. Our study aimed to examine the burden and trends in alcohol-attributed mortality rates in the US by race and ethnicity from 1999 to 2020. We used national mortality data from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database and employed the ICD-10 coding system to identify alcohol-related deaths. Disparity rate ratios were calculated using the Taylor series, and Joinpoint regression was used to analyze temporal trends and calculate annual and average annual percentage changes (APCs and AAPCs, respectively) in mortality rates. Between 1999 and 2020, 605,948 individuals died from alcohol-related causes in the US. The highest age-adjusted mortality rate (AAMR) was observed among American Indian/Alaska Natives, who were 3.6 times more likely to die from alcohol-related causes than Non-Hispanic Whites (95% CI: 3.57, 3.67). An examination of trends revealed that recent rates have leveled among American Indians/Alaska Natives (APC = 17.9; 95% CI: -0.3, 39.3) while increasing among Non-Hispanic Whites (APC = 14.3; 95% CI: 9.1, 19.9), Non-Hispanic Blacks (APC = 17.0; 95% CI: 7.3, 27.5), Asians/Pacific Islanders (APC = 9.5; 95% CI: 3.6, 15.6), and Hispanics (APC = 12.6; 95% CI: 1.3, 25.1). However, when the data were disaggregated by age, sex, census region, and cause, varying trends were observed. This study underscores the disparities in alcohol-related deaths among different racial and ethnic groups in the US, with American Indian/Alaska Natives experiencing the highest burden. Although the rates have plateaued among this group, they have been increasing among all other subgroups. To address these disparities and promote equitable alcohol-related health outcomes for all populations, further research is necessary to gain a better understanding of the underlying factors and develop culturally sensitive interventions.
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Affiliation(s)
- Ibraheem M. Karaye
- Department of Population Health, Hofstra University, Hempstead, NY 11549, USA
| | - Nasim Maleki
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia, SC 29208, USA
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12
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Mair C, Sumetsky N, Dougherty M, Thakar M. Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence? CURR EPIDEMIOL REP 2022; 9:282-289. [PMCID: PMC9672597 DOI: 10.1007/s40471-022-00315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Michelle Dougherty
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Maya Thakar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
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13
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Acevedo A, Rodriguez Borja I, Alarcon Falconi TM, Carzo N, Naumova E. Hospitalizations for Alcohol and Opioid Use Disorders in Older Adults: Trends, Comorbidities, and Differences by Gender, Race, and Ethnicity. Subst Abuse 2022; 16:11782218221116733. [PMID: 35966614 PMCID: PMC9373119 DOI: 10.1177/11782218221116733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
Background The prevalence of substance use disorders (SUDs) among adults ages 65 and older has been increasing at a notably high rate in recent years, yet little information exists on hospitalizations for SUDs among this age group. In this study we examined trends in hospitalizations for alcohol use disorders (AUDs) and opioid use disorders (OUDs) among adults 65 and older in the United States, including differences by gender and race/ethnicity. Methods We used Medicare claims data for years 2007-2014 from beneficiaries ages 65 and older. We abstracted hospitalization records with an ICD-9 diagnostic code for an AUD or OUD. Hospitalization rates were calculated using population estimates from the United States Census. We examined trends in quarterly hospitalization rates for hospitalizations with AUD/OUD as primary diagnoses, and separately for those with these disorders as secondary diagnoses. We also examined comorbidities for those with a primary diagnosis of AUD/OUD. Analyses were conducted for all hospitalizations with AUD/OUD diagnoses, and separately by gender and race/ethnicity. Results Between the last quarter of 2007 and the third quarter of 2014, AUD hospitalization rates increased from 485 to 579 per million (19%), and OUD hospitalization rates from 46 to 101 per million (120%) and varied by gender (for AUD) and race/ethnicity (for both AUD and OUD). Hospitalization rates were particularly high for Black older adults, as was the increase in hospitalization rates. The increase in hospitalization rates was substantially higher for hospitalizations with AUD (84%) and OUD (269%) as secondary diagnoses. Conclusions Hospitalizations for AUDs and OUDs among older adults increased at an alarming rate during the observation period, and disparities existed in hospitalization rates for these conditions. Interventions focusing on the needs of older adults with AUD and/or OUD are needed, particularly to address the needs of a growing racially/ethnically diverse older adult population.
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Affiliation(s)
- Andrea Acevedo
- Department of Community Health, Tufts
University, Medford, MA, USA
| | | | | | - Nicole Carzo
- Department of Community Health, Tufts
University, Medford, MA, USA
| | - Elena Naumova
- Friedman School of Nutrition Science
and Policy, Tufts University, Boston, MA, USA
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14
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Caetano R, Vaeth PA, Gruenewald PJ, Ponicki WR, Kaplan ZB, Annechino R. Trends and correlates of spatially aggregated alcohol-involved crashes among Whites and Hispanics in California. Alcohol Clin Exp Res 2022; 46:1449-1459. [PMID: 35702933 PMCID: PMC9427699 DOI: 10.1111/acer.14884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 01/31/2023]
Abstract
AIMS This paper examines trends and correlates of alcohol-involved motor vehicle crashes (AMVCs) in California between 2005 and 2016 among Hispanic and non-Hispanic Whites (Whites hereafter). Together these two groups comprise 76% of the state population. The paper also examines whether alcohol outlet density, percentage of Hispanics in census tract populations, and distance to the U.S./Mexico border are related to greater risks for AMVCs. The border is of interest given the greater availability of alcohol in the area. METHODS Crash data come from Statewide Integrated Traffic Records System maintained by the California Highway Patrol. Sociodemographic and community characteristics data from the U.S. Census and alcohol outlet density were aggregated to census tracts. Total motor vehicle crashes and AMVCs were related to these characteristics using hierarchical Bayesian Poisson space-time models. RESULTS There were over two million injury and fatality crashes during the period of analysis, of which 11% were AMVCs. About 1.7% of these crashes had fatalities. The rate of AMVCs increased among both Whites and Hispanics until 2008. After 2008, the rate among Whites declined through 2016 while the rate among Hispanics declined for 2 years (2009 and 2010) and increased thereafter. Crash distance from the border (RR = 1.016, 95% CI = 1.010 to 1.022) and percent Hispanic population (RR = 1.006; 95% CI = 1.003 to 1.009) were well-supported results with 95% credible intervals that did not include 1. The percentages of the following: bars/pubs, males, individuals aged 18 to 29 and 40 to 49 years, U.S. born population, individuals below the 150% poverty level, unemployed, housing vacant, and housing owner-occupied were all positively associated with AMVCs and well supported. CONCLUSIONS Between 2005 and 2016 the rate of AMVCs in California declined among Whites but not among Hispanics. Population-level indicators of percent Hispanic population, distance to the U.S. Mexico border, gender, age distribution, and socioeconomic stability were positively associated with crash rates, indicating that important contextual characteristics help determine the level of AMVC rates in communities.
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Affiliation(s)
- Raul Caetano
- Prevention Research Center, 2150 Shattuck Avenue, Suite
601, Berkeley, California 94704, U.S.A
| | - Patrice A.C. Vaeth
- Prevention Research Center, 2150 Shattuck Avenue, Suite
601, Berkeley, California 94704, U.S.A
| | - Paul J. Gruenewald
- Prevention Research Center, 2150 Shattuck Avenue, Suite
601, Berkeley, California 94704, U.S.A
| | - William R. Ponicki
- Prevention Research Center, 2150 Shattuck Avenue, Suite
601, Berkeley, California 94704, U.S.A
| | - Zoe B. Kaplan
- Prevention Research Center, 2150 Shattuck Avenue, Suite
601, Berkeley, California 94704, U.S.A
| | - Rachelle Annechino
- Prevention Research Center, 2150 Shattuck Avenue, Suite
601, Berkeley, California 94704, U.S.A
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15
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Troya M, Spittal MJ, Pendrous R, Crowley G, Gorton HC, Russell K, Byrne S, Musgrove R, Hannah-Swain S, Kapur N, Knipe D. Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis. EClinicalMedicine 2022; 47:101399. [PMID: 35518122 PMCID: PMC9065636 DOI: 10.1016/j.eclinm.2022.101399] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. METHODS Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. FINDINGS A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates. INTERPRETATION The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. FUNDING No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).
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Affiliation(s)
- M.Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, 4.07 Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Grace Crowley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hayley C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Kirsten Russell
- School of Psychological Sciences and Health, Graham Hills Building, 40 George Street, Glasgow, UK
| | - Sadhbh Byrne
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Musgrove
- Centre for Mental Health and Safety, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Navneet Kapur
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Corresponding author.
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16
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Pedersen SL, Kennedy TM, Holmes J, Molina BS. Momentary associations between stress and alcohol craving in the naturalistic environment: differential associations for Black and White young adults. Addiction 2022; 117:1284-1294. [PMID: 34859912 PMCID: PMC8983429 DOI: 10.1111/add.15740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Black drinkers compared with White drinkers experience more alcohol-related problems. Examination of social determinants of inequities in alcohol problems is needed. The current study measured (1) associations between acute stress and alcohol craving in the naturalistic environment for self-identified Black and White individuals who drink alcohol and (2) whether a history of attention deficit hyperactivity disorder (ADHD) moderated these associations. DESIGN AND SETTING Observational study using ecological momentary assessment (EMA) to collect data from participants at six semi-random time-points throughout the day during a 10-day period. A series of three-level multi-level models examined between- and within-person associations for stress and alcohol and tested if these associations differed for Black and White adults. PARTICIPANTS Participants were 229 adult drinkers (aged 21-35 years) who completed a larger study examining alcohol response for Black and White adults with and without a history of childhood ADHD. MEASUREMENTS Momentary stress and alcohol craving, ADHD history and socio-demographic characteristics (i.e. racial identity, sex, age, current education level, household income) were assessed. Participants were required to self-identify as either 'African American or Black' or 'European American or White'. FINDINGS Significant racial identity × stress interactions indicated that associations between stress and craving were stronger for Black compared with White adults across the 10-day period (between-person: B = 0.14, P = 0.007), concurrently within a given EMA time-point (within-person: B = 0.04, P = 0.001) and prospectively from time-point to time-point (within-person: B = 0.05, P = 0.001). Results remained while accounting for income × stress interactions. CONCLUSIONS Acute stress appears to be more strongly related to alcohol craving in self-identified Black compared with self-identified White individuals. This provides support for policy changes to eliminate structural inequities that increase stress exposure and the development of just-in-time culturally responsive interventions focused on coping with acute stress for Black individuals.
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Affiliation(s)
- Sarah L. Pedersen
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
| | - Traci M. Kennedy
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
| | - Jordan Holmes
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
| | - Brooke S.G. Molina
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St. Pittsburgh, PA, 15213, USA
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17
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Williams EC, Samet JH. Shifts at The Helm: gratitude, re-commitment to our work, and a call for addictions disparities research. Addict Sci Clin Pract 2022; 17:12. [PMID: 35180895 PMCID: PMC8855027 DOI: 10.1186/s13722-022-00290-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Emily C Williams
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
| | - Jeffrey H Samet
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University, School of Medicine and Boston Medical Center, Boston, MA, USA
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18
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Cherpitel CJ, Ye Y, Kerr WC. Racial/Ethnic and Gender Differences in Risk of Injury and Life-Course Drinking Patterns: Data from US National Alcohol Surveys. Alcohol Alcohol 2022; 57:340-346. [PMID: 35037021 PMCID: PMC9086744 DOI: 10.1093/alcalc/agab085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/10/2021] [Accepted: 11/26/2021] [Indexed: 01/19/2023] Open
Abstract
AIMS To estimate risk of injury associated with frequency of drinking and heavy drinking (5+ drinks on occasion) by gender and race/ethnicity in the US population. METHODS Data were from a merged sample of two National Alcohol Surveys (telephone and web-based) (2014-2015 and 2019-2020) on 16,639 respondents, and analyzed using Cox proportional hazards models with age as the timescale in a retrospective cohort design. Life-course drinking was determined by age of onset and questions on any drinking and heavy drinking by decade of life. The outcome measure was having had an injury from a serious accident at a certainage. RESULTS Frequent heavy drinking (5+ daily, weekly and monthly) was significantly predictive of injury with hazard ratios (HRs) of 2.40, 1.81 and 1.50, respectively, while frequent light drinking (alcohol at least weekly and 5+ yearly or less) was also significant for women (HR = 1.73). For White respondents, 5+ at least weekly was significant for both men (HR = 1.74) and women (HR = 2.42). Among Hispanic respondents, 5+ at least weekly and 5+ monthly were both significant for men (HR = 2.81 and 2.49, respectively) and women (HR = 2.81 and 3.48, respectively). Among Black women, risk was significant for 5+ monthly (HR = 2.90) and for any alcohol ≥ weekly (HR = 2.72), but neither frequency of any drinking or 5+ was significant for Blackmen. CONCLUSIONS Data suggest a greater risk of injury from a serious accident for frequent heavy drinkers among all White and Hispanic respondents, and Black women, but not for Blackmen.
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Affiliation(s)
- Cheryl J Cherpitel
- Corresponding author: Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA. Tel: 510597-3453; E-mail:
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
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19
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Lin LA, Bonar EE, Zhang L, Girard R, Coughlin LN. Alcohol-involved overdose deaths in US veterans. Drug Alcohol Depend 2022; 230:109196. [PMID: 34894477 PMCID: PMC8714700 DOI: 10.1016/j.drugalcdep.2021.109196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alcohol-involved overdose deaths are increasing and often occur with other substances but have been minimally studied compared to other causes of overdose. METHODS We used national Veterans Health Administration (VHA) records linked to National Death Index data from 2012 to 2018 to examine trends in alcohol-related overdose mortality. Patient characteristics and treatment receipt were compared across categories of alcohol overdose deaths (alcohol-only, alcohol+opioids which may include additional substances, and alcohol+other substances without opioids). RESULTS From 2012-2018, 2421 Veterans died from an alcohol-involved overdose (alcohol-only: 868, alcohol+opioids: 1269, alcohol+other substances: 284). The alcohol-involved overdose rate increased 57% during this period. Compared to those who died of an alcohol-only overdose, Veterans who died from alcohol+opioids and alcohol+other substances were more likely Black or Hispanic, and to have an opioid use disorder, but less likely to live in rural areas or to be diagnosed with alcohol use disorder (AUD). Only 32.5% of those who died from alcohol-involved overdose received treatment in a substance use disorder clinic in the year preceding death, compared to 65.1% seen in mental health and 85.7% in primary care. Only 9.5% of Veterans who died from alcohol overdose received medication treatment for AUD and 24.8% received psychotherapy for AUD in the year preceding death. CONCLUSIONS Alcohol overdose is increasing primarily related to overdoses involving opioids and other substances. Most patients did not receive any effective medication or psychotherapy treatments for AUD, suggesting further need to identify those at risk and to target treatment for this vulnerable group in healthcare settings.
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Affiliation(s)
- Lewei A Lin
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States.
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States
| | - Lan Zhang
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
| | - Rachel Girard
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Building 16 2800 Plymouth Rd, Ann Arbor, MI 48109, United States; Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
| | - Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States; University of Michigan Injury Prevention Center, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800, United States
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20
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Alcover KC, Lyons AJ, Oluwoye O, Muse ID, Kelly ME, McDonell MG. Onset of alcohol use disorder among alcohol initiates by race/ethnicity. Alcohol 2021; 97:13-21. [PMID: 34411688 PMCID: PMC8643325 DOI: 10.1016/j.alcohol.2021.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Prevalence of alcohol use disorders (AUD) varies across racial/ethnic groups. It remains unclear whether rapid transition from first-time alcohol use to developing AUD varies by race and ethnicity. In this study, we investigate racial/ethnic differences in AUD onset among first-time alcohol drinkers and identify specific predictors of AUD onset by racial/ethnic group. The study population was non-institutionalized US residents aged 12 and older. Within four nationally representative probability samples (n ∼70,000/year) drawn from the 2015-2018 National Surveys on Drug Use and Health, we identified 9,381 individuals who initiated alcohol use within 1-12 months prior to the survey. The probability of AUD after initiation was estimated for the entire sample, followed by racial/ethnic group stratification. Bivariate and multivariable logistic regression models were used to identify predictors of AUD onset among alcohol initiates. The overall incidence estimate of AUD among alcohol initiates was 3.7% (95% CI = 3.0%, 4.6%). There was no significant variation in the incidence of AUD between racial/ethnic groups. Drug use, drug use disorders, and major depressive episode were significant predictors of AUD onset among all alcohol initiates. However, these predictors were not significant among non-Hispanic/Latinx Black individuals. Drug use and drug use disorders were strong predictors of AUD onset among alcohol initiates, except among non-Hispanic/Latinx Black individuals. These findings strengthen the importance of focusing on the co-use of alcohol and other drugs and the need to further investigate the risk profile differences between racial/ethnic groups.
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Affiliation(s)
- Karl C Alcover
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, United States.
| | - Abram J Lyons
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210, United States
| | - Oladunni Oluwoye
- CHES Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210, United States
| | - Ian D Muse
- School Mental Health Assessment, Research, & Training Center, University of Washington College of Education, Seattle, WA, 98115, United States
| | - Morgan E Kelly
- Multidisciplinary Association for Psychedelic Studies Public Benefit Corporation, San Jose, CA, 95117, United States
| | - Michael G McDonell
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210, United States
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21
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Demographic risk factors for co-occurring suicidality and cannabis use disorders: Findings from a nationally representative United States sample. Addict Behav 2021; 122:107047. [PMID: 34284313 DOI: 10.1016/j.addbeh.2021.107047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/18/2021] [Accepted: 07/08/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Burgeoning research suggests a link between suicidality (i.e., ideation, attempts) and cannabis use; however, little is known about which demographic groups are at increased risk of co-occurring suicidality and cannabis use disorders (CUD). This study tested differences in suicidality, CUD, and their co-occurrence by gender, age, race/ethnicity, and sexual orientation in a nationally representative U.S. SAMPLE METHOD Five years (2015-2019) of National Survey of Drug Use and Heath surveys were combined. Multinomial logistic regressions tested demographic differences in odds of suicidality only, CUD only, and co-occurring CUD and suicidality, relative to neither suicidality nor CUD. Covariates included survey year, major depressive episode, and other substance use disorders. RESULTS Men had higher odds of co-occurring suicidal ideation and CUD than women (AOR = 2.06). All older age groups reported lower odds of co-occurring suicidal ideation and CUD and co-occurring suicide attempts and CUD than emerging adults (AORs = 0.06-0.39). Black/African American (AOR = 1.42) and Native (AOR = 2.16) adults reported higher odds of co-occurring suicidal ideation and CUD than White adults. Black/African American (AOR = 4.05) and Hispanic/Latinx (AOR = 2.49) adults reported higher odds of co-occurring CUD and suicide attempts than White adults. Gay/lesbian (AOR = 2.04) and bisexual (AOR = 3.16) adults reported higher odds of co-occurring suicidal ideation and CUD than heterosexual adults. CONCLUSIONS Men, emerging adults, Black/African American, Native, and sexual minority groups had elevated risk of co-occurring suicidal ideation and CUD. Emerging adults, Black/African American, and Hispanic/Latinx groups had elevated risk of co-occurring suicide attempts and CUD.
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22
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Phillips AZ, Rodriguez HP, Kerr WC, Ahern JA. Washington's liquor license system and alcohol-related adverse health outcomes. Addiction 2021; 116:1043-1053. [PMID: 33058384 PMCID: PMC8043979 DOI: 10.1111/add.15234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/08/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS In June 2012, Washington state (USA) implemented Initiative 1183, privatizing liquor sales. As a result, off-premises outlets increased from 330 to over 1400 and trading hours lengthened. Increased availability of liquor may lead to increased consumption. This study examines the impact of Initiative 1183 on alcohol-related adverse health outcomes, measured by inpatient hospitalizations for alcohol-related disorders and accidental injuries. It further assesses heterogeneity by urbanicity, because outlets increased most in metropolitan-urban areas. DESIGN County-by-quarter difference-in-difference linear regression models, estimated statewide and within metropolitan/rural strata. SETTING AND PARTICIPANTS Data are from AHRQ Healthcare Cost and Utilization State Inpatient Database 2010-2014 and HHS Area Health Resource File 2010-2014. Changes in the rates of hospitalizations in the 2.5 years following Initiative 1183 in Washington (n = 39 counties) are compared with changes in Oregon (n = 36 counties). MEASUREMENTS County rates of hospitalizations per 1000 residents, including all records with any-listed ICD-9 Clinical Classification Software code denoting an alcohol-related disorder, and all records with any-listed external cause of injury code denoting an accidental injury. FINDINGS The increase in the rate of accidental injury hospitalizations in Washington's metropolitan-urban counties was on average 0.289 hospitalizations per 1000 county residents per quarter greater than the simultaneous increase observed in Oregon (P = 0.017). This result was robust to alternative specifications using a propensity score matched sample and synthetic control methods with data from other comparison states. The evidence did not suggest that Initiative 1183 was associated with differential changes in the rate of hospitalizations for alcohol-related disorders in metropolitan-urban (P = 0.941), non-metropolitan-urban (P = 0.162), or rural counties (P = 0.876). CONCLUSIONS Implementing Washington's Initiative 1183 (privatizing liquor sales) appears to have been associated with a significant increase in the rate of accidental injury hospitalizations in urban counties in that state but does not appear to be significantly associated with changes in the rate of hospitalizations specifically for alcohol-related disorders within 2.5 years.
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Affiliation(s)
- Aryn Z. Phillips
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, Berkeley, CA, USA,Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Hector P. Rodriguez
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, Berkeley, CA, USA,University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | | | - Jennifer A. Ahern
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA
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23
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Cherpitel CJ, Ye Y, Kerr WC. Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016. Rev Panam Salud Publica 2021; 45:e36. [PMID: 33790956 PMCID: PMC7993239 DOI: 10.26633/rpsp.2021.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To analyze changes in racial/ethnic disparities for unintentional injury mortality from 1999-2016. METHODS Mortality data are from the National Center for Health Statistics (NCHS) for all unintentional injuries, analyzed separately by injury cause (motor vehicle accidents [MVA], poisonings, other unintentional) for white,black, and Hispanic populations within four age groups: 15-19, 20-34, 35-54, 55-74 for males and for females. RESULTS Rates across race/ethnic groups varied by gender, age and cause of injury. Unintentional injury mortality showed a recent increase for both males and females, which was more marked among males and for poisoning in all race/ethnic groups of both genders. Whites showed highest rates of poisoning mortality and the steepest increase for both genders, except for black males aged 55-74. MVA mortality also showed an increase for all race/ethnic groups, with a sharper rise among blacks, while Hispanics had lower rates than either whites or blacks. Rates for other unintentional injury mortality were similar across groups except for white women over 55, for whom rates were elevated. CONCLUSIONS Data suggest while mortality from unintentional injury related to MVA and poisoning is on the rise for both genders and in most age groups, blacks compared to whites and Hispanics may be suffering a disproportionate burden of mortality related to MVAs and to poisonings among those over 55, which may be related to substance use.
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Affiliation(s)
- Cheryl J. Cherpitel
- Public Health InstituteEmeryvilleUnited States of AmericaPublic Health Institute, Emeryville, United States of America
| | - Yu Ye
- Public Health InstituteEmeryvilleUnited States of AmericaPublic Health Institute, Emeryville, United States of America
| | - William C. Kerr
- Public Health InstituteEmeryvilleUnited States of AmericaPublic Health Institute, Emeryville, United States of America
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24
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Association of Alcohol Use and Physical Activity with Body Mass Index in Mexican-Origin Adults. J Racial Ethn Health Disparities 2021; 9:812-819. [PMID: 33721292 DOI: 10.1007/s40615-021-01019-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/10/2021] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Studies across racial/ethnic groups indicate that physical activity (PA) and alcohol consumption are positively associated, and that alcohol consumption is negatively associated with body mass index (BMI), but this relationship is less often evaluated in Hispanics. The purpose of this study was to assess the relationships between alcohol consumption, PA, and BMI in Hispanic adults. METHODS In this secondary data analysis of a Mexican-American cohort, we collected self-reported PA, alcohol consumption, and demographics, and measured height and weight. Linear regression assessed the association between PA and alcohol consumption with BMI, controlling for covariates. Total sample for analyses was n = 3897. RESULTS We found an inverse relationship between high PA and BMI in the full sample (adjusted estimate = - 0.03, 95% CI - 0.07, - 0.01) and in females, but not males. We also found an inverse relationship between current alcohol use and BMI in the full sample (adjusted estimate = - 0.05, 95% CI - 0.09, - 0.01) and both sexes. There was no significant interaction between PA and alcohol use on BMI. CONCLUSIONS In this study of Mexican-origin adults, current alcohol use and high PA were associated with lower BMIs, but there was no interaction between PA and alcohol use. These results can be used to inform multiple behavior change interventions in Mexican-origin adults.
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25
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Albright DL, McDaniel J, Suntai Z, Wallace J. Alcohol misuse among older military veterans: an intersectionality theory perspective. J Addict Dis 2021; 39:504-512. [PMID: 33709881 DOI: 10.1080/10550887.2021.1897201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Alcohol misuse among older adults is an emerging public health issue. Older veterans are particularly at risk of developing substance use dependency due to the enduring impacts of military service. The purpose of this study was to test the theory of intersectionality on alcohol misuse by veteran status and age, veteran status and sex, and veteran status and race. METHODS Combined data from the 2016, 2017, and 2018 Brief Risk Factor Resilience Survey (BRFSS) from the Centers for Disease Control and Prevention (CDC) were used in this cross-sectional study. The BRFSS is conducted annually with adults via landline or cellular telephones in all 50 states in the United States, as well as in the District of Columbia, Puerto Rico, and Guam. Alcohol misuse among individuals aged 65+ was examined by veteran status and the interaction between age, race, and sex using survey-weighted logistic regression models. RESULTS Results show no interaction between veteran status and age or sex. For the interaction between veteran status and race, significant disparities were found. Black/Other race veterans were significantly more likely to engage in binge drinking and heavy drinking compared to nonveterans of the same race, White veterans, and White nonveterans. CONCLUSION Older veterans who are also Black, Indigenous and/or people of color (BIPOC) are at great risk of engaging in alcohol misuse due to the combined stressors from their intersectional identities. Interventions targeting this population should consider the historical, cultural, and systemic factors that contribute to a disproportionally higher rate of binge drinking and heavy drinking among BIPOC veterans.
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Affiliation(s)
- David L Albright
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Justin McDaniel
- School of Human Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Zainab Suntai
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Juliane Wallace
- School of Human Sciences, Southern Illinois University, Carbondale, IL, USA
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26
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Westrick AC, De La Rosa MR, Sanchez M, Colón-Burgos JF, Rojas P, Cano MA. Associations of Objective and Perceived Neighborhood Ethnic Density on Hazardous Alcohol Use among Latinx Emerging Adults. Subst Use Misuse 2021; 56:339-344. [PMID: 33459146 PMCID: PMC7891859 DOI: 10.1080/10826084.2020.1840588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background/Purpose: Emerging adulthood is an important time where substance use often peaks. Neighborhood Latinx ethnic density could be protective against negative health behaviors. Most studies on neighborhood ethnic density have focused on census-level aggregate measures, however perception of the neighborhood ethnic density could differ from objectively measured neighborhood density. This study investigated the effects of neighborhood ethnic density, both perceived ethnic and objectively measured ethnic density, on hazardous alcohol use among Latinx emerging adults in Maricopa County Arizona and Miami-Dade County Florida by gender. Methods: 200 Latinx emerging adults residing in Arizona and Florida completed a cross-sectional survey. Inclusion criteria were being age 18-25, self-identify as Latinx, and currently living in Maricopa County or Miami-Dade County. Data were analyzed using multivariate logistic regression and moderation analyses. Results: There was a statistically significant difference between perceived and objective ethnic density (Kappa = 0.353, p < 0.001). When ethnic density was measured objectively, alcohol use severity was statistically significantly lower for individuals living in highly ethnically dense neighborhoods (OR: 0.34, 95% CI: 0.12, 0.92). However, this association was only found for women in moderation analyses. There was no statistically significant association between perceived ethnic density and alcohol use severity. Conclusion: The present study found a statistically significant decrease in alcohol use severity among Latinx emerging adults who live in highly ethnically dense neighborhoods after adjusting for covariates. Future research should investigate the potential mechanisms in which these neighborhoods protect against alcohol use severity among Latinx emerging adults.
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Affiliation(s)
- Ashly C Westrick
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Mario R De La Rosa
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Mariana Sanchez
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - José Félix Colón-Burgos
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Patria Rojas
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Miguel A Cano
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
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27
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Lee CS, Rosales R, Colby SM, Martin R, Cox K, Rohsenow DJ. Addressing social stressors in a brief motivational interview improve mental health symptoms for Latinx heavy drinkers. J Clin Psychol 2020; 76:1832-1850. [PMID: 32469106 PMCID: PMC7487011 DOI: 10.1002/jclp.22976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Depressive and anxiety symptoms co-occur with hazardous drinking among Latinxs. This secondary analysis of a clinical trial to reduce hazardous drinking (motivational interviewing adapted to address social stressors [CAMI] vs. motivational interviewing [MI]) examined effects on anxiety/depressive symptoms. Discrimination and acculturation were examined as moderators. METHODS Latinx (n = 296) hazardous drinkers (2+ occasions/month of heavy drinking; 4/5 drinks/occasion, females/males) were randomized to CAMI/MI. Generalized estimating equations analyzed how treatment conditions and interactions were related to depressive and anxiety symptoms after controlling for covariates. RESULTS Baseline symptoms (anxiety, depression) exceeded clinical thresholds (Anxiety ≥8, M = 14.62, SD = 13.52; Depression ≥ 12, M = 18.78, SD = 12.57). Cultural adaptation of motivational interviewing (CAMI) showed significantly lower anxiety and depressive symptoms (6/12 months, respectively) than MI. CAMI with high baseline discrimination reported significantly less depression than MI (12 months). CONCLUSIONS Explicitly addressing social stressors may be a beneficial adjunct to treatment for Latinx drinkers.
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Affiliation(s)
- Christina S. Lee
- Department of Clinical Practice, Boston University School of Social Work, 264 Bay State Road, Boston, MA, 02215
| | - Robert Rosales
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 South Main St., Providence, RI, 02912, USA
| | - Suzanne M. Colby
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 South Main St., Providence, RI, 02912, USA
| | - Rosemarie Martin
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 South Main St., Providence, RI, 02912, USA
| | - Koriann Cox
- Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, 02115
| | - Damaris J. Rohsenow
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 South Main St., Providence, RI, 02912, USA
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28
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Vaca FE, Dziura J, Abujarad F, Pantalon MV, Hsiao A, Field CA, D'Onofrio G. Trial study design to test a bilingual digital health tool for alcohol use disorders among Latino emergency department patients. Contemp Clin Trials 2020; 97:106128. [PMID: 32950400 DOI: 10.1016/j.cct.2020.106128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We describe an emergency department (ED)-based, Latino patient focused, unblinded, randomized controlled trial to empirically test if automated bilingual computerized alcohol screening and brief intervention (AB-CASI), a digital health tool, is superior to standard care (SC) on measures of alcohol consumption, alcohol-related negative behaviors and consequences, and 30-day treatment engagement. The trial design addresses the full spectrum of unhealthy drinking from high-risk drinking to severe alcohol use disorder (AUD). In an effort to surmount known ED-based alcohol screening, brief intervention, and referral to treatment process barriers, while addressing racial/ethnic alcohol-related health disparities among Latino groups, this trial will purposively use a digital health tool and seek enrollment of English and/or Spanish speaking self-identified adult Latino ED patients. Participants will be randomized (1:1) to AB-CASI or SC, stratified by AUD severity and preferred language (English vs. Spanish). The primary outcome will be the number of binge drinking days assessed using the 28-day timeline followback method at 12 months post-randomization. Secondary outcomes will include mean number of drinks/week and number of episodes of driving impaired, riding with an impaired driver, injuries, arrests, and tardiness and days absent from work/school. A sample size of 820 is necessary to provide 80% power to detect a 1.14 difference between AB-CASI and SC in the primary outcome. Showing efficacy of this promising bilingual ED-based brief intervention tool in Latino patients has the potential to widely and efficiently expand prevention efforts and facilitate meaningful contact with specialized treatment services.
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Affiliation(s)
- Federico E Vaca
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, United States of America.
| | - James Dziura
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, United States of America.
| | - Fuad Abujarad
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, United States of America.
| | - Michael V Pantalon
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, United States of America.
| | - Allen Hsiao
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, United States of America; Yale School of Medicine, Department of Pediatrics, Section of Emergency Medicine, 100 York St, Suite 1F, New Haven, CT 06511, United States of America.
| | - Craig A Field
- University of Texas at El Paso, Latino Alcohol and Health Disparities Research Center (LAHDR), Psychology Building; Rooms 102 and 104, The University of Texas at El Paso, El Paso, TX 79968, United States of America.
| | - Gail D'Onofrio
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, United States of America.
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29
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Trial study design to test a bilingual digital health tool for alcohol use disorders among Latino emergency department patients. Contemp Clin Trials 2020; 96:106104. [PMID: 32777381 DOI: 10.1016/j.cct.2020.106104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022]
Abstract
We describe an emergency department (ED)-based, Latino patient focused, unblinded, randomized controlled trial to empirically test if automated bilingual computerized alcohol screening and brief intervention (AB-CASI), a digital health tool, is superior to standard care (SC) on measures of alcohol consumption, alcohol-related negative behaviors and consequences, and 30-day treatment engagement. The trial design addresses the full spectrum of unhealthy drinking from high-risk drinking to severe alcohol use disorder (AUD). In an effort to surmount known ED-based alcohol screening, brief intervention, and referral to treatment process barriers, while addressing racial/ethnic alcohol-related health disparities among Latino groups, this trial will purposively use a digital health tool and seek enrollment of English and/or Spanish speaking self-identified adult Latino ED patients. Participants will be randomized (1:1) to AB-CASI or SC, stratified by AUD severity and preferred language (English vs. Spanish). The primary outcome will be the number of binge drinking days assessed using the 28-day timeline followback method at 12 months post-randomization. Secondary outcomes will include mean number of drinks/week and number of episodes of driving impaired, riding with an impaired driver, injuries, arrests, and tardiness and days absent from work/school. A sample size of 820 is necessary to provide 80% power to detect a 1.14 difference between AB-CASI and SC in the primary outcome. Showing efficacy of this promising bilingual ED-based brief intervention tool in Latino patients has the potential to widely and efficiently expand prevention efforts and facilitate meaningful contact with specialized treatment services.
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30
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Patrick ME, Terry-McElrath YM, Evans-Polce RJ, Schulenberg JE. Negative alcohol-related consequences experienced by young adults in the past 12 months: Differences by college attendance, living situation, binge drinking, and sex. Addict Behav 2020; 105:106320. [PMID: 32007832 DOI: 10.1016/j.addbeh.2020.106320] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/26/2019] [Accepted: 01/14/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE This study estimated the prevalence of negative consequences associated with alcohol use in a national sample of young adults one or two years after graduating from high school, focusing on differences by college attendance, living situation, binge drinking, and sex. METHODS A subsample (N = 1068) of U.S. nationally representative Monitoring the Future study 12th grade students from 2006 to 2016 cohorts was followed-up at modal age 19 or 20 (in 2008-2017) and asked about negative consequences related to their own alcohol use during the past 12 months. Differences in prevalence were estimated and multivariable models examined associations with college attendance, living situation, binge drinking, and sex. RESULTS Half of surveyed U.S. 19/20 year-old alcohol users (a third of non-binge drinkers and almost three-quarters of binge drinkers) experienced negative consequences in the past year. The likelihood of experiencing several consequence types was significantly associated with college attendance prior to controlling for living situation. In multivariable models controlling for living situation, unsafe driving due to drinking remained more likely for students attending 2-year colleges or vocational/technical schools than for 4-year college students or non-attenders. In general, negative consequence risk was elevated among young adults not living with parents (vs. those living with parents) and women (vs. men). CONCLUSION Negative consequences from alcohol use are prevalent among young adults and differ by college attendance, living situation, binge drinking, and sex. Students at 2-year/vocational/technical schools are at particular risk for unsafe driving, warranting specific research attention and targeted intervention.
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Affiliation(s)
- Megan E Patrick
- Institute of Child Development and Institute of Translational Research in Children's Mental Health, University of Minnesota, 1100 Washington Ave S., Suite 101, Minneapolis, MN 55415, USA.
| | - Yvonne M Terry-McElrath
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA.
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls, Room 2247, Ann Arbor, MI 48104, USA.
| | - John E Schulenberg
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA; Department of Psychology, and Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, MI 48106, USA.
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31
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El-Gabri D, Toomey N, Gil NM, de Oliveira AC, Calvo PRS, Tchuisseu YP, Williams S, Andrade L, Vissoci JRN, Staton C. Association Between Socioeconomic and Demographic Characteristics and Non-fatal Alcohol-Related Injury in Maringá, Brazil. Front Public Health 2020; 8:66. [PMID: 32269983 PMCID: PMC7109310 DOI: 10.3389/fpubh.2020.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Previous research has corroborated a high burden of alcohol-related injury in Brazil and the presence of socioeconomic disparities among the injured. Yet, individual-level data is scarce. To fill this gap, we examined the association between demographic and socioeconomic characteristics with non-fatal alcohol-related injury in Maringá, Brazil. Methods: We used household survey data collected during a 2015 cross-sectional study. We conducted univariate and multivariate analyses to evaluate associations of demographic (age, gender, race) and socioeconomic characteristics (employment, education, income) with non-fatal alcohol-related injury. Results: Of the 995 participants who reported injuries, 62 (6.26%) were alcohol-related. Fifty-three (85%) alcohol-related injuries were reported by males. Multivariate analysis indicated being male (OR = 5.98 95% CI = 3.02, 13.28), 15–29 years of age (OR = 3.62 95% CI = 1.72, 7.71), and identifying as Black (OR = 2.38 95% CI = 1.09, 4.95) were all significantly associated with increased likelihood of reporting an alcohol-related injury, whereas unemployment was significantly associated with decreased likelihood of reporting an alcohol-related injury (OR = 0.41 95% CI = 0.18, 0.88). Conclusion: Our findings suggest that in Maringá, being male, between the ages of 15 and 29, employed, or identifying as Black were characteristics associated with a higher risk for non-fatal alcohol-related injury. Individual level data, such as ours, should be considered in combination with area-level and country-level data when developing evidence-based public-health policies.
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Affiliation(s)
- Deena El-Gabri
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Nicole Toomey
- Duke Global Health Institute, Duke University, Durham, NC, United States.,Division of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
| | - Nelly Moraes Gil
- Department of Nursing, State University of Maringá, Maringá, Brazil
| | | | | | | | - Sarah Williams
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Luciano Andrade
- Department of Nursing, State University of Maringá, Maringá, Brazil
| | - Joao Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, Durham, NC, United States.,Division of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
| | - Catherine Staton
- Duke Global Health Institute, Duke University, Durham, NC, United States.,Division of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
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Randle R, Bazargan-Hejazi S, Pen D, Diab S, Shaheen M. Racial and ethnic differences in patients involved in alcohol-impaired motor vehicle crashes and its related clinical outcomes among various age groups in the U.S. TRAFFIC INJURY PREVENTION 2020; 21:115-121. [PMID: 32023129 DOI: 10.1080/15389588.2019.1688312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
Objective(s): 1) to determine whether the proportion of alcohol-impaired patients involved in motor vehicle crashes (MVCs) varies by race/ethnicity within different age groups; 2) to explore the relationship between alcohol impairment, race/ethnicity and clinical outcomes among patients involved in MVCs across age groups.Methods: The 2012 National Trauma Data Bank (NTDB) queried for patients aged 16-55 involved in MVCs who received a blood ethanol test on admission.Results: Of the 44,216 patients involved in MVC, 68% were White, 14% Black, and 13% were Hispanic. About 36% were 16-25 years old, and 19% were 46-55 years old. Alcohol-impaired patients constituted 34% of the patients. The multiple logistic regression analysis of HLOS ≥ 2 days revealed that, when controlling for age, gender, race/ethnicity, insurance status, and the interaction between alcohol impairment and age as well as alcohol impairment and race/ethnicity, alcohol impairment positivity carried a 15% increase in probability of HLOS ≥ 2 days (OR 1.15, p < 0.0001). Additionally, using the 16-25 age group as reference, each of the older age groupings showed an increased probability of HLOS ≥ 2 days with ORs of 1.15, 1.32, and 1.51 for ages 26-35, 36-45, and 46-55, respectively (p-values < 0.0001). Blacks, Hispanics, and Asians/others were less likely than Whites to have HLOS ≥ 2 days with OR of 0.88, 0.89, and 0.88, respectively (p < 0.05). There was no statistically significant difference in the clinical outcome of mortality between races/ethnicities and alcohol-impaired driving.Conclusions: This study demonstrates that the proportions of alcohol-impaired driving and the associated clinical outcomes vary among race/ethnic groups in different age groups. More research is needed to determine the reasons for the observed differences in these vulnerable sub-groups.
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Affiliation(s)
- Ryan Randle
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California
- David Geffen School of Medicine, UCLA, Los Angeles, California
- Medical Education Program, Department of Surgery, Oregon Health and Science University, Portland, Oregon
| | - Shahrzad Bazargan-Hejazi
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California
- David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Deyu Pen
- Preventive and Social Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Sara Diab
- Department of Public Health, University of California, Irvine, California
| | - Magda Shaheen
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California
- David Geffen School of Medicine, UCLA, Los Angeles, California
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Wiss DA. The Relationship Between Alcohol and Glycohemoglobin: A Biopsychosocial Perspective. Biores Open Access 2019; 8:146-154. [PMID: 31588381 PMCID: PMC6776959 DOI: 10.1089/biores.2019.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
With the rising prevalence of type 2 diabetes mellitus (T2DM), there is debate regarding biological and psychosocial risk factors. While it is well established that alcohol lowers glycohemoglobin (HbA1c) levels, it is less clear whether alcohol consumption is protective of T2DM. It is also unclear how gender and ethnicity influence the utility of HbA1c screening as a tool for T2DM diagnosis, particularly in the context of alcohol use. This cross-sectional study utilized the National Health and Nutrition Examination Survey 2013–2014 dataset and was restricted to adults 20 years and older, nonpregnant, and not on antihypertensive medication (n = 4299) to evaluate the relationship between alcohol use and HbA1c. A multilinear regression model controlled for gender, ethnicity, education level, body mass index, and age. After controlling for covariates, both moderate (β = −0.073; p = 0.033) and heavy drinking (β = −0.167; p < 0.001) are associated with reduced HbA1c levels. Additionally, female gender is a significant negative predictor of HbA1c (β = −0.052; p = 0.024) and all ethnic groups have higher levels of HbA1c compared with non-Hispanic whites. Plausible biological mechanisms are discussed. The clinical utility of HbA1c as a screening tool for T2DM without considering alcohol use, gender, and ethnicity may lead to diagnostic errors. Individualized approaches and focused efforts toward health equity are needed to address rising rates of T2DM.
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Affiliation(s)
- David A. Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
- Address correspondence to: David A. Wiss, MS, RDN, Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90025
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Field C, Oviedo Ramirez S, Juarez P, Castro Y. Process for developing a culturally informed brief motivational intervention. Addict Behav 2019; 95:129-137. [PMID: 30909079 DOI: 10.1016/j.addbeh.2019.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/28/2019] [Accepted: 03/01/2019] [Indexed: 01/18/2023]
Abstract
The present study culturally enhances a standard brief intervention for alcohol use. Through an iterative process engaging key stakeholders; including patients, and expert consultants, this research sought to enhance current evidence based interventions. Five culturally informed enhancements consistent with Motivational Interviewing were introduced into standard brief interventions. These culturally informed enhancements can be refined to address the cultural risk and protective factors of other priority populations. The distinctions and advantages of this approach over prior cultural adapted interventions is discussed. Importantly, the present study outlines a process for refining the culturally informed brief intervention to other target populations.
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Affiliation(s)
- Craig Field
- Department of Psychology, University of Texas at El Paso, USA.
| | | | - Patricia Juarez
- Department of Psychology, University of Texas at El Paso, USA
| | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, USA
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Moses TE, Lister JJ, Greenwald MK. A Comparison of Substance Use Patterns Among Lifetime Heroin-Injecting Individuals By Racial Groups. ADDICTION RESEARCH & THEORY 2019; 28:260-268. [PMID: 32863812 PMCID: PMC7454016 DOI: 10.1080/16066359.2019.1630384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND Studies have identified differential substance use patterns by racial groups. One of the most commonly reported differences is a higher rate of injection drug use (IDU) among Non-Hispanic Whites compared to African Americans, but this is complicated by factors related to IDU (e.g., earlier drug-use initiation) that overlap with being White. OBJECTIVE We explored differential substance use-patterns by racial groups within a sample of injection heroin users. METHODS Substance-use data were collected from 373 not-in-treatment heroin users who endorsed any lifetime injection use (69.4% male). We examined differences in substance-use patterns (e.g., age of initiation, gateway adherence) by racial groups. Multiple t-tests with Bonferroni correction were conducted to understand which demographic and substance-use characteristics varied by racial groups. RESULTS Relative to Non-Hispanic Whites, African Americans (45.8% of sample) were more likely to start using heroin earlier in their life, but also more likely to experience a longer delay between starting and regularly using heroin. We also identified differences in the degree of (injection) heroin-use consequences by racial groups. After correcting for multiple comparisons and controlling for age and gender, we observed differences for six substance-use and demographic characteristics by racial group. White participants were younger, started cocaine use earlier, and experienced more heroin-use consequences across two separate domains. CONCLUSIONS After controlling for injection use, we observed differential substance-use characteristics by racial groups. The findings could be used to develop targeted prevention and harm-reduction strategies.
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Affiliation(s)
- Tabitha E.H. Moses
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48201, USA
| | - Jamey J. Lister
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48201, USA
- School of Social Work, Wayne State University, Detroit, MI 48201, USA
| | - Mark K. Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48201, USA
- Department of Pharmacy Practice, Wayne State University, Detroit, MI 48201, USA
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McKone KM, Kennedy TM, Piasecki TM, Molina BS, Pedersen SL. In-the-Moment Drinking Characteristics: An Examination Across Attention-Deficit/Hyperactivity Disorder History and Race. Alcohol Clin Exp Res 2019; 43:1273-1283. [PMID: 30986327 PMCID: PMC6867083 DOI: 10.1111/acer.14050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 04/01/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Adults with a history of childhood attention-deficit/hyperactivity disorder (ADHD) and Black drinkers are at elevated risk for alcohol problems and alcohol use disorder. Processes that increase risk for these distinct populations have not focused on in-the-moment behaviors that occur while drinking. The present study examined in-the-moment drinking characteristics (i.e., location, social context, day, time, drink type, speed of consumption) that may differ for individuals with and without ADHD histories or for Black and White drinkers. We also examined the interplay among these in-the-moment drinking characteristics to further understanding of contexts when risk may be momentarily increased. METHODS As part of a larger study, 135 individuals (Mage = 27.81, 69.6% male, 45.9% ADHD, 69.6% White) completed a 10-day ecological momentary assessment protocol that included self-initiated reports following consumption of an alcoholic drink. Hypotheses were tested using multilevel modeling. RESULTS Controlling for multiple demographic covariates, Black drinkers drank significantly more quickly than White drinkers and were more likely to consume hard liquor-containing beverages. Differences in drinking speed remained significant when adjusting for Black drinkers' greater likelihood to consume liquor-containing beverages and momentary experience of discrimination; however, Black drinkers' increased likelihood to consume liquor-containing beverages was no longer significant when adjusting for momentary experience of discrimination. Individuals with ADHD histories did not differ from those without ADHD histories in any in-the-moment drinking characteristics. ADHD and race did not interact to predict any drinking characteristic. CONCLUSIONS Differences in speed of alcohol consumption and propensity to consume liquor-containing beverages may contribute to increased risk for alcohol problems experienced by Black drinkers compared to White drinkers.
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Affiliation(s)
- Kirsten M.P. McKone
- Department of Psychology, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Traci M. Kennedy
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Thomas M. Piasecki
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Brooke S.G. Molina
- Department of Psychology, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213, USA,Department of Psychiatry, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Sarah L. Pedersen
- Department of Psychiatry, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
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Nesoff ED, Branas CC, Martins SS. Challenges in studying statewide pedestrian injuries and drug involvement. Inj Epidemiol 2018; 5:43. [PMID: 30506421 PMCID: PMC6275152 DOI: 10.1186/s40621-018-0173-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing U.S. rates of pedestrian injuries could be attributable in part to changing policies and attitudes towards drugs and associated increases in use, yet drug use has not been investigated widely as a risk factor for pedestrian injury. This study details challenges to investigating drug-involved pedestrian crashes using existing surveillance systems. METHODS Using California police reports from 2004 to 2016, we performed simple linear regression with the proportion of data that was missing by year for drug and alcohol use as the outcome of interest. We also explored differences in the relative proportion of missing data across sex, race, and age groups through simple logistic regression. Finally, we compared missing data for alcohol and drug use indicators for pedestrians and drivers. RESULTS From 2004 to 2016, 182,278 pedestrians were involved in crashes across California. Only 1.22% (n = 2219) of records indicated drug use, and 98% had missing data for drug use; the proportion of missing data did not change over time (b = - 0.040, p = 0.145, 95% CI = (- 0.095, 0.016)). The proportion of missing values for alcohol use increased each year (b = 0.49, 95% CI = (0.26, 0.72), p = 0.001). Driver drug and alcohol use indictors showed similar data missingness, and missing data did not show significant variation over time. Hispanics were more likely to have missing data for drug use compared to Whites (OR = 0.61, p < 0.001, 95% CI = (0.56, 0.67)), and Blacks were more likely to have missing data for alcohol use compared to Whites (OR = 0.87, p < 0.0001, 95% CI = (0.84, 0.91)). CONCLUSIONS Drug use may be a key contributing factor to pedestrian injury, but drug use remains consistently and largely unmeasured in existing surveillance systems. Without better collection of drug and alcohol data, monitoring trends in drug-involved pedestrian injury will not be feasible.
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Affiliation(s)
- Elizabeth D. Nesoff
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W168th St, 5th floor, New York, NY 10032 USA
| | - Charles C. Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W168th St, 5th floor, New York, NY 10032 USA
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W168th St, 5th floor, New York, NY 10032 USA
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Kogan SM, Cho J, Beach SRH, Smith AK, Nishitani S. Oxytocin receptor gene methylation and substance use problems among young African American men. Drug Alcohol Depend 2018; 192:309-315. [PMID: 30308385 PMCID: PMC6202060 DOI: 10.1016/j.drugalcdep.2018.08.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Stressful or supportive social environments promote biological changes with regulatory implications for future relationships and substance abuse. Recent research suggests links between adverse social environments, prosocial relationships, methylation at the oxytocin receptor gene (OXTR), and substance abuse. The potential for OXTR methylation to act as the mechanism linking social environments to substance abuse has yet to be investigated. We hypothesized that, for young African American men, childhood adversity increases, and supportive, prosocial bonds with parents, peers, partners, and community mentors decrease OXTR methylation levels, which in turn predict increases in substance-related symptoms. METHODS A sample of 358 rural African American men (age 19 at baseline) provided self-report data at three time points separated by 18 months and a genetic specimen at Time 2. RESULTS Early adversity was associated with OXTR methylation indirectly via contemporary prosocial relationships. OXTR methylation was a proximal predictor of changes in substance-related symptoms. We found no evidence for a direct association of self-reported childhood trauma with OXTR methylation status. CONCLUSIONS Findings suggest that OXTR methylation is linked to substance use symptomatology, ostensibly resulting in increased expression of oxytocin (OT) in peripheral and central nervous systems. OXTR may act as a mechanism to explain how prosocial ties deter substance abuse and related problems. Despite conjectures in the literature that early adversity may become physiologically embedded via methylation in the OT system, direct effects were not evident. Rather, early adversity may affect OXTR methylation via influence on contemporary prosocial relationships.
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Affiliation(s)
- Steven M Kogan
- Department of Human Development and Family Science, University of Georgia, 305 Sanford Drive, Athens, GA, 30602, USA.
| | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, 2001 North Soto Street, Office 302-02, Los Angeles, CA, 90089-9034, USA.
| | - Steven R H Beach
- Center for Family Research, University of Georgia, 1095 College Station Road, Athens, GA, 30602-4527, USA.
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 101 Woodruff Circle, Suite 4217, Atlanta, GA, 30322, USA.
| | - Shota Nishitani
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 101 Woodruff Circle, Suite 4217, Atlanta, GA, 30322, USA.
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Acevedo A, Panas L, Garnick D, Acevedo-Garcia D, Miles J, Ritter G, Campbell K. Disparities in the Treatment of Substance Use Disorders: Does Where You Live Matter? J Behav Health Serv Res 2018; 45:533-549. [PMID: 29435862 PMCID: PMC6087681 DOI: 10.1007/s11414-018-9586-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study focused on (1) whether disparities in timely receipt of substance use services can be explained in part by the characteristics of the community in which the clients reside and (2) whether the effect of community characteristics on timely receipt of services was similar across racial/ethnic groups. The sample was composed of adults receiving publicly funded outpatient treatment in Washington State. Treatment data were linked to data from the US census. The outcome studied was "Initiation and Engagement" in treatment (IET), a measure noting timely receipt of services at the beginning of treatment. Community characteristics studied included community level economic disadvantage and concentration of American Indian, Latino, and Black residents in the community. Black and American Indian clients were less likely to initiate or engage in treatment compared to non-Latino white clients, and American Indian clients living in economically disadvantaged communities were at even greater risk of not initiating treatment. Community economic disadvantage and racial/ethnic makeup of the community were associated with treatment initiation, but not engagement, although they did not entirely explain the disparities found in IET.
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Affiliation(s)
- Andrea Acevedo
- Department of Community Health, Tufts University, 574 Boston Avenue, Suite 208, Medford, MA, 02155, USA.
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA.
| | - Lee Panas
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA
| | - Deborah Garnick
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA
| | - Dolores Acevedo-Garcia
- Institute for Child Youth and Family Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA
| | - Jennifer Miles
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA
| | - Grant Ritter
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA
| | - Kevin Campbell
- Behavioral Health Administration, Washington State Department of Social and Health Services, P.O. Box 45330 (MS: 45330), Olympia, WA, 98504-5330, USA
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Metzger IW, Salami T, Carter S, Halliday-Boykins C, Anderson RE, Jernigan MM, Ritchwood T. African American emerging adults' experiences with racial discrimination and drinking habits: The moderating roles of perceived stress. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2018; 24:489-497. [PMID: 29975077 PMCID: PMC6188820 DOI: 10.1037/cdp0000204] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVES Despite the abundance of research aimed at quantifying the impact of racism on the mental and physical health of African Americans, results remain inconclusive largely because of challenges with operationalization, as well as conflation with the concept of racial discrimination, which may be more readily assessed. The purpose of the current study was to: (a) determine whether racial discrimination had an impact on the degree of alcohol use and binge drinking among African American emerging adults, and if so, (b) determine whether perceived stress linked to racially discriminatory experiences moderated these associations. METHOD We used a series of hierarchical regressions to examine associations among racial discrimination, perceived stress, and degree of alcohol consumption in a sample of African American emerging adults in the southeast (n = 235). RESULTS We found that the association between racial discrimination and degree of alcohol consumption (alcohol use and binge drinking) was strongest among individuals who reported greater levels of perceived stress linked to racial discrimination experiences. This association, however, was not significant for individuals who reported lower levels of perceived stress in response to racial discrimination. CONCLUSIONS African Americans who experience a high degree of perceived stress in response to experiences with racial discrimination may be at greater risk for problem drinking than their peers with less perceived stress. These findings highlight the need for novel intervention efforts aimed at mitigating the effects of stress and racial discrimination on health outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Isha W. Metzger
- Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA 30602
| | - Temilola Salami
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Sierra Carter
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Colleen Halliday-Boykins
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, 2nd Floor, IOP South Building, Charleston, SC 29425
| | - Riana Elyse Anderson
- University of Pennsylvania, Applied Psychology, 3720 Walnut Street, Suite B17, Philadelphia, PA 1904
| | - Maryam M. Jernigan
- University of Saint Joseph, Department of Psychology, 1678 Asylum Avenue, West Hartford, CT 06117
| | - Tiarney Ritchwood
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, 2nd Floor, IOP South Building, Charleston, SC 29425
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St, Charleston, SC 29425
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Vaughan EL, Wright LA, Cano MÁ, de Dios MA. Gender as a Moderator of Descriptive Norms and Substance Use among Latino College Students. Subst Use Misuse 2018. [PMID: 29528765 DOI: 10.1080/10826084.2018.1441305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study addresses gaps in the literature by testing gender differences in the associations between substance use norms and substance use among Latino college students. Secondary data analysis was conducted using data from the 2009 National College Health Assessment. Participants selected for this study were 4,336 Latino undergraduates. Linear mixed modeling was used to test gender as a moderator of the relationship between alcohol use norms and alcohol use as well as marijuana use norms and marijuana use. Results indicated that the strength of the relationships between norms and substance use was stronger for males than for females. Substance use rates and gender roles differ for Latinos and Latinas and may partially account for the stronger relationship between these constructs for males. Implications for future research and prevention are discussed.
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Affiliation(s)
- Ellen L Vaughan
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Lauren A Wright
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Miguel Ángel Cano
- b Department of Epidemiology , Florida International University , Miami , Florida , USA
| | - Marcel A de Dios
- c Department of Psychological, Health, and Learning Sciences , College of Education, University of Houston , Houston , Texas , USA
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Mikhail JN, Nemeth LS, Mueller M, Pope C, NeSmith EG. The Social Determinants of Trauma: A Trauma Disparities Scoping Review and Framework. J Trauma Nurs 2018; 25:266-281. [DOI: 10.1097/jtn.0000000000000388] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Terry-McElrath YM, Patrick ME. U.S. adolescent alcohol use by race/ethnicity: Consumption and perceived need to reduce/stop use. J Ethn Subst Abuse 2018; 19:3-27. [PMID: 29452060 DOI: 10.1080/15332640.2018.1433094] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Understanding racial/ethnic drinking patterns and service provision preferences is critical for deciding how best to use limited alcohol prevention, intervention, and treatment resources. We used nationally representative data from 150,727 U.S. high school seniors from 2005 to 2016 to examine differences in a range of alcohol use behaviors and the felt need to reduce or stop alcohol use based on detailed racial/ethnic categories, both before and after controlling for key risk/protective factors. Native students reported particularly high use but corresponding high felt need to reduce/stop use. White and dual-endorsement students reported high use but low felt need to stop/reduce alcohol use.
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Gerrard M, Gibbons FX, Fleischli ME, Cutrona CE, Stock ML. Moderation of the effects of discrimination-induced affective responses on health outcomes. Psychol Health 2018; 33:193-212. [PMID: 28436272 PMCID: PMC6145071 DOI: 10.1080/08870446.2017.1314479] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The goal of the study was to examine differential mediation of long-term effects of discrimination on health behaviour and health status by internalising (anxiety and depression) and externalising (hostility and anger), and to explore moderation of these effects, specifically, by the presence of support networks and coping tendencies. DESIGN The current analyses employed structural equation modelling of five waves of data from Black female participants of the Family and Community Health Study over 11 years (M age 37-48). MAIN OUTCOMES MEASURES The main outcome variables were health status and alcohol use (frequency and problematic consumption). RESULTS Perceived racial discrimination was associated with increases in internalising and externalising. In addition, internalising reactions to discrimination were associated with deterioration in health status and increases in problematic drinking; externalising reactions were associated with increases in frequency of drinking. These relations were attenuated by availability of support networks, and exacerbated by use of avoidance coping. CONCLUSION The current study (a) replicated previous research suggesting that two different types of affective reactions mediate the relations between perceived racial discrimination and physical health status vs. health-impairing behaviours: internalising and externalising, and (b) revealed moderation of these effects by coping mechanisms.
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Affiliation(s)
- Meg Gerrard
- a Department of Psychological Sciences and Institute for Collaboration on Health, Intervention and Policy (InChip) , University of Connecticut , Storrs , CT , USA
| | - Frederick X Gibbons
- a Department of Psychological Sciences and Institute for Collaboration on Health, Intervention and Policy (InChip) , University of Connecticut , Storrs , CT , USA
| | - Mary E Fleischli
- b Institute for Collaboration on Health, Intervention and Policy (InChip) , University of Connecticut , Storrs , CT , USA
| | - Carolyn E Cutrona
- c Department of Psychology , Iowa State University , Ames , IA , USA
| | - Michelle L Stock
- d Department of Psychology , The George Washington University , Washington , DC , USA
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Socioeconomic disparities in the thoracic trauma population. J Surg Res 2017; 224:160-165. [PMID: 29506834 DOI: 10.1016/j.jss.2017.11.071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/27/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Health-care disparities based on socioeconomic status have been well documented in the trauma literature; however, there is a paucity of data on how these factors affect outcomes in patients experiencing severe thoracic trauma. This study aims to identify the effect of insurance status and race on patient mortality and disposition after thoracic trauma. METHODS The National Trauma Data Bank was queried from 2007 to 2012 for patients with sternal fractures, rib fractures, and flailed chest. Demographics data were examined for the cohort based on insurance status. Univariate and multivariate logistic regression models were used, controlling for patient comorbidities, age, injury severity score, and associated injuries, to determine the impact of race and insurance status on length of stay, mortality, and discharge disposition. RESULTS A total of 152,655 thoracic traumas were included in our analysis. As compared to privately insured patients, uninsured patients with thoracic trauma were 1.9 times more likely to die (odds ratio [OR]: 1.91, confidence interval [CI]: 1.76-2.09) and 4.6 times more likely to leave against medical advice (OR: 4.61, CI: 3.14-6.79). When compared to Caucasians, Hispanics had slightly higher in-hospital mortality (OR: 1.14, CI: 1.02-1.27), but there was no survival difference seen in black patients (OR: 0.95, CI: 0.86-1.05). CONCLUSIONS Insurance status appears to have a more significant effect on thoracic trauma patient outcomes than race, but substantial socioeconomic disparities were seen in this patient population. Further studies are needed to show reproducibility of our findings and to investigate the impact of universal health care and expansion of insurance availability on thoracic trauma outcomes. LEVEL OF EVIDENCE Level 3, economic/decision.
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Cherpitel CJ, Ye Y, Kerr WC. Risk of Past Year Injury Related to Hours of Exposure to an Elevated Blood Alcohol Concentration and Average Monthly Alcohol Volume: Data from 4 National Alcohol Surveys (2000 to 2015). Alcohol Clin Exp Res 2017; 42:360-368. [PMID: 29160960 DOI: 10.1111/acer.13561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/14/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND While a strong association exists between alcohol and injury in emergency department (ED) studies, these studies are not representative of the general population. METHODS The association of injury with the number of hours of exposure to a blood alcohol concentration (BAC) ≥ 0.05 and average monthly volume in drinks, both based on self-report of quantity and frequency of drinking in the last year, in a merged sample of respondents (n = 29,571) from 4 U.S. National Alcohol Surveys (2000 to 2015) are analyzed. Risk curves based on categorical step function and fractional polynomial modeling were analyzed separately by gender, and by age and race/ethnicity for males. RESULTS Risk of injury increased at 1 hour of a BAC exposure of ≥ 0.05 and at an average monthly volume of 1 drink. Risk of injury for spirits increased to an average daily volume of 1 drink, but no association was found for injury risk and average volume for either wine or beer. Risk of injury increased with both exposure hours and monthly volume among males, but little association was found for either consumption measure with risk of injury for females. Among males, increased risk of injury was greater for whites than for blacks or Hispanics for BAC exposure; Hispanics showed a continued elevated risk up to 8 hours of exposure. After peaking at a monthly volume of 1 drink, injury risk decreased substantially for blacks, but was more gradual for whites, while risk increased very slightly for Hispanics to about 4 drinks per day. Males aged 18 to 29 showed the largest increase in risk associated with the number of hours of exposure to a BAC of ≥0.05, with risk doubling at 1 hour of exposure, but subsequently falling. CONCLUSIONS While findings here are weaker than those from ED studies and likely due to the context of drinking, risk of injury appears to increase at relatively low levels of consumption, suggesting the importance of preventive efforts to reduce injury not only for heavier drinkers but also for more moderate drinkers.
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Affiliation(s)
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California
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Ransome Y, Slopen N, Karlsson O, Williams DR. The association between alcohol abuse and neuroendocrine system dysregulation: Race differences in a National sample. Brain Behav Immun 2017; 66:313-321. [PMID: 28751021 PMCID: PMC5671340 DOI: 10.1016/j.bbi.2017.07.154] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/01/2017] [Accepted: 07/23/2017] [Indexed: 02/07/2023] Open
Abstract
Health outcomes, including chronic disease and mortality, attributed to or associated with alcohol abuse are discrepant between African Americans and Whites. To date, the topic is not fully understood and few studies conducted have used biomarker indicators of health. We investigated whether the association between alcohol abuse and biomarkers of the neuroendocrine system vary between black or African American and White respondents aged 34-84 from the Midlife in the United States Study (MIDUS) II (2004-2006) (n=1129). Alcohol abuse was assessed with a modified version of the Michigan Alcohol Screening Test. Ordinary least squared (OLS) regression was used to evaluate whether race moderated the associations between alcohol abuse and four biomarkers-urinary cortisol and serum dehydroepiandrosterone sulfate (DHEA-S), epinephrine and norepinephrine-and two composite summary scores, each consisting of two components that characterize the hypothalamic pituitary adrenal (HPA)-axis and sympathetic nervous systems (SNS), respectively. Covariates included age, sex, education, income, current drinking, smoking, exercise, fast food consumption, heart disease, blood pressure, diabetes, body mass index, medication use, anxiety/depression, sleep duration, and cholesterol markers. Race significantly moderated the associations between alcohol abuse and norepinephrine concentration (χ2 [1]=4.48, p=0.034) and the SNS composite score (χ2 [1]=5.83, p=0.016). Alcohol abuse was associated with higher mean norepinephrine levels (b=0.26, standard error (SE)=0.12, p=0.034) and SNS composite score (b=0.23, SE=0.11, p=0.016) for African Americans compared to Whites. Interestingly, for Whites a paradoxical association between alcohol abuse, norepinephrine and SNS levels was observed; those who abused alcohol had lower mean norepinephrine levels than non-abusers. Race differences in neuroendocrine response could be biological pathways that contribute the excess risk of chronic disease and mortality attributed to alcohol abuse among African Americans compared to Whites. Replication of these analyses in larger cohorts are warranted in addition to further studies of underlying mechanisms among Blacks and Whites separately.
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Affiliation(s)
| | | | - Oskar Karlsson
- Harvard T.H. Chan School of Public Health, USA,Center for Molecular Medicine, Karolinska Institute, Sweden and Uppsala University, Sweden
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Wallisch L, Zemore SE, Cherpitel CJ, Borges G. Wanting and Getting Help for Substance Problems on Both Sides of the US-Mexico Border. J Immigr Minor Health 2017; 19:1174-1185. [PMID: 27286883 PMCID: PMC5149114 DOI: 10.1007/s10903-016-0442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The US-Mexico border presents potential cultural and logistic barriers to obtaining substance abuse treatment. We compare the prevalence and correlates of wanting and getting help between border and non-border residents in both the US and Mexico. Data come from the 2011 to 2012 US-Mexico Study on Alcohol and Related Conditions which surveyed 3214 border and 1582 non-border residents in the US and Mexico. Multivariate logistic regressions estimate the effect of border residence on desire for and receipt of help. In both countries, border substance users were about half as likely as nonborder substance users to have wanted or obtained any kind of help, independent of predisposing, need and enabling factors, including migration status. Among those desiring help, however, about half had obtained it, both on and off the border in both countries. While substantial proportions of those who need help do not get it either on or off the border, lower motivation for treatment may be more important than access in explaining border/non-border differences. Future research should investigate whether there are border-specific barriers to wanting help, and how to minimize them.
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Affiliation(s)
- Lynn Wallisch
- Addiction Research Institute, The University of Texas at Austin, 1717 W. 6th Street, Suite 335, Austin, TX, 78703, USA.
| | - Sarah E Zemore
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA, 94608, USA
| | - Cheryl J Cherpitel
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA, 94608, USA
| | - Guilherme Borges
- Instituto Nacional de Psiquiatría, Universidad Autónoma Metropolitana, Calzada México Xochimilco, No. 101, Col. San Lorenzo Huipulco, C.P. 14370, Mexico, DF, Mexico
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Cano MÁ, de Dios MA, Correa-Fernández V, Childress S, Abrams JL, Roncancio AM. Depressive symptom domains and alcohol use severity among Hispanic emerging adults: Examining moderating effects of gender. Addict Behav 2017; 72:72-78. [PMID: 28371697 DOI: 10.1016/j.addbeh.2017.03.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 03/06/2017] [Accepted: 03/21/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE A limited amount of research has examined the effects of unique depressive symptom domains on alcohol use behavior among Hispanics of any developmental stage. This study aimed to (a) examine the respective associations between depressive symptom domains (e.g., negative affect, anhedonia, interpersonal problems, and somatic complaints) and alcohol use severity among Hispanic emerging adults, and (b) examine if gender moderates each respective association. METHOD 181 Hispanic emerging adults (ages 18-25) completed an anonymous cross-sectional online survey. Participants completed a demographic questionnaire, the Alcohol Use Disorder Identification Test, and the Center Epidemiological Studies Depression Scale. Hierarchical multiple regression was used to estimate respective associations of negative affect, anhedonia, interpersonal problems, and somatic complaints in relation to alcohol use severity. Moderation tests were also conducted to examine if gender functioned as an effect modifier between respective depressive symptom domains and alcohol use severity. RESULTS Findings indicated higher levels of anhedonia were associated with higher alcohol use severity (β=0.20, p=0.02). Moderation analyses indicated that somatic complaints (β=-0.41, p=0.02) and interpersonal problems were associated with greater alcohol use severity among men (β=-0.60, p<0.001), but not women. CONCLUSIONS Findings underscore the need to examine the relationship between specific depressive symptom domains and alcohol use; and the importance of accounting for potential gender differences in these associations.
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Affiliation(s)
| | - Marcel A de Dios
- The University of Texas MD Anderson Cancer Center, United States
| | | | - Sarah Childress
- The University of Texas MD Anderson Cancer Center, United States
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Komro KA, Livingston MD, Garrett BA, Boyd ML. Similarities in the Etiology of Alcohol Use Among Native American and Non-Native Young Women. J Stud Alcohol Drugs 2017; 77:782-91. [PMID: 27588537 DOI: 10.15288/jsad.2016.77.782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined social-and individual-level factors associated with alcohol use among young women and tested whether differences exist between Native American and non-Native young women. METHOD School-based surveys were conducted among 952 young women (ages 14-19) attending four high schools within the tribal jurisdictional service area of the Cherokee Nation in northeastern Oklahoma. Structural equation modeling using Mplus was used to assess the direct and indirect effects of social-and individual-level factors on subsequent alcohol use among Native and non-Native young women. RESULTS We found no differences in the level of risk and protective factors among Native and non-Native young women. Among Native and non-Native young women, alcohol access, parental communication, and best friends' alcohol use had statistically significant direct and/or indirect effects on alcohol use. Indirect effects were mediated through alcohol expectancies and norms. A history of alcohol problems by an adult in the household and depression were not retained as independent risk factors in either model. CONCLUSIONS We found more similarities than differences in level of and relations to alcohol use among social and individual risk and protective factors between Native American and non-Native young women from northeastern Oklahoma. The results provide support for universal prevention strategies, suggesting the importance of increasing perceptions that it is difficult to obtain alcohol and increasing parent-child communication.
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Affiliation(s)
- Kelli A Komro
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Melvin D Livingston
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
| | - Brady A Garrett
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Cherokee Nation Behavioral Health, Tahlequah, Oklahoma
| | - Misty L Boyd
- Cherokee Nation Behavioral Health, Tahlequah, Oklahoma
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