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Tomas CW, Timmer-Murillo S, Kallies KJ, Snowden AJ, Borisy-Rudin F, Busalacchi M, Mackenzie R, Kostelac CA, Cassidy LD, deRoon-Cassini TA. Examining the role of social vulnerability, neighborhood characteristics, and geospatial patterns of firearm-related injuries and clinical outcomes in Milwaukee county. Soc Sci Med 2024; 352:117035. [PMID: 38850675 DOI: 10.1016/j.socscimed.2024.117035] [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: 02/22/2024] [Revised: 04/17/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Previous work has shown socioenvironmental factors can influence firearm injury. Milwaukee County, Wisconsin is a diverse midwestern county with historic disinvestment in marginalized communities yielding stark segregation along racial and ethnic lines. It is also one of the many U.S. counties burdened by surging firearm injuries. The differences among communities within Milwaukee County provides a unique opportunity to explore the intersection of socioenvironmental factors that may affect clinical outcomes and geospatial patterns of firearm injury. METHODS The trauma registry from the regional adult level 1 trauma center was queried for patients who sustained a firearm-related injury from 2015 to 2022 (N = 2402). The Social Vulnerability Index (SVI) ranking was derived using patient residence addresses to evaluate its association with traumatic injury clinical outcomes (i.e., in-hospital mortality, length of hospital stay, ICU or ventilator treatment, or injury severity score) and risk screening results for alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and depression. We evaluated hotspots of firearm injury density over time for patient residences and injury locations and distances between locations. A spatially lagged regression model tested the association between firearm injury density and SVI domains, alcohol outlet types, and park coverage. RESULTS Most firearm injury patients were younger, male, racial or ethnic minorities from disadvantaged neighborhoods (SVI total; M = 0.86, SD = 0.15). SVI was not associated with any clinical outcomes. Of those screened, 12.9% screened positive for AUD and 44.5% screened at risk for PTSD, depression, or both. Hotspot analysis indicated consistent concentrations of firearm injury density. There were no differences in clinical outcomes between those injured inside or outside the home. Census tracts with lower socioeconomic status, greater off-premises and lower on-premises alcohol outlet density were associated with greater firearm injury density. CONCLUSIONS In Milwaukee County, firearm injury patients are injured in and often return to the same disadvantaged neighborhoods that may hamper recovery. Results replicate and expand previous work and implicate specific socioenvironmental factors for intervention and prevention of firearm injury.
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Affiliation(s)
- C W Tomas
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, USA; Comprehensive Injury Center, Medical College of Wisconsin, USA.
| | - S Timmer-Murillo
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, USA
| | - K J Kallies
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, USA
| | - A J Snowden
- Department of Social and Cultural Sciences, Marquette University, USA
| | - F Borisy-Rudin
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, USA; Wisconsin Alcohol Policy Project, Comprehensive Injury Center, Medical College of Wisconsin, USA
| | - M Busalacchi
- Wisconsin Alcohol Policy Project, Comprehensive Injury Center, Medical College of Wisconsin, USA
| | - R Mackenzie
- Comprehensive Injury Center, Medical College of Wisconsin, USA
| | - C A Kostelac
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, USA; Comprehensive Injury Center, Medical College of Wisconsin, USA
| | - L D Cassidy
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, USA
| | - T A deRoon-Cassini
- Comprehensive Injury Center, Medical College of Wisconsin, USA; Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, USA
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Druffner N, Egan D, Ramamurthy S, O'Brien J, Davis AF, Jack J, Symester D, Thomas K, Palka JM, Thakkar VJ, Brown ES. IQ in high school as a predictor of midlife alcohol drinking patterns. Alcohol Alcohol 2024; 59:agae035. [PMID: 38804536 DOI: 10.1093/alcalc/agae035] [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: 06/28/2023] [Revised: 04/27/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
AIMS The aim of the present study was to assess the relationship between adolescent IQ and midlife alcohol use and to explore possible mediators of this relationship. METHODS Study data were from 6300 men and women who participated in the Wisconsin Longitudinal Study of high-school students graduating in 1957. IQ scores were collected during the participants' junior year of high school. In 2004, participants reported the number of alcoholic beverages consumed (past 30 days) and the number of binge-drinking episodes. A multinomial logistic regression was conducted to determine the relationship between adolescent IQ and future drinking pattern (abstainer, moderate drinker, or heavy drinker), and Poisson regression was used to examine the number of binge-drinking episodes. Two mediators-income and education-were also explored. RESULTS Every one-point increase in IQ score was associated with a 1.6% increase in the likelihood of reporting moderate or heavy drinking as compared to abstinence. Those with higher IQ scores also had significantly fewer binge-drinking episodes. Household income, but not education, partially mediated the relationship between IQ and drinking pattern. CONCLUSIONS The present study suggests that higher adolescent IQ may predict a higher likelihood of moderate or heavy drinking in midlife, but fewer binge-drinking episodes. The study also suggests that this relationship is mediated by other psychosocial factors, specifically income, prompting future exploration of mediators in subsequent studies.
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Affiliation(s)
- Natalie Druffner
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Donald Egan
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Swetha Ramamurthy
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Justin O'Brien
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Allyson Folsom Davis
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Jasmine Jack
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Diona Symester
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Kelston Thomas
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Jayme M Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Vishal J Thakkar
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Edson Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
- The Altshuler Center for Education & Research, Metrocare Services, 1345 River Bend Dr, Suite 200, Dallas, Texas, 75247, United States
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Gruenewald PJ, Sumetsky N, Mair C, Lee JP, Ponicki WR. Micro-temporal analyses of crime related to alcohol outlets: A comparison of outcomes over weekday, weekend, daytime and nighttime hours. Drug Alcohol Rev 2023; 42:902-911. [PMID: 36989160 PMCID: PMC10273326 DOI: 10.1111/dar.13644] [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: 05/24/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Causal relationships between alcohol outlets and crime are inferred from their statistical associations across neighbourhoods. However, many unobserved covariates may confound these effects. Recognising that outlet sales vary by time of day and day of week, we assess whether areas with more bars/pubs, restaurants or off-premise outlets have more crime during days and times when alcohol sales are greatest. METHODS Annual administrative crime counts, sociodemographic data and other area characteristics of 336 Census block groups in Oakland, California, USA, were related to outlet densities from 2000 to 2015. Bayesian space-time Poisson models were used to measure associations between outlet densities and crime during: (i) weekday daytime; (ii) weekday nighttime; (iii) weekend daytime; and (iv) weekend nighttime periods (four seemingly unrelated equations). Comparisons of parameter estimates across equations provided an assessment of outlet effects on crime across days and times within the same analysis units using the same constellation of confounding covariates. RESULTS Assault and driving under the influence crime incidents during weekend evening hours were more frequent in Census block group areas with greater numbers of bar/pubs. Burglaries were consistently greater in areas with greater densities of restaurants. DISCUSSION AND CONCLUSIONS The spatiotemporal signature relating densities of bars/pubs over weekend evening hours to assault and driving under the influence incidents suggests that these outlets are a critical source of these crimes across neighbourhoods. Prevention programs and policies that focus upon specific drinking establishments, days and times may be most effective in reducing assault and impaired driving incidents in neighbourhoods.
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Affiliation(s)
- Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences,
University of Pittsburgh School of Public Health, Pittsburgh, USA
- Department of Epidemiology, University of Pittsburgh School
of Public Health, Pittsburgh, USA
- Center for Social Dynamics and Community Health, University
of Pittsburgh School of Public Health, Pittsburgh, USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences,
University of Pittsburgh School of Public Health, Pittsburgh, USA
- Department of Epidemiology, University of Pittsburgh School
of Public Health, Pittsburgh, USA
- Center for Social Dynamics and Community Health, University
of Pittsburgh School of Public Health, Pittsburgh, USA
| | - Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, USA
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, USA
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Sumetsky N, Frankeberger J, Coulter RWS, Burke JG, Friedman MR, Mair C. Mental Health and Alcohol Use during and before the Early Phases of the COVID-19 Pandemic. Behav Med 2023; 49:195-203. [PMID: 35000570 PMCID: PMC9289939 DOI: 10.1080/08964289.2021.2015278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022]
Abstract
The early phases of the coronavirus 19 disease (COVID-19) pandemic were associated with changes in psychological well-being and alcohol use. However, it is unclear whether these changes are artifacts of psychological well-being and alcohol use prior to the pandemic across different sociodemographic groups. We received surveys from 247 adult residents of Allegheny County, Pennsylvania (United States), with an oversampling of sexual- and gender-minority individuals. Responses included measures of psychological well-being, substance use, and sociodemographic characteristics. Unadjusted mean depression scores, anxiety scores, and number of drinking days increased for all age and income groups during COVID-19, while average number of drinks per drinking day and days intoxicated differentially increased or decreased by age and income groups. Using Bayesian seemingly unrelated regression, we assessed depression and anxiety symptoms and alcohol use during the early stages of the pandemic and one month before COVID-19 was first identified in Allegheny County concurrently. Those in the youngest (18-24) group drank on more days during (but not before) the pandemic than those in the 25-44 age group. Compared to cisgender women, gender-minority adults had higher depression scores during the early stages of the pandemic. Employed adults had lower anxiety scores during (but not before) the pandemic than adults who were unemployed. Those with past-year annual incomes above $80,000 had fewer drinks on average drinking occasions than those in the $40,000 or below group before (but not during) the pandemic. Patterns of psychological distress and alcohol use associated with the COVID-19 pandemic differ by subgroup compared to patterns prior to the pandemic. Interventions addressing worsening mental health outcomes and shifting alcohol use patterns must be sensitive to the needs of vulnerable groups, such as younger adults and those experiencing poverty or unemployment.
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Affiliation(s)
- Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
| | - Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
| | - Robert W. S. Coulter
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
- Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health
| | - Jessica G. Burke
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
| | - M. Reuel Friedman
- Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
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Phillips AZ, Mulia N, Subbaraman MS, Kershaw KN, Kerr WC, Karriker-Jaffe KJ. Does the relationship between alcohol retail environment and alcohol outcomes vary by depressive symptoms? Findings from a U.S. Survey of Black, Hispanic and White drinkers. Addict Behav 2023; 136:107463. [PMID: 36029722 DOI: 10.1016/j.addbeh.2022.107463] [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: 10/24/2021] [Revised: 07/19/2022] [Accepted: 08/08/2022] [Indexed: 02/03/2023]
Abstract
AIMS To assess whether associations between alcohol availability and consumption, drinking to drunkenness, and negative drinking consequences vary among individuals with elevated depressive symptoms. METHODS 10,482 current drinkers in 2005-2015 National Alcohol Surveys (50.0% female; 74.4% White, 8.7% Black, 11.1% Hispanic). Elevated depressive symptoms was defined as having symptoms suggestive of major depressive disorder (above CES-D8/PHQ-2 cut-offs) versus no/sub-threshold symptoms (below cut-offs). Inverse probability of treatment weighted and covariate adjusted Poisson models with robust standard errors estimated associations of ZIP-code bar density and off-premise outlet density (locations/1,000 residents), elevated depressive symptoms, and their interaction with past-year volume consumed, monthly drinking to drunkenness, and negative drinking consequences. Models were then stratified by sex and race and ethnicity. RESULTS Overall, 13.7% of respondents had elevated depressive symptoms. Regarding density, the only statistically significant association observed was between off-premise density and volume consumed (rate ratio = 1.3, 95% confidence interval = 1.0, 1.7). Elevated depressive symptoms were associated with higher volume consumed, prevalence of drinking to drunkenness, and prevalence of negative consequences when controlling for off-premise density or bar density. However, there was no evidence of interaction between symptoms and density in the full sample nor among subgroups. CONCLUSION This study suggests that, while elevated depressive symptoms do not alter associations between alcohol availability and alcohol use and problems, they remain associated with these outcomes among past-year drinkers in a U.S. general population sample even when accounting for differential availability. Addressing depressive symptoms should be considered along with other policies to reduce population-level drinking and alcohol problems.
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Affiliation(s)
- Aryn Z Phillips
- Northwestern University Feinberg School of Medicine, 680 N. Lakeshore Drive Suite 1400, Chicago IL 60611, USA.
| | - Nina Mulia
- Alcohol Research Group, 6001 Shellmound St. #450, Emeryville, CA 94608, USA
| | | | - Kiarri N Kershaw
- Northwestern University Feinberg School of Medicine, 680 N. Lakeshore Drive Suite 1400, Chicago IL 60611, USA
| | - William C Kerr
- Alcohol Research Group, 6001 Shellmound St. #450, Emeryville, CA 94608, USA
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Sadler RC, Trangenstein P, Harris A, Buchalski Z, Wojciechowski TW, Furr-Holden CD. Establishing the Relative Accuracy of Using City Directories as Proxies to Define and Reconstruct Historical Alcohol Environments. J Stud Alcohol Drugs 2023; 84:158-170. [PMID: 36799686 PMCID: PMC9948143 DOI: 10.15288/jsad.21-00374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Research on alcohol environments has established that poorer and minoritized communities are frequently overburdened by off-premise outlets (e.g., liquor stores). These outlets have more associated harms, including increased alcohol consumption and crime rates. Little, if any, research has shown how these socio-spatial disparities in exposure have grown or shifted over time, and no studies have established a method for re-creating historical alcohol environments. METHOD Our results suggest that in our study city of Flint, MI, disparities in the alcohol environment have narrowed since 1950. Although liquor stores are still more likely to be located in poorer and more heavily African American neighborhoods, the pattern has become insignificant over time. Furthermore, the number of alcohol outlets per capita has declined. Thus, although the city remains more overburdened with alcohol outlets than its suburbs, the disparity has shrunk. CONCLUSIONS This work has implications for those working in alcohol prevention and policy, as well as in urban planning. Practitioners and researchers can use this method to model alcohol availability over time in their own communities, which helps better inform the discussion on disparities experienced in poor and minoritized neighborhoods.
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Affiliation(s)
- Richard Casey Sadler
- Department of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | | | - Alan Harris
- Department of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | - Zachary Buchalski
- Department of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | | | - C. Debra Furr-Holden
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
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Alcohol Consumption Patterns: A Systematic Review of Demographic and Sociocultural Influencing Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138103. [PMID: 35805782 PMCID: PMC9265892 DOI: 10.3390/ijerph19138103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
Background: Excessive alcohol consumption has negative effects not only on the drinkers’ health but also on others around them. Previous studies suggest that excessive alcohol consumption can be related to a combination of factors such as age, family background, religiosity, etc. Investigating and clarifying these roots of alcohol consumption is crucial so that the right type of interventions can be designed in a specific and targeted manner. Objectives: This work was conducted as a systematic review to reveal the factors associated with alcohol consumption and to heighten the understanding of the differences among various communities and segments of the population regarding their usage of alcohol. Data sources: A systematic search of Web of Science, PubMed, ScienceDirect, and Google Scholar was performed. Results: Forty-five studies were included in the review after excluding irrelevant records and duplicates. Conclusions: Alcohol consumption patterns can be associated with several factors related to communities and individuals, and our review revealed demographic factors, including age and proximity to alcohol outlets, as well as social factors, including family background, socioeconomic background, and religious influence. These findings can be used to establish a guideline for further studies in understanding alcohol consumption patterns among individuals according to their personal characteristics and sociocultural backgrounds.
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Freisthler B, Wernekinck U. Examining how the geographic availability of alcohol within residential neighborhoods, activity spaces, and destination nodes is related to alcohol use by parents of young children. Drug Alcohol Depend 2022; 233:109352. [PMID: 35176631 PMCID: PMC8957591 DOI: 10.1016/j.drugalcdep.2022.109352] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alcohol outlet density and drinking behaviors have been assessed based on where people live, but exposure may differ based on where people spend time. We assessed the relationship between alcohol outlet density (using three measures of geographic availability), frequency of use, and continued volume of alcohol among parents. Parents are a unique population of drinkers where the risk for harm to others can be higher as they are caring for minor children. METHODS We conducted a cross-sectional telephone and web-based survey of 1599 parents in 2015 across 30 cities in California. Participants provided information on drinking, residential addresses, and locations of daily activities. We created three measures of alcohol availability using residential neighborhoods, convex hull polygons, and destination nodes. Data were analyzed using zero-inflated negative binomial models. RESULTS Density of bars in residential neighborhoods were related to more frequent drinking (b = 0.0139, 95% CI = 0.0016, 0.0261) and higher continued volume (b = 0.0295, 95% CI = 0.0067, 0.0522). Density of bars (b = 0.0070, 95% CI = 0.0019, 0.0121) and restaurants (b = 0.0018, 95% CI = 0.0003, 0.0033) in destination nodes were related to drinking a higher continued volume of alcohol. Higher off-premise outlet density was related to a lower continued volume (b = -0.0026, 95% CI = -0.0049, -0.0002). CONCLUSIONS Outlet densities in residential neighborhood and destination nodes are related to frequency of drinking and continued volume of alcohol. Future work should seek to determine why and how residential neighborhoods and nodes are related to alcohol use behaviors and if they differ for parents compared to other adults.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210, USA.
| | - Uwe Wernekinck
- College of Social Work, The Ohio State University, 1947 College Rd. N, Columbus, OH 43210, USA.
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Wang-Schweig M, Gruenewald PJ, Gaidus A, Ponicki WR. Ethnic density effect on alcohol-related hospitalizations among Chinese enclaves and ethnoburbs in California, 2007-2011. Drug Alcohol Depend 2022; 232:109276. [PMID: 35077958 PMCID: PMC9128625 DOI: 10.1016/j.drugalcdep.2022.109276] [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: 03/15/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Research suggests there is an 'ethnic density effect' whereby racial/ethnic minority populations appear healthier when they reside in neighborhoods with greater numbers of people from the same ethnic group. The purpose of this study is to test whether this effect is observed for residents in Chinese enclaves (immigrant neighborhoods in urban areas) and ethnoburbs (immigrant neighborhoods in suburban areas) for measures on alcohol abuse and dependence. METHODS ZIP code areas of California that represented Chinese enclaves and ethnoburbs were identified and mapped. Spatial regression models were used to compare neighborhood-level effects, including the ethnic density of Chinese enclaves and ethnoburbs on observed rates of alcohol-related hospitalizations compared to the rest of California. Analyses used Bayesian Space-Time Misalignment Poisson models on the annual number of alcohol-related hospitalizations per ZIP code for the years 2007-2011 (n = 8488 space-by-time units). RESULTS Ethnic density effect appeared for residents of ZIP code areas with greater proportions of Chinese Americans (RR=0.986, 95% CI: 0.982, 0.990). After controlling for sociodemographic characteristics, residents of ZIP code areas representing Chinese enclaves had lower risks for alcohol-related hospitalizations (RR=0.766, 95% CI: 0.630, 0.927); hospitalizations among residents of Chinese ethnoburbs no longer differed from the rest of the state. Compared to Chinese enclaves, Chinese ethnoburbs had a lower poverty rate (p < .001), a greater English fluency rate (p = .002), and similar proportions of residents who were Chinese and foreign-born. CONCLUSION Despite the socioeconomic advantages of living in Chinese ethnoburbs, populations living in these neighborhoods experience more problems related to alcohol abuse and dependence.
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Affiliation(s)
- Meme Wang-Schweig
- Research Assistant Professor, Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, USA.
| | - Paul J Gruenewald
- Scientific Director, Senior Research Scientist, Prevention Research Center/PIRE, USA; Prevention Research Center, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704-1365, USA.
| | - Andrew Gaidus
- Research Associate, Prevention Research Center/PIRE, USA; Prevention Research Center, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704-1365, USA.
| | - William R Ponicki
- Research Scientist, Prevention Research Center/PIRE, USA; Prevention Research Center, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704-1365, USA.
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10
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Alcohol Use Frequencies and Associated Problems Across Drinking Contexts. J Stud Alcohol Drugs 2022; 83:91-98. [PMID: 35040764 PMCID: PMC8819891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To better quantify the impact of specific on- and off-premise drinking contexts on population-level alcohol-related problems, we evaluated context-specific risks relative to frequency of use of each context. METHOD We surveyed 860 adult (21-100 years) past-year drinkers in the California East Bay, sampled in areas of high versus low median household income and off-premise alcohol outlet densities. We examined associations of context-specific drinking frequencies in seven on- and off-premise drinking locations with individual and area characteristics using negative binomial regression. Next, we used heteroscedastic ordered logistic regression to relate context-specific drinking frequencies and continued volumes to five drinking-related problems (Alcohol Use Disorders Identification Test scores, physiological problems, risky sex, social problems, and driving after drinking too much). To estimate population-level effects, we assessed drinking frequencies relative to mean past-year use of each drinking context. RESULTS Higher individual annual income (>$60,000) was associated with more frequent drinking in all on-premise drinking contexts (bars/clubs, restaurants, and stadiums). Heavier overall drinking was associated with drinking more frequently at bars. Drinking more frequently in respondents' own homes and heavier drinking at friends'/relatives' homes were associated with most drinking-related problems. The population-level effects of physiological problems and driving after drinking too much were highest for parties and friends'/relatives' homes, whereas that of risky sex outcomes was highest for bars. CONCLUSIONS Assessing context-specific risks related to heavy and/or frequent drinking, in combination with scaling these risks to determine population-level impacts, can help tailor interventions to reduce alcohol-related problems across different on- and off-premise contexts.
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11
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Frankeberger J, Gruenewald PJ, Sumetsky N, Lee JP, Ghanem L, Mair C. Dual Use of Off-Premise Outlets for Alcohol and Grocery Purchases: Results From the East Bay Neighborhoods Study. J Stud Alcohol Drugs 2021; 82:758-766. [PMID: 34762035 PMCID: PMC8819615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/28/2021] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Alcohol privatization efforts have enabled consumers in many states in the United States to purchase alcohol in a variety of off-premise outlets, including grocery stores. This study examines the dual use of outlets to purchase both alcohol and groceries and the extent to which dual use is related to individual income, neighborhood income, and local physical availability of alcohol. METHOD The East Bay Neighborhoods Study surveyed residents from 72 microecological neighborhoods across six cities in Alameda County, California. Eligible respondents who purchased alcohol in the last year (n = 707) were asked about the off-premise outlet in which they most often purchase alcohol. Purchasing behaviors within this outlet, including purchasing groceries and frequency of visits to the outlet, were assessed. Multilevel logistic regression and negative binomial models assessed outcomes. RESULTS Seventy-three percent of participants reported dual use of their most used outlet for groceries and alcohol. In adjusted models, dual use of the outlet was not associated with individual income, alcohol use, or neighborhood outlet density but was positively associated with neighborhood income and the number of outlet visits. After adjustment, dual use of the most used outlet was associated with 0.77 more visits per 28 days. CONCLUSIONS Results suggest that convenience and reduced time costs for purchasing alcohol encourage the dual use of outlets, particularly in high-income neighborhoods. Differences in the dual use of outlets and frequency in outlet use by neighborhood environments highlight the importance of understanding the role of alcohol availability in distinct neighborhood income and outlet-level contexts.
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Affiliation(s)
- Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Lina Ghanem
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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Lee JP, Ponicki W, Mair C, Gruenewald P, Ghanem L. What explains the concentration of off-premise alcohol outlets in Black neighborhoods? SSM Popul Health 2020; 12:100669. [PMID: 33102679 PMCID: PMC7576518 DOI: 10.1016/j.ssmph.2020.100669] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Greater availability of commercial alcohol is associated with increased alcohol use and related public health problems. Greater alcohol outlet density, a marker of alcohol availability, is associated with poorer and predominantly minority neighborhoods. However, poorer populations, African Americans, and Latinxs report using less alcohol compared to Whites and wealthier groups. We consider the role of structural racism in the social ecology of alcohol availability. Specifically we examine racist urban land use practices in the USA which became codified in the 1930s through Federal Home Owner Lending Corporation (HOLC) designations for assigning parcel values, known as "redlining." Redlining demarcated low-density residential zones for wealthy Whites which excluded poor and non-White people as well as certain businesses, including alcohol retailers. We assessed the impacts of historic redlining on present day risks for exposure to retail alcohol availability in urban Northern California. METHODS For six contiguous and demographically diverse Northern California cities we obtained digital renderings of HOLC maps (1937) which demarcated exclusions of people and businesses for 119 neighborhood areas across four land valuation zones. We then identified the most prevalent HOLC rating for each of 520 current Census block groups in the six cities, including a residual category for areas not rated by HOLC. We geolocated all current (2016) off-premise alcohol sales outlets operating in the six cities (N = 401). We used Bayesian spatial Poisson models to relate current alcohol outlet densities and Census-based estimates of neighborhood characteristics to historic HOLC classifications. RESULTS Spatial Poisson analyses found far greater contemporary off-premise outlet densities in the lowest-valued HOLC zones than in the highest (median relative rate [RR] 9.6, 95% CI 4.8-22.1). The lowest-valued HOLC zones were also characterized by far higher current percentages of both Black residents (RR 30.4, 95% CI 17.0-54.6) and Hispanic residents (RR 9.7, 95% CI 7.2-12.9). CONCLUSIONS Present day risks for exposure to retail alcohol availability were delimited by historic exclusionary land use practices. Current inequitable health risks may be founded on racist spatial projects of past decades.
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Affiliation(s)
- Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Ave #601, Berkeley, CA, 94704, USA
| | - William Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Ave #601, Berkeley, CA, 94704, USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Ave #601, Berkeley, CA, 94704, USA
| | - Lina Ghanem
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Ave #601, Berkeley, CA, 94704, USA
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