Alcohol-related problems, abuse and dependence are an important public health problem in Puerto Rico. Unfortunately, public health authorities on the island lack the epidemiological data on drinking and its consequences that are necessary to respond to these problems. To cover this gap in knowledge, this application proposes an in-depth household epidemiological survey of drinking among adults 18 years of age and older in San Juan, Puerto Rico (sample N=1,500). A set of four innovative aims is proposed, which together will examine social, familial and neighborhood factors associated with drinking and its consequences on the island. The proposed specific aims are: 1) To examine the influence of attitudes and expectancies about drinking and of family cohesion and support on the association between drinking and alcohol-related problems, and DSM-IV abuse and dependence;2) To examine the impact of the present economic recession on drinking behavior and associated consequences by examining the association between unemployment and underemployment, stress, depression, drinking, alcohol-related problems, abuse and dependence;3) Expanding aims 1 and 2 to examine the association between neighborhood collective efficacy (social cohesion and social control), neighborhood disadvantage (as represented by the census-level variables poverty, under education and unemployment), volume of drinking, binge drinking, and alcohol abuse and dependence;4) Given the specific cultural circumstances of Puerto Rico, some of which are described in aims 1, 2 and 3, above, test the cross-cultural applicability of the dimensionality of the newly proposed DSM-V substance use disorder criteria and examine the proportion and characteristics of diagnostic "orphans". Results from this study will greatly enhance the ability of treatment providers and prevention professionals to understand more about alcohol problems in Puerto Rico. The study will collect detailed epidemiological data on individual- and neighborhood-level predictors of drinking, alcohol-related problems, abuse and dependence. These data will be shared with public health professionals in Puerto Rico, which will enable these professionals to plan effective treatment responses as well as prevention strategies to address alcohol problems on the island. With this in mind, the research team is composed of researchers on the U.S. mainland and in Puerto Rico so that translational application of this research is enhanced. Finally, the knowledge produced will also be applicable to understanding drinking and its consequences among Puerto Ricans as well as other Hispanic groups on the U.S. mainland.
Heavy drinking and alcohol-related problems are a serious health and social problem in Puerto Rico;yet, there is a dearth of up-to-date epidemiological data on the social, familial and neighborhood factors that determine drinking and its consequences on the island. Knowledge about these factors is important for implementing prevention interventions at the individual and neighborhood level. This project will study this complex array of factors in a random household sample of Puerto Rican adults in the San Juan metropolitan area.