In this component we test hypotheses about the social ecological correlates of heavy drinking and alcohol use disorders (AUDs). We know little about the many problems that may be related to AUDs per se, and we know nothing about the community contexts that may accelerate or mitigate AUD-related problems, the critical social ecological question considered here. We propose to:
Specific Aim 1 : Develop and test a dynamic model of relationships between drinking, problems and AUD symptoms, Specific Aim 2: Use this model to assess ways in which drinking contexts and situations differentially affect problems among AUD vs. non-AUD drinkers, and Specific Aim 3: Begin to measure broader impacts that AUDs have on alcohol problems across communities in the US. We develop a mathematical model that summarizes dynamic relationships between drinking, problems and AUD symptoms. That model is used to predict and test statistical relationships between measures of these constructs using general population survey data from 3000 adult respondents 18 years of age and older in California. AUD symptoms are measured using items from the World Mental Health Organization Composite International Diagnostic Interview. A subsample of about 267 AUD and 534 non-AUD drinkers will be drawn from the population survey, matched by drinking pattern, gender and age, then administered three web-based surveys at 6-month intervals, including additional measures of use in drinking contexts, routine daily drinking activities and social network supports for drinking. Critically, the model developed in Specific Aim 1 enables us to make unbiased comparisons between groups. In order to characterize public health problems related to AUDs at the community level we assess spatial statistical relationships between AUD-related hospital discharge diagnoses (HDDs) and a spectrum of alcohol-related problems across ZIP codes in California and other states in the US. These analyses also provide support for two other research components of the Center: the assessment of impacts of Mexican border access to alcohol on AUD-related HDDs among young adult Hispanic drinkers (Component #4) and, in combination with other survey data generated in this component, the parameterization of simulation models of alcohol problems in cities in the state and, as possible, across the nation (Component #5). With our short-term goals of understanding and estimating the impacts of AUD on alcohol problems achieved, we can take on the long-term goal of providing communities with essential information on how prevention policies can be used effectively to reduce problems related to AUDs in their communities.
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