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一种理解酒精问题进出转变中种族/民族差异的生命历程方法。

A Life Course Approach to Understanding Racial/Ethnic Differences in Transitions Into and Out of Alcohol Problems.

作者信息

Lui Camillia K, Mulia Nina

机构信息

Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA, USA.

出版信息

Alcohol Alcohol. 2018 Jul 1;53(4):487-496. doi: 10.1093/alcalc/agy015.

Abstract

AIMS

Alcohol problems are most prevalent in young adulthood and decrease thereafter, but some studies find that racial/ethnic minorities have elevated alcohol risk beyond the 20s. This study examines racial/ethnic differences in the transitions into and out of alcohol problems, and whether these are explained by heavy drinking (HD), socioeconomic disadvantages and adult role transitions from the 20s to 30s.

SHORT SUMMARY

Racial/ethnic groups had similar risks for earlier onset and recurrence/persistence of alcohol problems, but Blacks were at significantly greater risk than Whites for later onset in the 30s. Cumulative poverty and heavy drinking explained away this disparity, and were risk factors for recurring/persistent problems.

METHODS

Using data from the US National Longitudinal Survey of Youth 1979-1994 waves (n = 6098), past-year alcohol problems were measured in 1989 (mean age = 28) and in 1994 (mean age = 33) among drinkers. Patterns of alcohol problems were categorized as no problems, earlier onset in 20s/offset in 30s, later onset in 30s, and recurrence or persistence (at both time points). Multinomial regression models adjusted for demographics, cumulative poverty, HD and timing of social role transitions (marital, parental).

RESULTS

Compared to Whites, Blacks and Hispanics had similar risks for earlier alcohol problems but greater risk for developing problems in their 30s (AORs = 1.69 and 1.27, respectively, for later onset versus no problems); however, only the Black-White disparity was statistically significant. This was eliminated after taking into account cumulative poverty and lifecourse HD. There were no racial/ethnic differences in risk for recurring/persistent alcohol problems, which were associated with greater cumulative poverty and HD.

CONCLUSIONS

While Whites appear to 'age out' of alcohol problems in their 30s, Blacks are at greater risk after young adulthood. These findings signal a need for interventions that target racial/ethnic minorities beyond young adulthood.

摘要

目的

酒精问题在青年期最为普遍,此后逐渐减少,但一些研究发现,少数族裔在20多岁之后面临的酒精风险有所升高。本研究探讨了酒精问题发生和缓解过程中的种族/族裔差异,以及这些差异是否可以通过大量饮酒、社会经济劣势以及从20多岁到30多岁的成人角色转变来解释。

简短摘要

种族/族裔群体在酒精问题早期发作和复发/持续方面的风险相似,但黑人在30多岁时出现酒精问题的风险显著高于白人。累积贫困和大量饮酒解释了这种差异,并且是复发/持续问题的风险因素。

方法

使用美国全国青年纵向调查1979 - 1994年的数据(n = 6098),在1989年(平均年龄 = 28岁)和199年(平均年龄 = 33岁)对饮酒者过去一年的酒精问题进行测量。酒精问题模式分为无问题、20多岁时发作/30多岁时缓解、30多岁时发作以及复发或持续(在两个时间点均存在)。多项回归模型对人口统计学、累积贫困、大量饮酒以及社会角色转变(婚姻、为人父母)的时间进行了调整。

结果

与白人相比,黑人和西班牙裔在早期出现酒精问题的风险相似,但在30多岁时出现问题的风险更高(后期发作与无问题相比,调整后比值比分别为1.69和1.27);然而,只有黑人和白人之间的差异具有统计学意义。在考虑累积贫困和一生的大量饮酒情况后,这种差异消失了。在复发/持续酒精问题的风险方面没有种族/族裔差异,这与更高的累积贫困和大量饮酒有关。

结论

虽然白人在30多岁时似乎会“摆脱”酒精问题,但黑人在成年早期之后面临的风险更大。这些发现表明需要针对成年早期之后的少数族裔开展干预措施。

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