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保护因素解释了黑人和白人在重度饮酒方面差异的“悖论”。

Protective Factors as an Explanation for the "Paradox" of Black-White Differences in Heavy Drinking.

机构信息

a Alcohol Research Group , Public Health Institute , Emeryville , California , USA.

b University of Minnesota School of Public Health , Division of Epidemiology , Minnesota , Minneapolis , USA.

出版信息

Subst Use Misuse. 2018 Oct 15;53(12):2003-2016. doi: 10.1080/10826084.2018.1451892. Epub 2018 Apr 2.

Abstract

BACKGROUND

African Americans are generally known to have lower heavy drinking prevalence than Whites despite often greater individual and community risk factors. While it is supposed that their protective resources explain this "paradox," studies have not explicitly examined this.

OBJECTIVE

Assess the contribution of protective resources to Black-White differences in heavy drinking, and (secondarily) whether protective resources operate by reducing heavy drinking and/or increasing abstinence.

METHODS

Using data from the 2009-2010 U.S. National Alcohol Survey (N = 3,133 Whites and 1,040 Blacks ages 18+), we applied propensity score (PS) weighting to estimate racial differences in heavy drinking and abstinence under hypothetical conditions in which Whites are similar to Blacks in: (1) age and marital status; (2) socioeconomic position and unfair treatment; (3) neighborhood socioeconomic conditions and alcohol outlet density; and (4) protective resources (proscriptive religiosity, area-level religiosity, "drier" network drinking norms and patterns, and family social support).

RESULTS

The Black-White gap in male and female drinkers' baseline heavy drinking increased after weighting adjustments for demographics. In women, this gap was reduced after weighting on disadvantage and eliminated after adjusting for protective resources. In men, adjustment for disadvantage increased the racial gap, and protective resources reduced it. Protective resources had a stronger effect on Black-White differences in men's abstinence than heavy drinking, but similar effects on these outcomes in women.

CONCLUSION

Protective resources help explain Black-White differences in men's and particularly women's heavy drinking. Future research is needed to elucidate mechanisms of action and additional factors underlying racial differences in men's heavy drinking.

摘要

背景

尽管非裔美国人在个人和社区风险因素方面通常比白人更多,但他们的重度饮酒患病率却普遍较低。尽管人们认为他们的保护资源可以解释这种“悖论”,但研究并未明确对此进行检验。

目的

评估保护资源对黑人和白人重度饮酒差异的贡献,并(次要地)评估保护资源是否通过减少重度饮酒和/或增加戒酒来发挥作用。

方法

使用 2009-2010 年美国国家酒精调查(N = 3133 名白人,1040 名 18 岁以上的黑人)的数据,我们应用倾向评分(PS)加权来估计在以下假设条件下,白人在重度饮酒和戒酒方面与黑人之间的种族差异:(1)年龄和婚姻状况;(2)社会经济地位和不公平待遇;(3)邻里社会经济条件和酒精销售点密度;以及(4)保护资源(禁止性宗教信仰、地区宗教信仰、“较不”网络饮酒规范和模式以及家庭社会支持)。

结果

在对人口统计学因素进行加权调整后,男性和女性饮酒者的重度饮酒基准黑人和白人之间的差距增加。在女性中,这种差距在加权劣势后缩小,在调整保护资源后消除。在男性中,劣势调整增加了种族差距,而保护资源则减少了差距。保护资源对男性戒酒的黑人和白人差异的影响比对重度饮酒的影响更大,但对女性的影响则相似。

结论

保护资源有助于解释男性和特别是女性的黑人和白人之间在重度饮酒方面的差异。需要进一步的研究来阐明作用机制以及男性重度饮酒中种族差异的其他潜在因素。

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