Rural Southern Contexts, COVID-19, and Black Men'™s Alcohol Misuse

Project Summary/Abstract: The young Black men who are the focus of the proposed Urgent Competitive Revision to R01AA026623 arefrom small towns and rural communities in Georgia, an area of persistent poverty for Black residents thatcoincides with the nation's worst educational, economic, and health disparities by race. Black residentsaccount for more than 50% of Georgia's COVID-19 deaths, despite comprising less than 1/3 of the state'spopulation; the state's rural areas have a death rate 1.5 times that of its large cities. NIAAA reports that alcoholuse has increased since pandemic precautions (e.g., shelter in home, social distancing) have beenimplemented. Among rural Black men, we hypothesize that alcohol use may accelerate the spread of SARSCoV-2. In addition to effects on immune function, alcohol misuse undermines the judgement, self-regulation,and motivation to practice recommended disease mitigation behaviors (e.g., physical distancing, self-quarantine, hand washing). Alcohol misuse also encourages young adults' presence in settings andinteractions in which they may be likely to become infected or to infect others. We also propose to examine thepredictors of alcohol use. Many low-income Black men live below or near the federal poverty level and havefew financial resources, including economic assets to use during a protracted pandemic. Economic hardship isexacerbated by racial discrimination, family stress and conflict, fears of exposure to unsafe working conditionswhen work is available, and the greater likelihood that they, their families, or their friends will be affecteddirectly by SARS Cov-2 infection. Pandemic-related stressors are expected to foster the onset of alcohol useproblems and the amplification of existing problems. Importantly, many men will cope well, avoiding alcoholmisuse by drawing on both personal and social coping resources to deal with stress without alcohol use. Wepropose to conduct 3 remote surveys at 3-month intervals with a subsample (N = 242) of rural Black men froman ongoing study who provided past year, pre-pandemic data for the parent study. We will document men'sface-to-face social network contacts, COVID-19 mitigation behaviors, pandemic-related stressors and copingresources, and alcohol use. Our aims are to (a) model alcohol misuse trajectories among rural Black menduring the course of the pandemic, (b) investigate the influence of alcohol misuse, over time, on men's SARSCoV-2 transmission risk, and (c) investigate risk and protective processes associated with change in alcoholuse during the pandemic.