Epidemiology of Alcohol Problems: Alcohol-related Disparities

The COVID-19 (C-19) pandemic has drastically changed life in the US, starting in March 2020 with stay-at-homeorders for much of the population and mass closures of businesses, including on-premise alcohol outlets. Todate, off-premise alcohol sales have been maintained in most states, and delivery and to-go options temporarilyexpanded. Alcohol sales in March 2020 were substantially higher than expected, indicating consumers increasedhome alcohol stocks, and potentially consumption. By June 2020, bars and restaurants have re-opened in manystates with varying distancing restrictions, prompting concerns of virus spread through congregation. The focusof this Center Project was originally on analyses of selected major causes of illness, injury, disability and deathwhere significant racial/ethnic and socioeconomic disparities are evident in the US and which are substantiallyalcohol-related. The proposed revision Aims will focus on changes in drinking patterns, substance use andmental health measures from before to during the C-19 restriction period, associations between drinking patternsand C-19 risk behaviors and behavioral health care need, access and utilization with attention to racial/ethnicand socioeconomic disparities. The 2019-2020 National Alcohol Survey (N14) completed fielding on April 20,2020 with 80% of cases collected before March 2020 and included web survey respondents recruited throughaddress-based sampling (ABS; n=5,176) and telephone respondents recruited through random digit dialing(RDD; n=1,323). We propose to re-survey 1,500 N14 ABS and RDD respondents with a follow-up instrument,N14C, focused on drinking, substance use, and C-19 risk behaviors and attitudes in the C-19 period. Thislongitudinal design allows us to build on the rich lifecourse data and pre-C-19 measures collected in N14,integrating new questions on recent substance use behaviors and problems, physical and mental health, and C-19-related risk behaviors, attitudes and impacts, including job loss and financial insecurity. N14C questions onalcohol and drug use and related problems will reference appropriate C-19 period timeframes, including duringstay-at-home orders (closed period) and during phased reopening (open period). Changes in alcohol and druguse, co-use and problems will be assessed through comparisons with N14 responses. N14C questions willinclude drinking motives and alcohol purchasing, as well as C-19 risk behaviors such as mask wearing, handwashing and congregating in groups of non-household members. Updated geocoding information of areacharacteristics and policies, such as bar closures and expanded delivery, will be utilized, allowing policy analysesutilizing within-person, pre-post comparisons to assess impacts on alcohol use and problems. Measures of anindividual's pre-existing health conditions, including diabetes, hypertension and heart disease, will facilitateanalyses of factors expected to raise the risk of C-19 impacts and measures of depression and anxiety symptomsand discrimination will be utilized for important and timely analyses focused on mental health, stress, anddiscrimination experiences related to C-19 impacts.