COVID Impacts on Alcohol Use in Communities Affected by Repeated Disasters

Summary/Abstract Excessive drinking is a major problem in the United States, particularly among coastal communities surrounding the Gulf of Mexico, where nearly one in four residents screen positive for alcohol misuse. Stressors related to the COVID-19 pandemic and associated response policies (e.g., stay-at-home orders, closure of schools and businesses) may have increased alcohol misuse particularly for those disproportionately affected by the pandemic and job loss, like racial/ethnic minorities and women. This proposal addresses the NIAAA priorities described in NOT-AA-20- 011, helping to lay groundwork for public health emergencies such as COVID-19. We plan to examine patterns and predictors of change in alcohol consumption in vulnerable Gulf Coast communities over the course of the pandemic, including as vaccines and new variants emerge and unemployment persists. Prospective studies are rare in disaster research, but the proposed study will address this gap by collecting two new waves of survey data from an existing, population representative cohort of 2,520 Gulf Coast residents we have been following since 2016 via the Survey of Trauma, Resilience, and Opportunity in Neighborhoods in the Gulf (STRONG). The new work will build on extensive baseline data about mental health, alcohol misuse, employment history, disaster exposure, and social resources. The proposed work also builds on our team's productive line of longitudinal studies of alcohol misuse, including studies examining interactions between individual- and community-level risk factors, the role of stress and trauma, co-occurrence of mental health symptoms, and psychosocial reactions to risks and disasters in the Gulf Coast region. Two factors unique to COVID-19 are massive increases in unemployment and growing feelings of loneliness caused by stay-at-home orders, both of which might change people's drinking behavior. Through two new survey waves we will: estimate the magnitude of changes in frequency and quantity of alcohol consumption following the onset of COVID-19; examine trajectories of change in alcohol misuse within individuals; identify pre-COVID-19 predictors of patterns of change (e.g., demographic characteristics, cumulative trauma exposure, co-occurring mental health symptoms); and determine whether COVID-19-related losses (i.e., unemployment, loneliness) predict change in alcohol use over time. Existing and new data will be mergeable via a common respondent identifiers and also be geocoded, providing a unique resource for public health research and response. Results from this study could significantly advance scientific knowledge and clinical practice for vulnerable Gulf Coast residents.