Health Disparities in Alcohol Use and Other Risk Behaviors after the Onset of Cancers and Cardiovascular Disease-Related Conditions

Public Health Institute, Oakland CA

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Abstract

The proposed Health Effects on Alcohol Use and Other Risk Behaviors after the Onset of Cancers and Cardiovascular Disease-Related Conditions is a continuation of the 2016-2020 Health Project focusing on alcohol’s role in chronic disease outcomes. We shift the focus to patterns of drinking and other health risk behaviors among individuals with diagnosed chronic health conditions focusing on diabetes, hypertension, heart/coronary problems, and cancer as well as multimorbidity among these conditions. As continued heavy drinking with these conditions carries risks for increased morbidity and mortality, which are likely to be further elevated when combined with other health risk behaviors (such as obesity, physical inactivity and tobacco and other drug use), there is a critical need for multifaceted interventions to address these. However, few studies investigating health behaviors following diagnosis or treatment for specific health conditions have focused on alcohol use or the clustering of risky drinking with other risk behaviors. Furthermore, little has been documented regarding population knowledge of alcohol’s role in disease risk, which may also influence decisions about drinking. To increase the knowledge base for improved interventions, the proposed research will address three specific aims. First, analyses of drinking patterns after diagnosis of cancers, hypertension, diabetes, heart problems, and alcohol-attributed health harms using the 2015, 2020 and 2024 NAS will evaluate the impacts of condition onset on drinking patterns and the correlates of continued risky drinking. Second, examination of current drinking patterns, other lifestyle risk factors (physical activity and overweight/obesity), and substance use (tobacco, marijuana, and illicit drugs) in those with above-stated conditions and multimorbidity among them will identify associations between these behaviors with attention to US population differences. These analyses will utilize the 2010-2020 NAS and 2015-2020 National Surveys on Drug Use and Health. Third, evaluation of the predictors of knowledge regarding alcohol’s role in cancers and other chronic health conditions and population differences in these, utilizing the 2020 NAS and the National Cancer Institute’s 2017 Health Information National Trends Survey, will identify groups and characteristics associated with accurate knowledge of alcohol as a risk factor for each condition and the sources of information associated with accurate knowledge. Advanced epidemiologic models including generalized estimating equation modeling, propensity score weighting, and latent class analysis will be utilized as appropriate.