Associations between structural stigma and alcohol use among sexual minority women and their offspring - Project Summary
Sexual minority women (SMW) are twice as likely to report risky drinking behaviors as heterosexual women.
One cause of this disparity is structural stigma, which refers to contextual-level conditions, norms, and policies
that constrain opportunities, resources, and well-being. [Structural stigma also has intergenerational impacts,
evidenced by its adverse effects among children and infants across marginalized groups. However, little is
known about when structural stigma is most harmful across the lifecourse for SMW and the extent to which
intergenerational effects impact offspring health behaviors. Further, the mechanisms of these intergenera-
tional effects are underexplored, as are the moderating risk and resiliency factors. These knowledge gaps con-
tribute to perpetuating alcohol-related health disparities and limit our understanding of what factors may re-
duce risk among SMW and their children.] It has not been previously possible to examine these associations
because doing so requires a unique data structure with: 1) a large number of SMW living in different places and
measured over their lifecourse; 2) longitudinal structural stigma measures, which are very limited prior to the
1990s; and 3) alcohol measures among both parents and offspring. This mentored research proposal will pro-
vide the first opportunity to address these questions by pairing training in structural stigma measurement over
time using natural language processing (NLP) with data from two unique, intergenerational cohort studies: the
Nurses’ Health Study 2 (N=116,429), and their offspring in the linked Growing Up Today Study (N=27,704).
[By leveraging NLP on a corpus of >9,000 unique, digitized newspapers from all 50 US states during the
lifecourse of respondents in the Nurses’ Health Study 2 (75 years), I will develop and extensively validate a
time-varying measure of structural stigma related to sexual orientation (Aim 1). I will then elucidate the associ-
ation between structural stigma and alcohol use across the lifecourse among SMW (Aim 2) and their offspring
(Aim 3) and examine intervenable, modifiable characteristics moderate the effects of structural stigma. Ad-
vanced training in NLP and lifecourse epidemiology will provide the necessary tools to develop a novel struc-
tural stigma measure and test its relationship with alcohol consumption among SMW and their offspring
across the lifecourse, representing a critical next step for understanding and decreasing alcohol-related health
inequalities. This award will support essential career development in my path toward independence as an alco-
hol and stigma researcher and is highly consistent with NIAAA’s priorities for understanding the social con-
texts of drinking behavior in minoritized populations. The proposed studies are the essential next step towards
identifying modifiable targets for protecting against the impact of stigma on risky drinking and laying the foun-
dation for similar research in other stigmatized, high-risk populations. This work represents an innovative ap-
proach to understand the reverberating impact of structural stigma not only on those who are stigmatized but
also across generations.]
