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.