Session: The Application of Innovative Methods to Track Substance Use and Related Mechanisms over Time: Implications for Prevention, Policy, and Health Equity (Society for Prevention Research 26th Annual Meeting)

National health surveillance data are imperative to improving population health. For example, a recent study indicating increased rates of alcohol use and alcohol use disorders among US adults since 2001 (Grant et al., 2017) sparked fervent public and professional discourse on prevention and intervention strategies to address them. Such studies highlight the importance of evaluating public health issues across historical time to identify emerging needs for intervention and prevention. However, many traditional epidemiological methods that assess trends in health over time may mask important within-group and developmental differences, limiting prevention strategies. Using population-based data, this symposium highlights novel approaches to investigate disparities, causal mechanisms, and developmental differences of substance use over time.

In response to changing policies and public discourse surrounding marijuana and opioid use, the first presentation uses time-varying effect modeling (TVEM) to test age-related changes in the prevalence of marijuana and opioid use among US adults in the 2001 and 2012 National Epidemiological Survey of Alcohol and Related Conditions (NESARC) cohorts; findings indicate increased use and offer unique perspectives for prevention strategies. The second study utilizes a decade of data from the Youth Risk Behavior Survey to assess trends in cigarette use disparities between heterosexual and sexual minority (lesbian, gay, and bisexual [LGB]) youth. Using a newly designed method to test the size of health disparities across cohorts, the results address critical questions about whether LGB cigarette use has declined alongside increased public acceptance of LGB people in the US. In this same vain, the final presentation uses TVEM to estimate age-specific prevalences of anti-LGB discrimination, a key explanatory mechanism of LGB substance use disparities, from the 2004 and 2012 NESARC cohorts. Along with an unprecedented look at whether experiences of anti-LGB discrimination have declined, the application of TVEM illuminates age-period-cohort effects in the experience of anti-LGB discrimination for a population that has experienced rapid social change in the last fifty years.

Together, studies demonstrate how the application of innovative methods with cohort data inform policy and prevention efforts aimed at improving population health. The discussant, a prevention scientist with expertise in substance use disparities across the life course, will provide insight on the implications of findings and moderate a discussion on how these methods can be applied to inform the development of more effective prevention and intervention strategies to improve population health and health equity.