dianacoronel75

[dianacoronel75]

SAS lessons, Running my first program I´m working with the GAPMINDER data base; below you will find my program (Program2.sas~).   1. Code

2. Log

Outputs with frequency tables of the 4 variables I selected: Income per person, alcohol consumption, HIV rates, Suicide rate.

3. Frequency distribution description:

The current data base is managing mostly averages per country; in this case when reviewing the frequencies and selecting rows by: high income >= 12375 and Alcohol consumption >=5; we can see that indeed high incomes could be related with heavy alcohol consumption; when we review the HIV rates it does not seem to be a relation between heavy alcohol consumption; suicide rates are higher in higher income countries

[dianacoronel75]

Day 1 Coursera Data management

I chose Gapminder, it represents several key indicators related with the achievement of the United Nations Millennium Development Goals; and this is close related with my job. 

My research questions:

a) Is the alcohol consumption higher when the income per person is also higher?

b) Is the alcohol consumption related with the suicide index?

c) Is the life expectancy directly related with the alcohol consumption?

The rationale for this questions is to evaluate the impact of alcohol consumption in other key variables that traditionally has been negatively correlated, nevertheless there are several new trials showing that alcohol consumption could have some positive impact in life expectancy as an example. 

Literature Review

Most people with alcohol-use disorders  are hard  to  identity, since they are likely to have jobs and families, and present with  general complaints  such  as  malaise,  insomnia, anxiety, sadness, or a range of medical problems (1).

Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. The Centers for Disease Control and Prevention (CDC) (2012) conducted a population-based study of the association between heavy episodic drinking (HED) and several SES-related variables among adults (N = 457,677) in 48 States and Washington, DC. The findings indicated that people who did not graduate from high school and had a low income had the lowest prevalence of HED. In fact, HED prevalence increased with household income and was highest among those with a household income greater than $75,000 a year. However, among those respondents who did engage in HED, those who reported the lowest educational and income levels reported the highest frequency of HED and the highest quantity consumed per occasion (CDC 2012). Another population-based study conducted in New York City at the neighborhood level yielded similar findings (Galea et al. 2007). Specifically, the neighborhoods with the highest income and with the greatest income disparities showed the highest prevalence of alcohol use as well as greater frequency of drinking (2).

Besides the income, other important association with alcohol that has been widely studied is suicide. Risk factors for attempted and completed suicide in individuals with alcoholism include being male, older than approximately 50 years of age, living alone, being unemployed, poor social support, interpersonal losses, continued drinking, consumption of a greater amount of alcohol when drinking, a recent alcohol binge, previous alcohol treatment, a family history of alcoholism, a history of substance abuse (especially cocaine), major depressive episode, serious medical illness, suicidal communication, and prior suicidal behavior. Suicidal behavior is especially frequent in patients with comorbid alcoholism and major depression. However, all patients with alcoholism should be evaluated for suicide risk. Protective factors for suicide in alcoholism are quite varied and include an individual's biological and behavioral characteristics, as well as attributes of the environment and culture. Protective factors include effective clinical care for psychiatric (including alcoholism and drug abuse) and physical disorders, easy access to a  variety of clinical interventions and support for seeking help, restricted access to highly lethal means of suicide, strong connections to family and community support, skills in problem solving and conflict resolution, cultural and religious beliefs that discourage suicide and support self-preservation (3). A moderate alcohol consumption has been related with increase levels of optimism and happiness (4); it would be interesting to analyze is any correlation can be found in this data base.

Finally, another associated factor is HIV infection. African countr4ies with high rates of alcoholism also reportedly have higher rates of HIV infections (5); also the HIV stigma can contribute with substance use problems among people living with HIV (6)

 1.       Schuckit MA. Alcohol-use disorders. Lancet. 2009 Feb 7;373(9662):492-501. doi: 10.1016/S0140-6736(09)60009-X. Epub 2009 Jan 23. PMID: 19168210.

2.       Collins SE. Associations Between Socioeconomic Factors and Alcohol Outcomes. Alcohol Res. 2016;38(1):83-94. PMID: 27159815; PMCID: PMC4872618.

3.       Sher L. Risk and protective factors for suicide in patients with alcoholism. ScientificWorldJournal. 2006 Oct 31;6:1405-11. doi: 10.1100/tsw.2006.254. PMID: 17086346; PMCID: PMC5917221

4.       Trudel-Fitzgerald C, James P, Kim ES, Zevon ES, Grodstein F, Kubzansky LD. Prospective associations of happiness and optimism with lifestyle over up to two decades. Prev Med. 2019 Sep;126:105754. doi: 10.1016/j.ypmed.2019.105754. Epub 2019 Jun 18. PMID: 31220509; PMCID: PMC6697576.

5.       Muturi N. Gender and HIV infection in the context of alcoholism in Kenya. Afr J AIDS Res. 2015;14(1):57-65. doi: 10.2989/16085906.2015.1016986. PMID: 25920984.

6.       Felker-Kantor EA, Wallace ME, Madkour AS, Duncan DT, Andrinopoulos K, Theall K. HIV Stigma, Mental Health, and Alcohol Use Disorders among People Living with HIV/AIDS in New Orleans. J Urban Health. 2019 Dec;96(6):878-888. doi: 10.1007/s11524-019-00390-0. PMID: 31520231; PMCID: PMC6904691.

 Research Hypotheses

H1.- Highest levels of alcohol consumption are associated with the highest incomes

H2.- Suicide rates are increased in individuals with heavy alcohol consumption

H3.-  HIV rates are higher in individuals with heavy alcohol consumption.