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2.
Proc Natl Acad Sci U S A ; 121(33): e2309066121, 2024 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-39102541

RESUMEN

Violence is a key mechanism in the reproduction of community disadvantage. The existing evidence indicates that violence in a community impacts the intergenerational mobility of its residents. The current study explores the possibility of a reverse relationship. This study provisionally tests the hypothesis that depressed intergenerational mobility in a community may also spark subsequent community violence. We deploy a county measure of intergenerational mobility captured during early adulthood for a cohort of youth born between 1980 and 1986 and raised in low-income families [R. Chetty, N. Hendren, Quart. J. Econom. 133, 1163-1228 (2018)]. We model the relationship between county mobility scores and two county-level outcomes: violent crime and homicide. We find that a county's level of intergenerational mobility as measured by the Chetty-Hendren data is a major predictor of its rate of violent crime and homicide in 2008, when the youth in Chetty's mobility cohort were young adults (the same age the mobility measure was captured). In fact, mobility is a significantly stronger and more consistent predictor of community violent crime and homicide rates than more commonly used factors like poverty, inequality, unemployment, and law enforcement presence.


Asunto(s)
Violencia , Humanos , Violencia/estadística & datos numéricos , Masculino , Femenino , Relaciones Intergeneracionales , Adulto , Adolescente , Pobreza , Adulto Joven , Homicidio/estadística & datos numéricos , Características de la Residencia , Crimen/estadística & datos numéricos
3.
Lancet ; 403(10430): 935-945, 2024 03 09.
Artículo en Inglés | MEDLINE | ID: mdl-38342127

RESUMEN

BACKGROUND: In the USA, Black women aged 25-44 years are disproportionately murdered compared with their White counterparts. Despite ongoing efforts to reduce racial and structural inequities, the result of these efforts remains unclear, particularly in light of the COVID-19 pandemic. METHODS: This study examined a cross-sectional time series of homicide death rates, by race, from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research system. We included data for women aged 25-44 years between 1999 and 2020 among 30 states in the USA. Homicide death was classified using underlying cause and multiple cause of death codes; mortality rates were calculated per 100 000 based on US Census Bureau population sizes. Homicide methods were classified as firearm, cutting or piercing, and other. Firearm homicides were compared with other homicides with logistic regression including covariates of race, time, and their interaction. We report odds ratios and 95% CIs. FINDINGS: In 2020, the homicide rate among Black women was 11·6 per 100 000, compared with 3 per 100 000 among White women. This inequity has persisted over time and is virtually unchanged since 1999. Homicide inequities vary across US states; in 11 states, racial inequities have increased since 1999. The racial inequity was greatest in Wisconsin, where in 2019-20, Black women aged 25-44 years were 20 times more likely to die by homicide than White women. Homicide by firearm is increasing in frequency; women in the USA had 2·44 (95% CI 2·14-2·78) times the odds of homicide involving firearms in 2019-20 compared with 1999-2003. Firearm homicide deaths are disproportionately concentrated among Black women in every region in the USA. INTERPRETATION: Our findings suggest that there is an urgent need to address homicide inequities among Black and White women in the USA. Enacting federal legislation that reduces gun access is a crucial step. Policy makers must address long-standing structural factors that underpin elevated gun violence by implementing sustainable wealth-building opportunities; developing desegregated, mixed income and affordable housing; and increasing green spaces in communities where Black women largely reside. FUNDING: National Institute of Mental Health of the National Institutes of Health.


Asunto(s)
Armas de Fuego , Suicidio , Estados Unidos/epidemiología , Humanos , Femenino , Homicidio , Factores de Tiempo , Estudios Transversales , Pandemias , Blanco
4.
Natl Vital Stat Rep ; 72(9): 1-10, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37498283

RESUMEN

Objectives-This report describes homicide rates among infants (under age 1 year) by selected maternal, pregnancy-related, and infant characteristics. Methods-Linked birth/infant death files based on data collected on U.S. birth and death certificates were used to calculate homicide rates among infants for the period 2017-2020. Results-A total of 1,067 homicides occurred among infants in the United States from 2017 through 2020, an average of 267 per year. More than one-half of all infant homicides occurred among infants aged 3 months and under. Homicide rates were higher among infants born to mothers who were young, had multiple previous live births, were Black non-Hispanic, were born in the United States, had lower levels of education, lived in rural areas, had no prenatal care, and delivered outside of a hospital. Rates were also higher for infants who were part of a multiple-gestation pregnancy, were born preterm or low birthweight, or were admitted to a neonatal intensive care unit.


Asunto(s)
Homicidio , Recién Nacido de Bajo Peso , Recién Nacido , Embarazo , Femenino , Lactante , Humanos , Estados Unidos/epidemiología , Embarazo Múltiple , Mortalidad Infantil , Madres
5.
Proc Natl Acad Sci U S A ; 119(10): e2108801119, 2022 03 08.
Artículo en Inglés | MEDLINE | ID: mdl-35239440

RESUMEN

SignificanceWe introduce an approach to identify latent topics in large-scale text data. Our approach integrates two prominent methods of computational text analysis: topic modeling and word embedding. We apply our approach to written narratives of violent death (e.g., suicides and homicides) in the National Violent Death Reporting System (NVDRS). Many of our topics reveal aspects of violent death not captured in existing classification schemes. We also extract gender bias in the topics themselves (e.g., a topic about long guns is particularly masculine). Our findings suggest new lines of research that could contribute to reducing suicides or homicides. Our methods are broadly applicable to text data and can unlock similar information in other administrative databases.


Asunto(s)
Bases de Datos Factuales , Homicidio , Modelos Teóricos , Violencia , Humanos , Estados Unidos
6.
Proc Natl Acad Sci U S A ; 119(17): e2117556119, 2022 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-35446706

RESUMEN

Understanding the influence of climate change and population pressure on human conflict remains a critically important topic in the social sciences. Long-term records that evaluate these dynamics across multiple centuries and outside the range of modern climatic variation are especially capable of elucidating the relative effect of­and the interaction between­climate and demography. This is crucial given that climate change may structure population growth and carrying capacity, while both climate and population influence per capita resource availability. This study couples paleoclimatic and demographic data with osteological evaluations of lethal trauma from 149 directly accelerator mass spectrometry 14C-dated individuals from the Nasca highland region of Peru. Multiple local and supraregional precipitation proxies are combined with a summed probability distribution of 149 14C dates to estimate population dynamics during a 700-y study window. Counter to previous findings, our analysis reveals a precipitous increase in violent deaths associated with a period of productive and stable climate, but volatile population dynamics. We conclude that favorable local climate conditions fostered population growth that put pressure on the marginal and highly circumscribed resource base, resulting in violent resource competition that manifested in over 450 y of internecine warfare. These findings help support a general theory of intergroup violence, indicating that relative resource scarcity­whether driven by reduced resource abundance or increased competition­can lead to violence in subsistence societies when the outcome is lower per capita resource availability.


Asunto(s)
Cambio Climático , Violencia , Historia Antigua , Homicidio , Humanos , Dinámica Poblacional , América del Sur , Guerra
7.
PLoS Med ; 21(1): e1004336, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38236843

RESUMEN

Little is known about the prevalence and dynamics of femicide, a persistent form of violence against women and girls, due to challenges associated with its documentation. Research by Abrahams and colleagues comparing rates of femicide in South Africa over 18 years, however, suggests that femicide is preventable.


Asunto(s)
Homicidio , Violencia , Humanos , Femenino , Homicidio/prevención & control , Violencia/prevención & control , Parejas Sexuales , Sudáfrica/epidemiología
8.
PLoS Med ; 21(1): e1004330, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38236895

RESUMEN

BACKGROUND: In most countries, reliable national statistics on femicide, intimate partner femicide (IPF), and non-intimate partner femicide (NIPF) are not available. Surveys are required to collect robust data on this most extreme consequence of intimate partner violence (IPV). We analysed 3 national surveys to compare femicide, IPF, and NIPF from 1999 to 2017 using age-standardised rates (ASRs) and incidence rate ratios (IRRs). METHODS AND FINDINGS: We conducted 3 national mortuary-based retrospective surveys using weighted cluster designs from proportionate random samples of medicolegal laboratories. We included females 14 years and older who were identified as having been murdered in South Africa in 1999 (n = 3,793), 2009 (n = 2,363), and 2017 (n = 2,407). Further information on the murdered cases were collected from crime dockets during interviews with police investigating officers. Our findings show that South Africa had an IPF rate of 4.9/100,000 female population in 2017. All forms of femicide among women 14 years and older declined from 1999 to 2017. For IPF, the ASR was 9.5/100,000 in 1999. Between 1999 and 2009, the decline for NIPF was greater than for IPF (IRR for NIPF 0.47 (95% confidence interval (CI) 0.42 to 0.53) compared to IRR for IPF 0.69 (95% CI 0.63 to 0.77). Rates declined from 2009 to 2017 and did not differ by femicide type. The decline in IPF was initially larger for women aged 14 to 29, and after 2009, it was more pronounced for those aged 30 to 44 years. Study limitations include missing data from the police and having to use imputation to account for missing perpetrator data. CONCLUSIONS: In this study, we observed a reduction in femicide overall and different patterns of change in IPF compared to NIPF. The explanation for the reductions may be due to social and policy interventions aimed at reducing IPV overall, coupled with increased social and economic stability. Our study shows that gender-based violence is preventable even in high-prevalence settings, and evidence-based prevention efforts must be intensified globally. We also show the value of dedicated surveys in the absence of functional information systems.


Asunto(s)
Violencia de Pareja , Conducta Sexual , Humanos , Femenino , Estudios Retrospectivos , Sudáfrica/epidemiología , Parejas Sexuales , Homicidio
9.
Am J Epidemiol ; 193(8): 1061-1065, 2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-38583934

RESUMEN

Strong epidemiologic evidence from ecological and individual-level studies in the United States supports the claim that access to firearms substantially increases the risk of dying by suicide, homicide, and firearm accidents. Less certain is how well particular interventions work to prevent these deaths and other firearm-related harms. Given the limits of existing data to study firearm violence and the infeasibility of conducting randomized trials of firearm access, it is important to do the best we can with the data we already have. We argue that falsification strategies are a critical-yet underutilized-component of any such analytical approach. The falsification strategies we focus on are versions of "negative controls" analyses in which we expect that an analysis should yield a null causal effect, and thus where not obtaining a null effect estimate raises questions about the assumptions underlying causal interpretation of a study's findings. We illustrate the saliency of this issue today with examples drawn from studies published in leading peer-reviewed journals within the last 5 years. Collecting rich, high-quality data always takes time, urgent as the need may be. On the other hand, doing better with the data we already have can start right now.


Asunto(s)
Armas de Fuego , Violencia con Armas , Humanos , Violencia con Armas/prevención & control , Violencia con Armas/estadística & datos numéricos , Estados Unidos , Armas de Fuego/legislación & jurisprudencia , Interpretación Estadística de Datos , Homicidio/prevención & control , Homicidio/estadística & datos numéricos , Heridas por Arma de Fuego/prevención & control , Heridas por Arma de Fuego/epidemiología
10.
Epidemiology ; 35(4): 458-468, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38597728

RESUMEN

BACKGROUND: Evidence about which firearm policies work, to what extent, and for whom is hotly debated, perhaps partly because variation in research methodology has produced mixed and inconclusive effect estimates. We conducted a scoping review of firearm policy research in the health sciences in the United States, focusing on methodological considerations for causal inference. METHODS: We identified original, empirical articles indexed in PubMed from 1 January 2000 to 1 September 2021 that examined any of 18 prespecified firearm policies. We extracted key study components, including policy type(s) examined, policy operationalization, outcomes, study setting and population, study approach and design, causal language, and whether and how authors acknowledged potential sources of bias. RESULTS: We screened 7733 articles and included 124. A plurality of studies used a legislative score as their primary exposure (n = 39; 32%) and did not examine change in policies over time (n = 47; 38%). Most examined firearm homicide (n = 51; 41%) or firearm suicide (n = 40; 32%) as outcomes. One-third adjusted for other firearm policies (n = 41; 33%). Three studies (2%) explicitly mentioned that their goal was to estimate causal effects, but over half used language implying causality (n = 72; 58%). Most acknowledged causal identification assumptions of temporality (n = 91; 73%) and exchangeability (n = 111; 90%); other assumptions were less often acknowledged. One-third of studies included bias analyses (n = 42; 34%). CONCLUSIONS: We identified a range of methodologic approaches in firearm policy research in the health sciences. Acknowledging the imitations of data availability and quality, we identify opportunities to improve causal inferences about and reporting on the effects of firearm policies on population health.


Asunto(s)
Armas de Fuego , Armas de Fuego/legislación & jurisprudencia , Armas de Fuego/estadística & datos numéricos , Humanos , Estados Unidos , Homicidio/estadística & datos numéricos , Proyectos de Investigación , Política de Salud , Suicidio/estadística & datos numéricos
11.
Psychol Sci ; 35(3): 250-262, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38289294

RESUMEN

Fundamental frequency ( fo) is the most perceptually salient vocal acoustic parameter, yet little is known about how its perceptual influence varies across societies. We examined how fo affects key social perceptions and how socioecological variables modulate these effects in 2,647 adult listeners sampled from 44 locations across 22 nations. Low male fo increased men's perceptions of formidability and prestige, especially in societies with higher homicide rates and greater relational mobility in which male intrasexual competition may be more intense and rapid identification of high-status competitors may be exigent. High female fo increased women's perceptions of flirtatiousness where relational mobility was lower and threats to mating relationships may be greater. These results indicate that the influence of fo on social perceptions depends on socioecological variables, including those related to competition for status and mates.


Asunto(s)
Voz , Adulto , Humanos , Masculino , Femenino , Homicidio , Percepción Social , Parejas Sexuales
12.
Milbank Q ; 102(1): 97-121, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37818775

RESUMEN

Policy Points Promoting healthy public policies is a national priority, but state policy adoption is driven by a complex set of internal and external factors. This study employs new social network methods to identify underlying connections among states and to predict the likelihood of new firearm-related policy adoption given changes to this interstate network. This approach could be used to assess the likelihood that a given state will adopt a specific new firearm-related law and to identify points of influence that could either inhibit or promote wider diffusion of specific laws. CONTEXT: US states are largely responsible for the regulation of firearms within their borders. Each state has developed a different legal environment with regard to firearms based on different values and beliefs of citizens, legislators, governors, and other stakeholders. Predicting the types of firearm laws that states may adopt is therefore challenging. METHODS: We propose a parsimonious model for this complex process and provide credible predictions of state firearm laws by estimating the likelihood they will be passed in the future. We employ a temporal exponential-family random graph model to capture the bipartite state law-state network data over time, allowing for complex interdependencies and their temporal evolution. Using data on all state firearm laws over the period 1979-2020, we estimate these models' parameters while controlling for factors associated with firearm law adoption, including internal and external state characteristics. Predictions of future firearm law passage are then calculated based on a number of scenarios to assess the effects of a given type of firearm law being passed in the future by a given state. FINDINGS: Results show that a set of internal state factors are important predictors of firearm law adoption, but the actions of neighboring states may be just as important. Analysis of scenarios provide insights into the mechanics of how adoption of laws by specific states (or groups of states) may perturb the rest of the network structure and alter the likelihood that new laws would become more (or less) likely to continue to diffuse to other states. CONCLUSIONS: The methods used here outperform standard approaches for policy diffusion studies and afford predictions that are superior to those of an ensemble of machine learning tools. The proposed framework could have applications for the study of policy diffusion in other domains.


Asunto(s)
Armas de Fuego , Estados Unidos , Política Pública , Predicción , Proteínas Represoras , Homicidio
13.
Am J Public Health ; 114(4): 387-397, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38478866

RESUMEN

Objectives. To describe all-outcome injurious shootings by police and compare characteristics of fatal versus nonfatal injurious shootings nationally. Methods. From July 2021 to April 2023, we manually reviewed publicly available records on all 2015-2020 injurious shootings by US police, identified from Gun Violence Archive. We estimated injury frequency, case fatality rates, and relative odds of death by incident and victim characteristics. Results. A total of 1769 people were injured annually in shootings by police, 55% fatally. When a shooting injury occurred, odds of fatality were 46% higher following dispatched responses than police-initiated responses. Injuries associated with physically threatening or threat-making behaviors, behavioral health needs, and well-being checks were most frequently fatal. Relative to White victims, Black victims were overrepresented but had 35% lower odds of fatal injury when shot. Conclusions. This first multiyear, nationwide analysis of injurious shootings by US police suggests that injury disparities are underestimated by fatal shootings alone. Nonpolicing responses to social needs may prevent future injuries. Public Health Implications. We call for enhanced reporting systems, comprehensive evaluation of emerging reforms, and targeted investment in social services for equitable injury prevention. (Am J Public Health. 2024;114(4):387-397. https://doi.org/10.2105/AJPH.2023.307560).


Asunto(s)
Armas de Fuego , Violencia con Armas , Heridas por Arma de Fuego , Humanos , Estados Unidos/epidemiología , Policia , Oportunidad Relativa , Homicidio
14.
Am J Public Health ; 114(S3): S268-S277, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37948056

RESUMEN

Objectives. To investigate differences in the documentation of mental health symptomology between male and female suicide decedents in the 2003-2020 US National Violent Death Reporting System (NVDRS). Methods. Using information on 271 998 suicides in the 2003-2020 NVDRS, we evaluated precoded mental health-related variables and topic model-derived latent mental health themes in the law enforcement and coroner or medical examiner death narratives compiled by trained public health workers. Results. Public health records of male compared with female suicides were less likely to include notations of mental health conditions or treatment interventions. However, topic modeling of death summaries revealed that male suicide decedents were more likely to evidence several subclinical cognitive and emotional indicators of distress. Conclusions. Suicide death records vary by gender, both in recorded evidence for mental health conditions at time of death and in accompanying narratives describing proximal circumstances surrounding these deaths. Our findings hint that patterns of subclinical mental health changes among men might be less well captured in commonly used mental health indicators, suggesting that prevention efforts may benefit from measures that also target assessment of subclinical distress. (Am J Public Health. 2024;114(S3):S268-S277. https://doi.org/10.2105/AJPH.2023.307427).


Asunto(s)
Suicidio , Humanos , Masculino , Femenino , Estados Unidos/epidemiología , Homicidio , Salud Mental , Causas de Muerte , Violencia , Vigilancia de la Población
15.
Am J Public Health ; 114(7): 733-742, 2024 07.
Artículo en Inglés | MEDLINE | ID: mdl-38754064

RESUMEN

Objectives. To examine changes in cause-specific pregnancy-associated deaths during the COVID-19 pandemic by race and ethnicity and assess changes in racial and ethnic inequities in pregnancy-associated deaths. Methods. We used US vital statistics mortality data from 2018 to 2021 to identify pregnancy-associated deaths among females aged 15 to 44 years. We calculated crude pregnancy-associated death rates (deaths per 100 000 live births) by year, cause, and race/ethnicity, percent change in death rate, and the inequity (difference) in rate for each racial or ethnic group compared with non-Hispanic White people. Results. The pregnancy-associated death rate for obstetric, drug-related, homicide, and other causes of death increased during 2020, and obstetric deaths continued to increase in 2021. Overall estimates mask 2021 increases in drug-related deaths among Hispanic, non-Hispanic American Indian and Alaska Native (AI/AN), and non-Hispanic Asian people; increases in homicide among most racial and ethnic groups; and increases in suicide among Hispanic, non-Hispanic AI/AN, and non-Hispanic Asian people. Conclusions. We found disproportionate increases in pregnancy-associated deaths from nonobstetric causes among minoritized racial and ethnic groups during the COVID-19 pandemic. (Am J Public Health. 2024;114(7):733-742. https://doi.org/10.2105/AJPH.2024.307651).


Asunto(s)
COVID-19 , Causas de Muerte , Adolescente , Adulto , Femenino , Humanos , Embarazo , Adulto Joven , COVID-19/mortalidad , COVID-19/etnología , Etnicidad/estadística & datos numéricos , Inequidades en Salud , Disparidades en el Estado de Salud , Pandemias , Complicaciones del Embarazo/etnología , Complicaciones del Embarazo/mortalidad , Grupos Raciales/estadística & datos numéricos , SARS-CoV-2 , Estados Unidos/epidemiología , Hispánicos o Latinos , Indio Americano o Nativo de Alaska , Asiático , Homicidio/etnología , Homicidio/estadística & datos numéricos , Suicidio/etnología , Suicidio/estadística & datos numéricos
16.
J Surg Res ; 297: 109-120, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38484452

RESUMEN

INTRODUCTION: Health disparities in the Asian and Pacific Islander Americans (APIAs) community have not been well described, unlike non-Hispanic Black and Hispanic communities. However, there has been a rise in violence against the APIA community. This study explores and characterizes violent death by incident (e.g., homicide, suicide), weapon (e.g., firearm, strangulation), and location types among APIAs as they compare with other racial or ethnic groups. METHODS: We used the National Violent Death Reporting System from 2003 to 2018 to characterize violent deaths among APIA and compared them to all other races. We compared these racial categories in two ways. First, we compared all races as a categorical variable that included six non-Hispanic racial categories including "Other or unspecified" and "two or more races. We then created a binary variable of APIA versus All Other Races for analysis. We explored the incident type of death, substance abuse disorders, mental health history, and gang involvement among other variables. We used Chi-square tests for categorical variables and Mann-Whitney U-tests for continuous variables. RESULTS: Overall, APIAs had a unique pattern of violent death. APIAs were more likely to commit suicide (71.74%-62.21%, P<0.001) and less likely to die of homicide than other races (17.56%-24.31%, P<0.001). In the cases of homicide, APIAs were more likely to have their deaths precipitated by another crime (40.87% versus 27.87%, P < 0.001). APIAs were more than twice as likely to die of strangulation than other races (39.93%-18.06%, P<0.001). Conversely, APIAs were less likely to die by firearm than other races (29.69-51.51, P<0.001). CONCLUSIONS: APIAs have a unique pattern of violence based on analysis of data from the National Violent Death Reporting System. Our data reveal a significant difference in the incident, weapon and location type as compared to Americans of other races, which begs further inquiry into the patterns of change in time and factors that contribute to inter-racial differences in death patterns.


Asunto(s)
Homicidio , Nativos de Hawái y Otras Islas del Pacífico , Suicidio , Violencia , Humanos , Causas de Muerte , Vigilancia de la Población , Estados Unidos
17.
J Surg Res ; 293: 490-496, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37827026

RESUMEN

INTRODUCTION: To investigate differences in homicide and suicide rates across college town status and determine whether college towns were predisposed to changes in rates over time. METHODS: We analyzed county-level homicide and suicide rates (total and by firearm) across college town status using 2015-2019 CDC death certificate data and data from the American Communities Project. RESULTS: Population-level homicide rates were similar across college town status, but younger age groups were at increased risk for firearm homicide and total homicide in college towns. College town status was associated with lower population-level firearm suicide rates, but individuals aged less than 18 y were at increased risk for total and firearm suicide. Finally, college towns were not classified as outliers for changes in either firearm homicide or suicide rates over time. CONCLUSIONS: College towns had similar homicide rates and significantly lower firearm suicide rates than other counties; however, individuals aged less than 18 y were at increased risk for both outcomes. The distinctive demographic, social, economic, and cultural features of college towns may contribute to differing risk profiles among certain age groups, thus may also be amenable to focused prevention efforts.


Asunto(s)
Armas de Fuego , Suicidio , Heridas por Arma de Fuego , Humanos , Estados Unidos/epidemiología , Homicidio , Ciudades , Vigilancia de la Población , Heridas por Arma de Fuego/epidemiología
18.
Prev Med ; 181: 107899, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38373477

RESUMEN

OBJECTIVE: To better understand processes of mental health crisis line utilization by examining associations between reasons for contacting a crisis line with the initiation of emergency dispatches (i.e., activation of 911 or local emergency services) in a national sample. METHODS: Contacts (i.e., calls, texts, email, and chats) to the Veterans Crisis Line (VCL) across 2017-2020 were used to examine associations among stated reasons for the contact and the use of an emergency dispatch. Hierarchical logistic regression models were used to determine the odds of an emergency dispatch by reason for the contact. RESULTS: Suicidal thoughts/crisis were present in 61.5% of contacts that ended in emergency dispatches and were associated with the largest adjusted odds of a dispatch, (Adjusted Odds Ratio [AOR] [95% CI] = 9.34 [9.21, 9.48]), followed by homicidal thoughts/crisis (AOR [95% CI] = 3.84 [3.73, 3.95]), and third-party concerns (AOR [95% CI] = 2.42 [2.37, 2.47]). Substance use/ addiction (AOR [95% CI] = 2.14 [2.10, 2.18]), abuse and violence (AOR [95% CI] = 1.89 [1.82, 1.96]), and physical health (AOR [95% CI] = 1.87 [1.84, 1.91]) were also associated with increased odds of a dispatch. CONCLUSIONS: Emergency dispatches are primarily used in response to imminent suicide risk but are also used in other potentially violent or lethal circumstances such as homicides, violence or abuse, and other crises. These findings highlight the role that crisis lines play in emergency service delivery, and the need to better understand how they are utilized under real world circumstances.


Asunto(s)
Trastornos Relacionados con Sustancias , Veteranos , Humanos , Ideación Suicida , Homicidio , Violencia , Salud Mental
19.
Prev Med ; 181: 107917, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38408647

RESUMEN

INTRODUCTION: Firearms are now the number one killer of children and adolescents in the United States. Firearm homicides among Black male youth are the driver of this increase. Prevention requires a multi-faceted life course approach. Academic achievement has been identified as a protective factor. Early childhood education, which is linked to later achievement, is thus an intervention area of interest. Conceptualizing the potential links between early childhood education and reduced risk for youth firearm homicide is important for guiding policy advocacy and informing future research. METHODS: This paper presents a conceptual model linking early childhood education to reduced risk for firearm homicide. Each link in the model is discussed, and a corresponding review of the literature is presented. The need for anti-racist policies to strengthen the impact of early childhood education is highlighted. RESULTS: Early education and firearm homicide research are each well-established but largely disconnected. There are clear immediate benefits of early childhood education; however, these effects wane with time, particularly for youth of color. At the same time, juvenile delinquency-a major risk factor for firearm homicide-is influenced by educational inequities. CONCLUSIONS: Effective interventions to reduce firearm homicides among Black male youth in the United States are needed. Early childhood education shows promise as an intervention. However, to have an impact, this education needs to be accessible and affordable for all, particularly families of color and low income. Societal structures and policies must also better support the positive gains seen through early childhood education to avoid dissipation.


Asunto(s)
Éxito Académico , Armas de Fuego , Adolescente , Niño , Preescolar , Humanos , Masculino , Escolaridad , Homicidio/prevención & control , Estados Unidos , Negro o Afroamericano
20.
Int J Legal Med ; 138(4): 1323-1328, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38438570

RESUMEN

Brodifacoum exerts its antagonistic effect against the metabolism of vitamin K, an essential component in the synthesis of blood coagulation factors. This effect ultimately hinders the blood's capacity to clot effectively, rendering it a commonly employed rodenticide. Instances of lethal poisonings are exceedingly rare owing to expeditious medical intervention and treatment. Within this report, we present a case of brodifacoum-induced homicide, wherein the patient exhibited distinct clinical examinations and symptoms. Moreover, the patient's blood sample exhibited a noteworthy brodifacoum concentration of 0.681 µg/mL even after a period of 43 days following the incident of poisoning. Although an autopsy was not conducted due to religious restrictions, we endeavor to reasonably deduce the cause of death and furnish corroborative evidence for clinical diagnosis, treatment, and forensic examination in instances involving brodifacoum poisoning.


Asunto(s)
Homicidio , Rodenticidas , Humanos , Rodenticidas/envenenamiento , Masculino , Cromatografía Liquida , Espectrometría de Masas en Tándem , Toxicología Forense , 4-Hidroxicumarinas/envenenamiento , Adulto , Cromatografía Líquida con Espectrometría de Masas
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