State-level structural racism and adolescent mental health in the United States.

We explored state-level indicators of structural racism on internalizing symptoms of depressive affect among US adolescents. We merged 16 indicators of state-level structural racism with 2015-19 Monitoring the Future surveys (N=41,258) examining associations with loneliness, self-esteem, self-derogation, and depressive symptoms using regression analyses. Students racialized as Black in states with bans on food stamp eligibility and temporary assistance for drug felony conviction had 1.37 times the odds of high depressive symptoms (95% C.I. 1.01-1.89) compared to students in states without bans. In contrast, students racialized as White living in states with more severe disenfranchisement of people convicted of felonies had lower odds of high self-derogation (OR=0.89, 95% C.I. 0.78-1.02) and high depressive symptoms (OR=0.83, 95% C.I. 0.70-0.99) compared to states with less severe disenfranchisement. These findings demonstrate the need to address the legacy of structural racism at the state level to reduce mental distress for US youth.

The association between street construction projects and community violence in New York City.

Introduction: Community violence is a major cause of injury and death in the United States. Empirical studies have identified that some place-based interventions of urban private places, such as remediations of vacant lots and buildings, are associated with reductions in community violence in surrounding areas. The aim of this study was to examine whether routine maintenance and repair of urban public places (e.g., street construction projects) are also associated with reductions in community violence, proxied by violent crime. Method: This staggered adoption difference-in-difference analysis investigated the association between street construction projects and community violence in New York City from 2010-2019, divided into 40 calendar quarters. The units of analysis were street-quarters (n = 155,280). Intervention street-quarters were those with completed projects in 2010-2019; control streets were those where projects were scheduled but not completed before 2019. The outcome of community violence was proxied by counts of crime and violence incidents reported to the New York Police Department, within street-quarters. Results: There were 79,592 street-quarters with any community violence incidents (51.2%). We found that street construction projects were associated with a decrease in reckless endangerment (ATT = -0.013; 95% CI = -0.021, -0.004), robbery (ATT = -0.035; 95% CI = -0.063, -0.007), and weapons offenses (ATT = -0.016; 95% CI = -0.031, -0.001) occurring on street-quarters. Conclusion: Street construction projects may be yet another type of place-based intervention to reduce community violence.

Physical environmental roadway interventions and injury and death for vulnerable road users: a natural experiment in New York City.

INTRODUCTION: This study examined the effectiveness of three physical environmental roadway interventions (enhanced crossings, speed humps, and turn traffic calming) in preventing crashes involving pedestrian and cyclist injury and mortality in New York City. METHODS: We examined crashes that occurred within a 100-foot radius of intervention and control sites from 2015 to 2019. We used a staggered difference-in-difference design to estimate the association between each intervention type and pedestrian and cyclist crash outcomes. RESULTS: Estimates for enhanced crossings and speed humps included the possibility of no association with crashes, but estimates for turn traffic calming interventions showed reduced odds of crashes involving pedestrian injury by 16% (OR 0.84, 95% CI 0.74 to 0.95) and crashes involving pedestrian fatality by 80% (OR 0.20, 95% CI 0.08 to 0.47). When stratifying by street segment length as a proxy for areas with high speeding risk, turn traffic calming treatments appeared to be most effective at intersections connected to long street segments. DISCUSSION: Turn traffic calming may substantially reduce crash risks for pedestrians. Municipalities can prioritise this physical environmental intervention, especially at turns near long street segments, as a low-cost intervention with substantial public health impact.

Trends in police complaints and arrests on New York City subways, 2018 to 2023: an interrupted time-series analysis.

BACKGROUND: Public transportation use is influenced by perceptions of safety. Concerns related to crime on New York City (NYC) transit have risen following NYC's COVID-19 pandemic state of emergency declaration in 2020, leading to declines in subway ridership. In response, the most recent mayoral administration implemented a Subway Safety Plan in 2022. This study aimed to quantify the effects of the COVID-19 pandemic and the Subway Safety Plan on rates of complaints to and arrests by the New York City Police Department (NYPD) Transit Bureau. METHODS: Using publicly available data on complaints and arrests, we conducted interrupted time-series analyses using autoregressive integrated moving average models applied to monthly data for the period from September 2018 to August 2023. We estimated changes in the rates of complaints to and arrests by the NYPD Transit Bureau before and after: (1) the COVID-19 pandemic state of emergency declaration (i.e., March 2020), and (2) the announcement of the Subway Safety Plan (i.e., February 2022). We also examined trends by complaint and arrest type as well as changes in proportion of arrests by demographic and geographic groups. RESULTS: After the COVID-19 pandemic declaration, there was an 84% increase (i.e., an absolute increase of 6.07 per 1,000,000 riders, CI 1.42, 10.71) in complaints to the NYPD Transit Bureau, including a 99% increase (0.91 per 1,000,000 riders, CI 0.42, 1.41) in complaints for assault and a 125% increase in complaints for harassment (0.94 per 1,000,000 riders, CI 0.29, 1.60). Following the Subway Safety Plan there was an increase in the rate of arrests for harassment (0.004 per 1,000,000 riders, CI 0.001, 0.007), as well as decreases in the proportion of arrests for individuals racialized as White (- 0.02, CI - 0.04, - 0.01) and proportion of arrests in the borough of Manhattan (- 0.13, CI - 0.17, - 0.09). CONCLUSIONS: The increased rates of complaints to the NYPD Transit Bureau following the onset of the COVID-19 pandemic remained elevated following the enactment of the Subway Safety Plan. Further evaluation efforts can help identify effective means of promoting safety on public transportation.

"Hang Ups, Let Downs, Bad Breaks, Setbacks": Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black.

Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as "hang ups, let downs, bad breaks, setbacks" that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. Methods: We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930-2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954-59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models. Results: Older adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts. Discussion: These findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.

Interstate Highway Connections and Traced Gun Transfers Between the 48 Contiguous United States.

Importance: Interstate gun flow has critical implications for gun violence prevention, as gun transfers across state lines can undermine local gun control policies. Objective: To identify possible gun trafficking routes along interstate highways in the US. Design, Setting, and Participants: This repeated-measures, ecological, cross-sectional study used data from the Bureau of Alcohol, Tobacco, Firearms and Explosives from January 1, 2010, to December 31, 2019, to examine associations between interstate connections via 13 highways that each spanned at least 1000 miles and interstate traced gun transfer counts for the 48 contiguous United States. Analyses were completed in November 2023. Exposures: Characteristics of the origin states and the transportation connections between the destination state and the origin states. Main Outcomes and Measures: The main outcome was the total count of guns used in crimes in each destination state per year that were originally purchased in the origin state. Bayesian conditional autoregressive Poisson models were used to examine associations between the count of guns used in crime traced to interstate purchases and interstate highway connections between origin and destination states. Results: Between 2010 and 2019, 526 801 guns used in crimes in the contiguous 48 states were traced to interstate purchases. Northbound gun transfers along the Interstate 95 corridor were greater than expected to New Jersey (incidence rate ratio [IRR], 2.80; 95% credible interval [CrI], 1.01-7.68) and Maryland (IRR, 3.07; 95% CrI, 1.09-8.61); transfers were similarly greater along Interstate 15 southbound, Interstate 25 southbound, Interstate 35 southbound, Interstate 75 northbound and southbound, Interstate 10 westbound, and Interstate 20 eastbound and westbound. Conclusions and Relevance: This repeated-measures, ecological, cross-sectional study identified that guns used in crimes traced to interstate purchases moved routinely between states along multiple major transportation routes. Interstate gun transfers are a major contributor to gun crime, injury, and death in the US. National policies and interstate cooperation are needed to address this issue.

Defining Spatial Epidemiology: A Systematic Review and Re-orientation.

BACKGROUND: Spatial epidemiology has emerged as an important subfield of epidemiology over the past quarter century. We trace the origins of spatial epidemiology and note that its emergence coincided with technological developments in spatial statistics and geography. We hypothesize that spatial epidemiology makes important contributions to descriptive epidemiology and analytic risk-factor studies but is not yet aligned with epidemiology's current focus on causal inference and intervention. METHODS: We conducted a systematic review of studies indexed in PubMed that used the term "spatial epidemiolog*" in the title, abstract, or keywords. Excluded articles were not written in English, examined disease in animals, or reported biologic pathogen distribution only. We coded the included papers into five categories (review, demonstration of method, descriptive, analytic, and intervention) and recorded the unit of analysis (i.e., individual vs. ecological). We additionally examined articles coded as analytic ecologic studies using scales for lexical content. RESULTS: A total of 482 articles met the inclusion criteria, including 76 reviews, 117 demonstrations of methods, 122 descriptive studies, 167 analytic studies, and 0 intervention studies. Demonstration studies were most common from 2006 to 2014, and analytic studies were most common after 2015. Among the analytic ecologic studies, those published in later years used more terms relevant to spatial statistics (incidence rate ratio =1.3; 95% confidence interval [CI] = 1.1, 1.5) and causal inference (incidence rate ratio =1.1; 95% CI = 1.1, 1.2). CONCLUSIONS: Spatial epidemiology is an important and growing subfield of epidemiology. We suggest a re-orientation to help align its practice with the goals of contemporary epidemiology.

Individuals' travel to alcohol outlets: The fallacy of the local bar.

INTRODUCTION: Studies relating alcohol outlet density around homes to alcohol consumption produce mixed results. One possible explanation is that people travel to outlets away from their homes. This study aims to characterise individuals' trips to outlets, describe these trip locations relative to other activities and estimate associations between alcohol outlet density and trips to outlets. METHODS: This cross-sectional study used 2014-2018 household travel data from the Victoria Integrated Survey of Travel and Activity. We estimated the average change in the cumulative travel characteristics associated with each additional trip to bars and liquor stores, accounting for complex trips to multiple destinations. Logistic regression models estimated odds that individuals travelled to outlets in relation to outlet density in their home local government area (LGA). RESULTS: Among 23,512 respondents, 378 (1.6%) travelled to any bar and 79 (0.3%) any liquor store the survey day. Bar trips added 8.2 km (95% confidence interval [CI] 4.6, 11.8) and 18.1 min (95% CI 13.6, 22.6) to cumulative travel; 41% of attended bars were co-located in participants' home LGA. Greater bar and liquor store density within the home LGA were associated with overall trips to these outlet types. DISCUSSION AND CONCLUSIONS: Individuals travel beyond their residential area to bars, but travel to liquor stores closer to home. Bar and liquor store density within individuals' home LGA were associated with trips to outlets. Trips to local bars in near home comprised a minority of trips to bars in this sample. Studies of retail alcohol access should account for trips to bars away from home.

The Effect of Gun-Free School Zones on Crimes Committed with a Firearm in Saint Louis, Missouri.

There have been no peer-reviewed, quantitative research studies on the effectiveness of gun-free school zones. The objective of this study was to use a cross-sectional, multi-group controlled ecological study design in St. Louis, MO city that compared the counts of crimes committed with a firearm occurring in gun-free school zones compared to a contiguous area immediately surrounding the gun-free school zone (i.e., gun-allowing zones) in 2019. Gun-free school zones were measured and analyzed in two ways. In the primary analysis, boundaries of the tax parcels were used for each school as the beginning of the gun-free school zone. Results from this analysis, after adjustment for pair-matching and confounding, were null. In the secondary analysis, gun-free school zones were measured as beginning at the geographic centroid of the school's address. After adjusting for the pair-matching and confounding, this analysis showed 13.7% significantly fewer crimes committed with a firearm in gun-free school zones compared to gun-allowing zones. These results suggest that gun-free school zones are not being targeted for firearm crime in St. Louis, MO.

Assessing the Gun Violence Archive as an Epidemiologic Data Source for Community Firearm Violence in 4 US Cities.

Importance: Firearm injury is a major public health burden in the US, and yet there is no single, validated national data source to study community firearm violence, including firearm homicide and nonfatal shootings that result from interpersonal violence. Objective: To assess the validity of the Gun Violence Archive as a source of data on events of community firearm violence and to examine the characteristics of individuals injured in shootings. Design, Setting, and Participants: This cross-sectional observational study compared data on community firearm violence from the Gun Violence Archive with publicly available police department data, which were assumed to be the reference standard, between January 1, 2015, and December 31, 2020. Cities included in the study (Philadelphia, Pennsylvania; New York, New York; Chicago, Illinois; and Cincinnati, Ohio) had a population of greater than 300 000 people according to the 2020 US Census and had publicly available shooting data from the city police department. A large city was defined as having a population greater than or equal to 500 000 (ie, Philadelphia, New York City, and Chicago). Data analysis was performed in December 2022. Main Outcomes and Measures: Events of community firearm violence from the Gun Violence Archive were matched to police department shootings by date and location. The sensitivity and positive predictive value of the data were calculated (0.9-1.0, excellent; 0.8-0.9, good; 0.7-0.8, fair; 0.6-0.7, poor; and <0.6, failed). Results: A total of 26 679 and 32 588 shooting events were documented in the Gun Violence Archive and the police department databases, respectively, during the study period. The overall sensitivity of the Gun Violence Archive over the 6-year period was 81.1%, and the positive predictive value was 99.0%. The sensitivity steadily improved over time. Shootings involving multiple individuals and those involving women and children were less likely to be missing from the Gun Violence Archive, suggesting a systematic missingness. Conclusions and Relevance: These findings support the use of the Gun Violence Archive in large cities for research requiring its unique advantages (ie, spatial resolution, timeliness, and geographic coverage), albeit with caution regarding a more granular examination of epidemiology given its apparent bias toward shootings involving multiple persons and those involving women and children.

Trends in alcohol-impaired crashes in California, 2016 to 2021: A time series analysis for alcohol involvement and crash distribution among demographic subgroups.

BACKGROUND: In 2020, the COVID-19 pandemic and control measures changed alcohol consumption in the United States (US) and globally. Before the pandemic, alcohol-impaired crashes contributed to approximately one-third of all road traffic crash injuries and fatalities nationally. We examined the impact of the COVID-19 pandemic on crashes and examined differences in alcohol-involved crashes across various subgroups. METHODS: The University of California Berkeley Transportation Injury Mapping Systems provided information on all crashes reported to the California Highway Patrol from January 1, 2016 through December 31, 2021. Using autoregressive integrated moving average (ARIMA) models applied to weekly time series data, we estimated the effect of California's first mandatory statewide shelter-in-place order (March 19, 2020) on crashes per 100,000 population. We also examined crash subgroups according to crash severity, sex, race/ethnicity, age, and alcohol involvement. RESULTS: In California, the mean crash rate per week before the pandemic (January 1, 2016-March 18, 2020) was 9.5 crashes per 100,000 population, and 10.3% of those were alcohol-involved. After the initiation of the COVID-19 stay-at-home order, the percentage of crashes that were alcohol-involved rose to 12.7%. Overall, the crash rate across California decreased significantly (-4.6 crashes per 100,000; 95% CI: -5.3, -3.9), including across all examined subgroups, with the greatest decrease among the least severe crashes. However, there was a 2.3% absolute increase in the proportion of crashes that were alcohol-involved (0.02 crashes per 100,000; 95% CI: 0.02, 0.03). CONCLUSIONS: The initiation of a COVID-19 stay-at-home ordinance in California was associated with a substantial decrease in overall crash rates. While crashes have returned to pre-pandemic levels, alcohol-involved crashes remain elevated. The initiation of the stay-at-home order significantly increased alcohol-impaired driving, which has remained elevated.

Self-Report Survey Measures of Alcohol-Impaired Driving: A Systematic Review.

OBJECTIVE: Alcohol-impaired driving is a major contributor to motor vehicle crash deaths and injury. Many survey studies include self-report measures of alcohol-impaired driving, but no guidance is available to help researchers select from among available measures. The aims of this systematic review were to compile a list of measures that researchers have used previously, to compare performance between measures, and to identify the measures with highest validity and reliability. METHOD: Literature searches of PubMed, Scopus, and Web of Science identified studies that assessed alcohol-impaired driving behavior through self-report. The measures from each study and, if available, indices of reliability or validity were extracted. Using the measures' text, we developed 10 codes to group similar measures and compare them. For example, the "alcohol effects" code refers to driving while feeling dizzy or lightheaded after drinking, and the "drink count" code pertains to the number of drinks someone consumed before driving. For measures with multiple items, each item was categorized separately. RESULTS: After screening according to the eligibility criteria, 41 articles were included in the review. Thirteen articles reported on reliability. No articles reported on validity. The self-report measures with the highest reliability coefficients contained items from multiple codes, namely alcohol effects and drink count. CONCLUSIONS: Self-report alcohol-impaired driving measures with multiple items evaluating distinct aspects of alcohol-impaired driving show better reliability than measures using a single item. Future work investigating the validity of these measures is needed to determine the best approach for conducting self-report research in this area.

Firearm Death Rates in Rural vs Urban US Counties.

This cross-sectional study examines the variability in firearm mortality risk by county type across the full rural-urban continuum in the US.

Optimizing sobriety checkpoints to maximize public health benefits and minimize operational costs.

BACKGROUND: Sobriety checkpoints are a highly effective strategy to reduce alcohol-impaired driving, but they are used infrequently in the USA. Recent evidence from observational studies suggests that using optimized sobriety checkpoints-operating for shorter duration with fewer officers-can minimize operational costs without reducing public health benefits. The aim of this research was to conduct a pilot study to test whether police can feasibly implement optimized sobriety checkpoints and whether researchers can examine optimized sobriety checkpoints compared to usual practice within a non-randomized controlled trial study design. METHODS: The study site was the Town of Apex, NC. We worked with Apex Police Department to develop a schedule of sobriety checkpoints during calendar year 2021 that comprised 2 control checkpoints (conducted according to routine practice) and 4 optimized checkpoints staffed by fewer officers. Our primary operations aim was to test whether police can feasibly implement optimized sobriety checkpoints. Our primary research aim was to identify barriers and facilitators for conducting an intervention study of optimized sobriety checkpoints compared to usual practice. A secondary aim was to assess motorist support for sobriety checkpoints and momentary stress while passing through checkpoints. RESULTS: Apex PD conducted 5 of the 6 checkpoints and reported similar operational capabilities and results during the optimized checkpoints compared to control checkpoints. For example, a mean of 4 drivers were investigated for possibly driving while impaired at the optimized checkpoints, compared to 2 drivers at control checkpoints. The field team conducted intercept surveys among 112 motorists at 4 of the 6 checkpoints in the trial schedule. The survey response rate was 11% from among 1,045 motorists who passed through these checkpoints. Over 90% of respondents supported sobriety checkpoints, and momentary stress during checkpoints was greater for motorists who reported consuming any alcohol in the last 90 days compared to nondrinkers (OR = 6.7, 95%CI: 1.6, 27.1). CONCLUSIONS: Results of this study indicate the sobriety checkpoints can feasibly be optimized by municipal police departments, but it will be very difficult to assess the impacts of optimized checkpoints compared to usual practice using an experimental study design.

Casino accessibility and suicide: A county-level study of 50 US states, 2000 to 2016.

BACKGROUND AND AIMS: Suicide is the tenth leading cause of death in the United States (US). Research over many decades identifies that its etiology is complex, with risk factors operating in multiple domains. One such risk factor is gambling. Over the past three decades, exposure to gambling has increased dramatically in the United States. The aim of this study was to measure the magnitude of the association between casino density and absolute risk of suicide in US counties. DESIGN, SETTING, CASES: This spatial panel analysis used data for 3131 counties from 50 US states from 2000 to 2016, for an overall sample of 53 227 county-year units. Using Bayesian conditional autoregressive Poisson models, we measured incidence rate ratios and credible intervals for the association between the density per population of casinos and other gambling outlets and the incidence of suicide. MEASUREMENTS: The outcome of interest was counts of suicides. The main exposures of interest were casinos and other gambling outlets. FINDINGS: A total of 527 401 suicides occurred during the study period. On average, there was a mean of 1.3 casinos (SD = 9.1) and 1.4 other gambling venues (SD = 5.9) in each county-year. After controlling for confounding, the incidence rate ratio for casinos was 1.016, and the credible interval was between 1.010 and 1.023. CONCLUSIONS: The density of casinos and other gambling venues is positively associated with suicide mortality in the United States.

Firearm assaults against US law enforcement officers in the line-of-duty: Associations with firearm ownership and state firearm laws.

Law enforcement officers are disproportionately affected by occupational injury. Firearm violence is the second leading cause of occupational mortality for this group behind motor vehicle crashes. In the general population, greater firearm ownership and weaker firearm laws are associated with increased firearm violence incidence. It is plausible that a high prevalence of firearms could also be associated with a greater incidence of LEO assault with a firearm. Using data from the Federal Bureau of Investigation's, Uniform Crime Reporting, Police Employee Data for 2006-2016, we conducted a panel analysis to estimate the association between state-level estimates of household firearm ownership and LEO assault with a firearm. We additionally examined if effect modification by universal background check law status was present. Higher state-level firearm ownership was associated with an increased odds of LEO assault with a firearm in multi-level models. This association was modified by universal background check law status. In states without a universal background check law, for every 1% increase in state-level firearm ownership per agency-year, there was a 12.4% increase in the odds of an LEO assault with a firearm when adjusting for confounders (OR:1.124; 95% CI:1.018,1.240). In states with a universal background check law, there was no association. Findings, though small in magnitude, suggest aggregate firearm ownership may contribute to LEO assault with a firearm in states without a universal background check law. Future research to prevent LEO assault with a firearm should combine measures to address high rates of firearm ownership with other evidence-based prevention strategies.

Historical redlining and the epidemiology of present-day firearm violence in the United States: A multi-city analysis.

Firearm violence is a major cause of morbidity, mortality, and racial health disparities in the United States. Previous studies have identified associations between historically racist housing discrimination (i.e., redlining practices) and firearm violence; however, these studies generally have been limited to a single city and have yet to provide sufficient evidence through which to determine the extent and dynamics of the impact of this relationship across the country. The aim of our study was (1) to estimate the association of historical redlining on both violent and firearm death across the country in nested models; and (2) to examine spatial non-stationarity to determine whether the impact of historical redlining on violent and firearm death was the same across the U.S. We used multilevel Bayesian conditional autoregressive Poisson models to determine the relationship between redlining as illustrated through Home Owners' Loan Corporation maps and 2019 violent and firearm deaths at the ZIP code-level nested within 21 cities across the U.S. We found that at the ZIP code level, there was a dose-responsive relationship between HOLC grading and the incidence of present-day firearm deaths. In general, redlined ZIP codes had higher relative incidence of firearm deaths. Associations were not stable across cities. For example, associations were relatively stronger in Baltimore, MD and weaker in Los Angeles, CA. This research reinforces the findings of previous studies examining the impact of redlining on firearm death across the extent of the entire country in 21 cities and claim that HOLC grades are associated with present-day violence.

Gun shows and universal background check laws across state lines.

States with more gun laws have fewer gun assaults, and associations are strongest for background check laws. However, sales between private buyers and sellers (i.e., gun shows) are exempt from some background check requirements according to federal and most state laws. The aim of this study was to determine whether gun shows are more likely to take place in counties that are near states with universal background check laws. This cross-sectional study used gun show data from a 2018 public online listing aggregated within 3107 counties in the contiguous 48 states. The main independent variable was the presence of a universal background check law in neighboring states. We controlled for potential drivers of demand for gun shows, including the total number of gun laws within-state and in neighboring states, local and in-flowing population size, and proportion of the local and in-flowing population who were gun owners. Bayesian conditional autoregressive Poisson models estimated associations between neighboring-state universal background check law and the presence of a gun show in each county while accounting for spatial dependencies and nesting of counties within states. Of the 1869 identified gun shows, nine of the states in which they occurred had a universal background check law. The presence of excess gun shows in counties near states with universal background check laws is consistent with the hypothesis that gun shows service demand from people seeking to circumvent prohibitions against gun purchases.

Overflowing Disparities: Examining the Availability of Litter Bins in New York City.

In the 1980s, activists' concerns about the disproportionate placements of landfills in low-income communities ignited the environmental justice movement. Today, similar issues of environmental injustice-the limited availability of litter bins across New York City (NYC) neighborhoods-remain unresolved. This study examines the association between NYC neighborhood income and litter bin availability. The NYC Department of Sanitation 2020 Litter Bin Inventory and archival measures of neighborhood composition and socioeconomic status were aggregated within NYC census tract neighborhoods. Multilevel Bayesian conditional autoregressive Poisson models estimated the prevalence rate ratio for counts of litter bins according to median household income in each census tract, accounting for spatial autocorrelation. Bivariate associations identified that census tracts with higher median household income had a greater prevalence of litter bins than census tracts with lower median household income; however, spatial autocorrelation attenuated the relationship between median household income and availability of litter bins. Further research is necessary to identify the spatially structured condition that accounted for the observed effect. The results warrant further investigation of both perceived and actual disparities in litter bin availability.

The changing epidemiology of interpersonal firearm violence during the COVID-19 pandemic in Philadelphia, PA.

Recent increases in firearm violence in U.S. cities are well-documented, however dynamic changes in the people, places and intensity of this public health threat during the COVID-19 pandemic are relatively unexplored. This descriptive epidemiologic study spanning from January 1, 2015 - March 31, 2021 utilizes the Philadelphia Police Department's registry of shooting victims, a database which includes all individuals shot and/or killed due to interpersonal firearm violence in the city of Philadelphia. We compared victim and event characteristics prior to the pandemic with those following implementation of pandemic containment measures. In this study, containment began on March 16, 2020, when non-essential businesses were ordered to close in Philadelphia. There were 331 (SE = 13.9) individuals shot/quarter pre-containment vs. 545 (SE = 66.4) individuals shot/quarter post-containment (p = 0.031). Post-containment, the proportion of women shot increased by 39% (95% CI: 1.21, 1.59), and the proportion of children shot increased by 17% (95% CI: 1.00, 1.35). Black women and children were more likely to be shot post-containment (RR 1.11, 95% CI: 1.02, 1.20 and RR 1.08, 95% CI: 1.03, 1.14, respectively). The proportion of mass shootings (≥4 individuals shot within 100 m within 1 h) increased by 53% post-containment (95% CI: 1.25, 1.88). Geographic analysis revealed relative increases in all shootings and mass shootings in specific city locations post-containment. The observed changes in firearm injury epidemiology following COVID-19 containment in Philadelphia demonstrate an intensification in firearm violence, which is increasingly impacting people who are likely made more vulnerable by existing social and structural disadvantage. These findings support existing knowledge about structural causes of interpersonal firearm violence and suggest structural solutions are required to address this public health threat.