Geo-spatial risk factor analysis for drug overdose death in South Florida from 2014 to 2019, and the independent contribution of social determinants of health.

PURPOSE: The physical environment and social determinants of health have been shown to influence health behaviors including drug use and fatal drug overdose. The current research examines the effects of the built environment, social determinants of health measures and aggregated risk from the built environment at neighborhood-level on drug overdose death locations in Miami-Dade County, Florida. METHODS: Risk Terrain Modeling (RTM) was used to assess the place features risk factors that significantly increase the risk of drug overdose death spatially in Miami-Dade County ZIP Code Tabulation Areas, Florida from 2014 to 2019. An aggregated neighborhood risk of fatal drug overdose measure was developed by averaging the risk per grid cell from the RTM within census block groups each year. Six logistic and zero-inflated regression models were built to examine the effects of three indices of incident-specific social determinants of health (IS-SDH) measures and aggregated risk measures separately, and simultaneously on drug overdose death locations each year. RESULTS: Seven place features including parks, bus stops, restaurants and grocery stores were significantly related to the occurrence of fatal drug overdoses. When examined separately, one or more indices of the IS-SDH were significant covariates of drug overdose locations in some years. When examined simultaneously, the three indices of the IS-SDH and aggregated risk of fatal drug overdose measure could be all significant in certain years. CONCLUSIONS: The patterns of high-risk areas and place features identified from the RTM related to drug overdose deaths may be used to inform the placement of treatment and prevention resources. A multi-factor approach that combines an aggregated neighborhood risk measure reflecting the risk from the built environment and the incident-specific social determinants of health measures can be used to identify the drug overdose death locations in certain years.

Cognitive and Affective Processing of Risk Information: A Survey Experiment on Risk-Based Decision-Making Related to Crime and Public Safety.

The current study, using a multi-factorial survey experiment with a sample of the general public (N = 800), investigates if and how types of risk information on crime and public safety, such as maps, graphs, or tables, commonly used and communicated by law enforcement elicit dual-process (affective and cognitive) risk information processing in risk-based decision-making, and if such processing or decision-making differs depending on the risk level, context, or the type or format of risk information communicated. Participants responded to a vignette in which they were asked to choose a ride-share pick-up point within a certain geographic area with varying risk levels of being involved in a pedestrian-automobile crash. Results showed that risk information related to crime and public safety elicits dual-process risk information processing, and that both affective and cognitive processing significantly predicted risk-based decision-making, regardless of the risk level or type of risk information examined. Interestingly, risk information was used to create an almost "black and white" distinction for participants, in which their lowest-risk choice was treated as their comparison point, relative to all other higher levels of risk, in risk processing and decision-making. Further, the risk level or type of risk information examined did affect the nature and level of affective and cognitive processing elicited, suggesting that different types or characteristics of risk information can change modes of processing and their effects on risk-based decisions. Our findings provide first-of-its-kind data that show members of the general public, as consumers of risk information in relation to crime and public safety, process and make decisions surrounding such information using the dual-process approach. Implications for communicating risk information in relation to crime and public safety to both the general public and police, as well as how to extend the current inquiry to future areas of research on police, are discussed.

Cholera deaths in Soho, London, 1854: Risk Terrain Modeling for epidemiological investigations.

Risk Terrain Modeling (RTM) is a spatial analysis technique used to diagnose environmental conditions that lead to hazardous outcomes. Originally developed for applications to violent crime analysis, RTM is utilized here to analyze Dr. John Snow's data from the 1854 cholera outbreak in London to demonstrate its potential value to contemporary epidemiological investigations. Dr. Snow saved countless lives when he traced the source of the cholera outbreak to a specific water pump through inductive reasoning, which he communicated through maps and spatial evidence. His methods have since inspired several fields of scientific inquiry. Informed by the extant research on RTM, we speculated that it could have helped test Dr. Snow's hypothesis about cholera and empirically identified the sole source of contaminated well water. We learned that it could and, although it was not available to Dr. Snow in the 1800s, we discuss RTM's implications for present-day research and practice as it relates to the analysis, prevention and treatment of cholera and other public health threats around the world.

Neighborhood Violent Crime and Academic Performance: A Geospatial Analysis.

Decades of empirical work have confirmed that experiences with violence are associated with a variety of adverse behavioral and mental health as well as academic outcomes for children and adolescents. Yet this research largely has relied on indirect measures of exposure. In this study, we apply geospatial analysis to examine the relation between neighborhood violent crime (via police reports) and academic performance (via school-level standardized test proficiency rates). Findings suggest that greater numbers of crimes proximal to school buildings relate to lower levels of academic performance. These results persisted even when controlling economic disadvantage in the student body. Implications for research and policy are discussed.

Parole release decisions: impact of positive and negative victim and nonvictim input on a representative sample of parole-eligible inmates.

This study analyzed administrative data from the New Jersey State Parole Board to determine the extent to which victim and nonvictim input impacted parole release decisions. Positive and negative input, in both verbal and written forms, was studied for a representative sample of 820 parole-eligible adult inmates. Victim input was not found to be a significant predictor of parole release; measures of institutional behavior, crime severity, and criminal history were significant. Though insignificant, verbal input had a greater effect than written input. Results suggest that the impact of victim input is not generalizable across different types of offenders or across different paroling jurisdictions. It can no longer be assumed that victim rights laws and public participation at parole guarantee victim-desired outcomes.

A meta-analysis of prehospital care times for trauma.

BACKGROUND: Time to definitive care is a major determinant of trauma patient outcomes yet little is empirically known about prehospital times at the national level. We sought to determine national averages for prehospital times based on a systematic review of published literature. METHODS: We performed a systematic literature search for all articles reporting prehospital times for trauma patients transported by helicopter and ground ambulance over a 30-year period. Forty-nine articles were included in a final meta-analysis. Activation time, response time, on-scene time, and transport time were abstracted from these articles. Prehospital times were also divided into urban, suburban, rural, and air transports. Statistical tests were computed using weighted arithmetic means and standard deviations. RESULTS: The data were drawn from 20 states in all four U.S. Census Regions and represent the prehospital experience of 155,179 patients. Average duration in minutes for urban, suburban, and rural ground ambulances for the total prehospital interval were 30.96, 30.97, and 43.17; for the response interval were 5.25, 5.21, and 7.72; for the on-scene interval were 13.40, 13.39, and 14.59; and for the transport interval were 10.77, 10.86, and 17.28. Average helicopter ambulance times were response 23.25, on-scene 20.43, and transport 29.80 minutes. CONCLUSIONS: Despite the emphasis on time in the prehospital and trauma literature there has been no national effort to empirically define average prehospital time intervals for trauma patients. We provide points of reference for prehospital intervals so that policymakers can compare individual emergency medical systems to national norms.