Neighborhood Racial and Economic Segregation and Disparities in Violence During the COVID-19 Pandemic.

Objectives. To describe associations between neighborhood racial and economic segregation and violence during the COVID-19 pandemic. Methods. For 13 US cities, we obtained zip code-level data on 5 violence outcomes from March through July 2018 through 2020. Using negative binomial regressions and marginal contrasts, we estimated differences between quintiles of racial, economic, and racialized economic segregation using the Index of Concentration at the Extremes as a measure of neighborhood privilege (1) in 2020 and (2) relative to 2018 through 2019 (difference-in-differences). Results. In 2020, violence was higher in less-privileged neighborhoods than in the most privileged. For example, if all zip codes were in the least privileged versus most privileged quintile of racialized economic segregation, we estimated 146.2 additional aggravated assaults (95% confidence interval = 112.4, 205.8) per zip code on average across cities. Differences over time in less-privileged zip codes were greater than differences over time in the most privileged for firearm violence, aggravated assault, and homicide. Conclusions. Marginalized communities endure endemically high levels of violence. The events of 2020 exacerbated disparities in several forms of violence. Public Health Implications. To reduce violence and related disparities, immediate and long-term investments in low-income neighborhoods of color are warranted. (Am J Public Health. 2022;112(1):144-153. https://doi.org/10.2105/AJPH.2021.306540).

Dog thefts - but not prosecutions - on the rise.

Georgina Mills reports on new findings from the Kennel Club showing that dog thefts are on the rise but criminal charges are rarely brought.

Analyzing the relationship between air pollution and various types of crime.

Air pollution has a severe impact on human physical and mental health. When the air quality is poor enough to cause respiratory irritation, people tend to stay home and avoid any outdoor activities. In addition, air pollution may cause mental health problems (depression and anxiety) which were associated with high crime risk. Therefore, in this study, it is hypothesized that increasing air pollution level is associated with higher indoor crime rates, but negatively associated with outdoor crime rates because it restricts people's daily outdoor activities. Three types of crimes were used for this analysis: robbery (outdoor crime), domestic violence (indoor crime), and fraud (cybercrime). The results revealed that the geographically and temporally weighted regression (GTWR) model performed best with lower AIC values. In general, in the higher population areas with more severe air pollution, local authorities should allocate more resources, extra police officers, or more training programs to help them prevent domestic violence, rather than focusing on robbery.

Impact of a crime prevention ordinance for small retail establishments.

BACKGROUND: Ordinances requiring the implementation of robbery prevention measures have been enacted at the city level in many jurisdictions. We evaluated the impact of an ordinance requiring crime prevention measures on subsequent crime rates. METHODS: Crime reports for robbery and aggravated assault from January 2006 through December 2015 were linked to randomly-selected convenience stores and small retail grocers in Houston (n = 293). Store characteristics and compliance with a list of safety measures were collected by surveyors in 2011. Generalized linear mixed models were used to compare rates of crime before and after the implementation of the ordinance. RESULTS: Robberies decreased significantly after the ordinance went into effect (rate ratio = 0.38; 95% confidence interval 0.29-0.51). No individual safety measure was associated with decreased robbery rates. No similar decrease was observed for aggravated assault. CONCLUSIONS: City ordinances mandating crime prevention measures can be effective. We could not parse out the effectiveness of individual elements, suggesting a comprehensive approach may be more effective.

Perceived Types, Causes, and Consequences of Financial Exploitation: Narratives From Older Adults.

OBJECTIVES: The goal of this study was to investigate the perception of financial exploitation and its causes and consequences by older adults who have firsthand experience of being exploited. METHOD: Thirty-one cognitively healthy older adult participants aged 50 or older were drawn from the Finance, Cognition, and Health in Elders Study. In-depth, one-on-one interviews were conducted. Interview transcripts were analyzed using an iterative, data-driven, thematic coding scheme and emergent themes were summarized. RESULTS: Categories of financial exploitation included (a) investment fraud, (b) wage theft/money owed, (c) consumer fraud, (d) imposter schemes, and (e) manipulation by a trusted person. Themes emerged around perceived causes: (a) element of trust, (b) promise of financial security, (c) lack of experience or awareness, (d) decision-making, and (e) interpersonal dynamics. Perceived consequences included negative and positive impacts around (a) finances, (b) financial/consumer behaviors (c) relationships and trust, (d) emotional impact, and (e) future outlook. DISCUSSION: These narratives provide important insights into perceived financial exploitation experiences.

Friends and relatives as sources of prescription opioids for misuse among young adults: The significance of physician source and race/ethnic differences.

Background: Given the public health issues associated with prescription opioid misuse, there is surprisingly little research on sources of prescription opioids for misuse. We know that free from friends/relatives is the most common source, that source is associated with patterns of misuse, and that sources vary based on the sociodemographic characteristics. The current research assesses how friends/relatives obtain the prescription opioids they freely share with others. Methods: Data were from the 2009-2014 National Survey on Drug Use and Health and focused on respondents aged 18 to 25 (N = 106,845), as they report the highest prevalence of opioid misuse and are also more likely to obtain prescription opioids free from friends/relatives. Analyses used weighted cross-tabulations and design-based logistic regression to examine the relationships between sources of prescription opioids shared by friends/relatives and sociodemographic characteristics, substance use disorders, and risk behavior. Results: The most common source was from one physician (68.8%), and 18.4% of respondents reported multiple sources of opioids. We also found significant differences in friend/relative sources based on school enrollment, sex, and race/ethnicity of the person obtaining the opioids. Notably, white respondents were more likely to report theft/fake prescription, purchases, and multiple sources. Finally, friend/relative sources were significantly associated with substance use disorders and other risk behaviors. Conclusions: The current research assesses the sharing of prescription opioids between friends/relatives, highlights physicians as a major source, and identifies whites as a vulnerable group. Policy implications associated with the sharing of prescription opioids among friends/relatives are discussed.

Crimes by people with schizophrenia in Korea: comparison with the general population.

BACKGROUND: This study was performed to describe the prevalence of crimes committed by persons with schizophrenia using population-based data and to compare the crime prevalence of persons with schizophrenia and the general population. METHODS: The number of crimes was obtained from the Korean National Policy Agency (KNPA) crime statistics (2012-2016), which provide the number of crimes in terms of the criminal's mental status and mental health conditions. For the number of persons with schizophrenia, estimates were used which had been calculated from the inpatient and outpatient claims from the National Health Insurance Service. The crime prevalence in persons with schizophrenia was calculated according to the types of crimes, and a comparison with the general population was conducted. RESULTS: The overall crime prevalence of persons with schizophrenia was 72.7 to 90.3 per 10,000 from 2012 through 2016, which was about one fifth that of the general population. While the crime rates of the persons with schizophrenia were lower than the general population in most types of crimes including violence, intellectual crimes, and theft, the prevalence of murder, arson, and drug-related crimes in persons with schizophrenia was about five times, six times, and two times that of the general population respectively. CONCLUSION: The higher prevalence of serious offences among persons with schizophrenia suggests the need for closer and more appropriate care for the population, which would be achieved through effective continuity of institutional and community care.

Corruption in Anglophone West Africa health systems: a systematic review of its different variants and the factors that sustain them.

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals. The first step in tackling corruption systematically is to understand its scale and nature. We present a systematic review of literature that explores corruption involving front-line healthcare providers, their managers and other stakeholders in health sectors in the five Anglophone West African (AWA) countries: Gambia, Ghana, Liberia, Nigeria and Sierra Leone, identifying motivators and drivers of corrupt practices and interventions that have been adopted or proposed. Boolean operators were adopted to optimize search outputs and identify relevant studies. Both grey and published literature were identified from Research Gate, Yahoo, Google Scholar, Google and PubMed, and reviewed and synthesized around key domains, with 61 publications meeting our inclusion criteria. The top five most prevalent/frequently reported corrupt practices were (1) absenteeism; (2) diversion of patients to private facilities; (3) inappropriate procurement; (4) informal payments; and (5) theft of drugs and supplies. Incentives for corrupt practices and other manifestations of corruption in the AWA health sector were also highlighted, while poor working conditions and low wages fuel malpractice. Primary research on anti-corruption strategies in health sectors in AWA remains scarce, with recommendations to curb corrupt practices often drawn from personal views and experience rather that of rigorous studies. We argue that a nuanced understanding of all types of corruption and their impacts is an important precondition to designing viable contextually appropriate anti-corruption strategies. It is a particular challenge to identify and tackle corruption in settings where formal rules are fluid or insufficiently enforced.

Misappropriation of medications and equipment in the emergency department.

OBJECTIVE: To determine the nature and extent of misappropriation of medications and equipment from the ED. METHODS: We undertook a retrospective audit of medications procured and administered, and equipment replaced, in 2016, within a tertiary referral ED. Medication procurement and administration data were obtained from our MERLIN® pharmacy system and CERNER® electronic prescribing system, respectively. A medication 'discrepancy rate' was defined as the percentage of a medication procured that could not be accounted for by electronic administrations. The study also comprised a nested intervention sub-study where, from July 1, 2016, all Panadeine Forte tablets were stored in a locked facility. Victorian Hospital Healthcare Equipment invoices were audited to determine which major non-disposable equipment items most commonly needed resupply. RESULTS: Discrepancy rates for paracetamol 500mg and 665mg tablets were 23.3% and 54.9%, respectively. Following the Panadeine Forte intervention, the discrepancy rate for this medication fell from 70.5% to 8.8%. Orally administered medications with the potential for misappropriation had high discrepancy rates: caffeine (90.6%), cephalexin (62.9%), ondansetron (50.1%), pantoprazole (42.9%), amoxicillin (41.1%), metoclopramide (41.0%) and the 'morning after pill' (levonorgestrel) (36.4%). Parenterally administered medications had lower discrepancy rates: ceftriaxone (7.9%) and ampicillin (3.4%). The largest equipment replacement rates were for tourniquets and crutches. CONCLUSION: Discrepancy rates for many medications, especially those administered orally, are high. Further research is required to determine how these medications 'go missing'. Placing a medication with a high discrepancy rate in a locked facility with a 'logbook' substantially reduces this rate. Misappropriation of non-disposable equipment items is uncommon.

High prevalence of shoplifting in patients with eating disorders.

PURPOSE: Shoplifting, prevalent in patients diagnosed with bulimia nervosa (BN), is a serious behavioral problem in eating disorder (ED) patients. However, little is known about its overall presence, etiology, and consequences. This study aimed to determine whether shoplifting occurs before or after the onset of ED and to investigate the prevalence and correlates of shoplifting in ED patients. METHODS: This was a cross-sectional study of 284 treatment-seeking female patients aged 13-45 with EDs [171 anorexia nervosa (AN); 113 BN]. Shoplifting, impulsive behaviors (self-injury, suicide attempt, sexual promiscuity, alcohol, and illicit drug use), depression, self-esteem, and clinical features of EDs were assessed with an interview. RESULTS: Lifetime shoplifting prevalence was 28.5% (81/284) with 70.4% (57/81) occurring before ED onset. Multivariate logistic regression analysis revealed that depression [odds ratio (OR), 2.63; 95% confidence interval (CI), 1.24-5.60], alcohol abuse (OR, 3.91; 95% CI 1.34-11.38), illicit substance use (OR, 14.42; 95% CI, 1.65-125.86), and self-esteem (OR, 0.90; 95% CI; 0.82-0.99) were associated with lifetime shoplifting, while illness duration, BN, and ED symptom severity were not. CONCLUSIONS: Shoplifting is common in ED patients and precedes ED onset in most patients with a shoplifting history, although the causal relationship between shoplifting and EDs remains inconclusive. Shoplifting may be associated with impulsive behaviors (e.g., alcohol and illicit drug use), depression, and low self-esteem, but not with ED severity. Future research should focus on the unrecognized role of shoplifting as a marker to identify patients at risk of impulsive behaviors and consider treatment options. LEVEL OF EVIDENCE: Level V, observational cross-sectional descriptive study.

Deterring delinquents with information. Evidence from a randomized poster campaign in Bogotá.

In this article, we test whether an isolated information campaign can deter criminals by appealing to their apprehension risk perception. A randomized trial was conducted around 154 high crime housing blocks in Bogotá. With support of the Colombian Police, half of the blocks were exposed to a three month poster campaign reporting the number of "arrests around this street block" and half to a no-treatment control condition. The main outcome measure (total registered crime) and secondary outcome measures (calls to the emergency line for thefts and attacks, and minor wrongdoings) were provided by the Police. Additionally, trust in police, security perception, and police performance perception were measured among residents and workers in the treatment and control areas (N = 616) using a post-treatment survey. Measures were analyzed with linear regression analysis and two-sample t-tests. Over the course of the treatment period, premeditated crime was reduced, while spontaneous crime remained unchanged. Overall levels of crime were not significantly altered. Also, a moderate crime reduction is detectable during the first month of the treatment period. The posters were highly visible (93% of respondents in the treated areas recalled them) and positively received (67% "liked" them). Perceptions of security and police among locals improved, though not significantly. Inherent among residents of Bogotá is a pervasive feeling of impunity and low trust in authorities, making the city a hard test case for an offender-targeted advertising campaign. Initial reductions of crime and overall reductions of premeditated crime are thus noteworthy. These results align with key principles of apprehension risk updating theory.

Gun Theft and Crime.

Some law enforcement officials and other observers have asserted that theft is the primary source of guns to crime. In fact, the role of theft in supplying the guns used in robbery, assault, and murder is unknown, and current evidence provides little guidance about whether an effective program to reduce gun theft would reduce gun violence. The current article analyzes publicly available national data on gun theft together with a unique data set for Chicago. The results tend to support a conclusion that stolen guns play only a minor role in crime. First, publicly available data are used to calculate that thefts are only about 1% of all gun transactions nationwide. Second, an analysis of original data from Chicago demonstrates that less than 3% of crime guns recovered by the police have been reported stolen to the Chicago Police Department (CPD). If a gun is reported stolen, there is a 20% chance that it will be recovered, usually in conjunction with an arrest for illegal carrying. Less than half of those picked up with a stolen gun have a criminal record that includes violent offenses. Third, results from surveys of convicted criminals, both nationally and in Chicago, suggest that it is rare for respondents to have stolen the gun used in their most recent crime. The data on which these results are based have various shortcomings. A research agenda is proposed that would provide more certainty about the role of theft.

An Epidemiological Study of Burglary Offenders: Trends and Predictors of Self-Reported Arrests for Burglary in the United States, 2002-2013.

Burglary is serious property crime with a relatively high incidence and has been shown to be variously associated with other forms of criminal behavior. Unfortunately, an epidemiological understanding of burglary and its correlates is largely missing from the literature. Using public-use data collected between 2002 and 2013 as part of the National Survey on Drug Use and Health (NSDUH), the current study compared those who self-reported burglary arrest in the prior 12 months with and without criminal history. The unadjusted prevalence estimates of self-reported burglary arrest were statistically different for those with a prior arrest history (4.7%) compared with those without an arrest history (0.02%) which is a 235-fold difference. Those with an arrest history were more likely to report lower educational attainment, to have lower income, to have moved more than 3 times in the past 5 years, and to use alcohol, tobacco, illicit drugs, and engage in binge drinking. Moreover, those with prior arrest histories were younger and more likely to be male. There is considerable heterogeneity among burglars with criminal history indicating substantially greater behavioral risk.

Shoplifting and eating disorders: an anonymous self-administered survey.

PURPOSE: To explore the characteristics of eating disorders related to shoplifting behavior and identify the risk and protective factors related to shoplifting among patients with eating disorders. METHODS: Eighty females with eating disorders were recruited from an eating disorders clinic. They were asked to complete anonymous self-report questionnaires on demographic characteristics, shoplifting behavior, psychological characteristics and eating disorder symptomology. We investigated differences in clinical characteristics between those with and without shoplifting history or a current drive to shoplift. RESULTS: The response rate was 92.5%. Of the respondents, 37.8% reported a history of shoplifting and 16.2% a current drive for shoplifting. The patients with shoplifting history had lower socioeconomic status (SES), higher impulsivity and higher symptom severity of eating disorders compared with those without this history. The patients with a current drive for shoplifting had more depressive symptoms, more severe anxiety, more obsessional traits, and higher symptom severity of eating disorders. CONCLUSIONS: Severity of illness and SES seem to have a serious impact on shoplifting behavior among eating disordered patients. These findings may suggest risk and protective factors related to shoplifting among eating disordered patients.

Patterns of substance use and mortality risk in a cohort of 'hard-to-reach' polysubstance users.

AIMS: To examine the mortality risk in a cohort of 'hard-to-reach' polysubstance users and its putative associations with substance use. Specifically, we estimated all-cause mortality risk as a function of individual substance use indicators, and then as a function of their complex, 'real-life' patterns as identified through latent class analysis (LCA). DESIGN: Prospective cohort study among street- and low-threshold service-recruited polysubstance users included between September and November 2013 and followed through the National Cause of Death Registry until 31 October 2015. SETTING: Seven Norwegian cities. PARTICIPANTS: A total of 884 users of illegal opioids and/or stimulants. Of these, 357 were in opioid substitution treatment (OST) at the time of inclusion. Forty-four participants died during follow-up. MEASUREMENTS: Primary outcome: all-cause mortality risk. Unadjusted and adjusted Cox proportional hazard (PH) regression models (covariates: male, age, homelessness/shelter use, overdose experience, OST status, years of injecting, individual substance use indicators, city, use patterns). LCA models estimated separately for those in and those not in OST due to measurement invariance. FINDINGS: The crude mortality rate was 2.52 per 100 person-years. Standardized mortality ratio was 26.11 [95% confidence interval (CI) = 10.06-54.87] for women and 10.71 (95% CI = 6.39-16.81) for men. No single drug use indicator, such as 'heroin injection' or 'number of drugs used', was associated with the mortality risk. However, meaningful use patterns were identified; three OST and non-OST patterns each. The non-OST patterns 'polysubstance injectors' [hazard ratio (HR) = 3.45, 95% CI = 0.98-12.14] and 'low frequent injectors' (HR = 3.17, CI = 1.05-9.56) were associated significantly with the mortality risk even when adjusted for other known risk factors. CONCLUSIONS: In a Norwegian prospective cohort study, 'hard-to-reach' polysubstance users had a more than 10 times higher mortality risk than the general population. Mortality risk was not a function of any single drug use indicator, but two distinct combinations of substances, frequencies and routes of administration were associated with the mortality risk.

Violence in public transportation: an approach based on spatial analysis.

OBJECTIVE: To carry out a spatial analysis of the occurrence of acts of violence (specifically robberies) in public transportation, identifying the regions of greater incidence, using geostatistics, and possible causes with the aid of a multicriteria analysis in the Geographic Information System. METHODS: The unit of analysis is the traffic analysis zone of the survey named Origem-Destino, carried out in Salvador, state of Bahia, in 2013. The robberies recorded by the Department of Public Security of Bahia in 2013 were located and made compatible with the limits of the traffic analysis zones and, later, associated with the respective centroids. After determining the regions with the highest probability of robbery, we carried out a geographic analysis of the possible causes in the region with the highest robbery potential, considering the factors analyzed using a multicriteria analysis in a Geographic Information System environment. RESULTS: The execution of the two steps of this study allowed us to identify areas corresponding to the greater probability of occurrence of robberies in public transportation. In addition, the three most vulnerable road sections (Estrada da Liberdade, Rua Pero Vaz, and Avenida General San Martin) were identified in these areas. In these sections, the factors that most contribute with the potential for robbery in buses are: F1 - proximity to places that facilitate escape, F3 - great movement of persons, and F2 - absence of policing, respectively. CONCLUSIONS: Indicator Kriging (geostatistical estimation) can be used to construct a spatial probability surface, which can be a useful tool for the implementation of public policies. The multicriteria analysis in the Geographic Information System environment allowed us to understand the spatial factors related to the phenomenon under analysis.

"It Keeps Us from Putting Drugs in Pockets": How a Public-Private Partnership for Hospital Management May Help Curb Corruption.

INTRODUCTION: Health care sector corruption diverts resources that could otherwise be used to improve access to health services. Use of private-sector practices such as a public-private partnership (PPP) model for hospital governance and management may reduce corruption. In 2011, a government-run hospital in Lesotho was replaced by a PPP hospital, offering an opportunity to compare hospital systems and practices. OBJECTIVE: To assess whether a PPP model in a hospital can help curb corruption. METHODS: We conducted 36 semistructured interviews with key informants between February 2013 and April 2013. We asked about hospital operations and practices at the government-run and PPP hospitals. We performed content analysis of interview data using a priori codes derived from the Corruption in the Health Sector framework and compared themes related with corruption between the hospitals. RESULTS: Corrupt practices that were described at the government-run hospital (theft, absenteeism, and shirking) were absent in the PPP hospital. In the PPP hospital, anticorruption mechanisms (controls on discretion, transparency, accountability, and detection and enforcement) were described in four management subsystems: human resources, facility and equipment management, drug supply, and security. CONCLUSION: The PPP hospital appeared to reduce corruption by controlling discretion and increasing accountability, transparency, and detection and enforcement. Changes imposed new norms that supported personal responsibility and minimized opportunities, incentives, and pressures to engage in corrupt practices. By implementing private-sector management practices, a PPP model for hospital governance and management may curb corruption. To assess the feasibility of a PPP, administrators should account for cost savings resulting from reduced corruption.

Violence in public transportation: an approach based on spatial analysis / Violência em transporte público: uma abordagem baseada em análise espacial

ABSTRACT OBJECTIVE To carry out a spatial analysis of the occurrence of acts of violence (specifically robberies) in public transportation, identifying the regions of greater incidence, using geostatistics, and possible causes with the aid of a multicriteria analysis in the Geographic Information System. METHODS The unit of analysis is the traffic analysis zone of the survey named Origem-Destino, carried out in Salvador, state of Bahia, in 2013. The robberies recorded by the Department of Public Security of Bahia in 2013 were located and made compatible with the limits of the traffic analysis zones and, later, associated with the respective centroids. After determining the regions with the highest probability of robbery, we carried out a geographic analysis of the possible causes in the region with the highest robbery potential, considering the factors analyzed using a multicriteria analysis in a Geographic Information System environment. RESULTS The execution of the two steps of this study allowed us to identify areas corresponding to the greater probability of occurrence of robberies in public transportation. In addition, the three most vulnerable road sections (Estrada da Liberdade, Rua Pero Vaz, and Avenida General San Martin) were identified in these areas. In these sections, the factors that most contribute with the potential for robbery in buses are: F1 - proximity to places that facilitate escape, F3 - great movement of persons, and F2 - absence of policing, respectively. CONCLUSIONS Indicator Kriging (geostatistical estimation) can be used to construct a spatial probability surface, which can be a useful tool for the implementation of public policies. The multicriteria analysis in the Geographic Information System environment allowed us to understand the spatial factors related to the phenomenon under analysis.

RESUMO OBJETIVO Realizar uma análise espacial da ocorrência de atos de violência (específicamente roubos) em transporte público, identificando as regiões de maior incidência, por meio da geoestatística, e possíveis causas com auxílio de análise multicritério em Sistema de Informação Geográfica. MÉTODOS A unidade de análise é a zona de tráfego da pesquisa Origem-Destino, realizada em Salvador, BA, Brasil, em 2013. Os roubos registrados pela Secretaria de Segurança Pública da Bahia, no mesmo ano, foram localizados e compatibilizados aos limites das zonas de tráfego e, posteriormente, associados aos respectivos centroides. Após determinação das regiões de maior probabilidade de ocorrências, foi feita uma análise geográfica de possíveis causas na região de maior potencial, considerando fatores analisados por meio de uma análise multicritério em ambiente de Sistema de Informação Geográfica. RESULTADOS A execução das duas etapas deste trabalho permitiu identificar áreas correspondentes à maior probabilidade de ocorrência de roubo em transporte público. Além disso, foram identificados três trechos viários (Estrada da Liberdade, Rua Pero Vaz e Avenida General San Martin) mais vulneráveis, localizados nessas áreas. Nesses trechos, os fatores que mais contribuem para o potencial de ocorrência de roubo em ônibus são: F1 - proximidade a locais que facilitam a fuga, F3 - grande movimentação de pessoas e F2 - ausência de policiamento, respectivamente. CONCLUSÕES Com o uso da Krigagem indicativa (estimação geoestatística), é possível a construção de uma superfície espacial de probabilidades de ocorrências, que pode ser uma ferramenta útil para implementação de políticas públicas. A análise multicritério no ambiente do Sistema de Informação Geográfica permitiu a compreensão dos fatores espaciais relacionados ao fenômeno em análise.