The public health impacts of supervised injection sites in Canada: Moving beyond social acceptability and impacts on crime.

Canada has been a pioneer in adopting a harm reduction approach to address risks associated with drug use for people who inject drugs. Today, Canada is home to 39 supervised injection sites spread throughout the country. The scientific literature demonstrates, unequivocally, that these sites have numerous health benefits for people who inject drugs, namely by decreasing risks of blood-borne diseases, overdose, and mortality. Yet, a lack of clear guidelines on optimal locations for the implementation of such sites and NIMBYISM ("Not In My Back Yard") have been stumbling blocks for planned and operating sites. Various Canadian governments have introduced their own policies to overcome the lack of national public health guidelines on community planning. Namely, policies aim to limit the exposure to sites and drug use for vulnerable populations, such as children. However, there is a veritable lack of research on the public health impacts of supervised injection sites for local communities, who tend to be disadvantaged. The existing literature fails to address the broader and differential impacts of such sites for local vulnerable and disadvantaged populations, including use of active transportation, psychological distress, perceived safety, and social cohesion. Moreover, existing research, largely focusing on assessing pre-implementation social acceptability and post-implementation impacts on crime, faces important methodological limitations. The following commentary reviews the existing literature and makes recommendations for future public health research on the impacts of supervised injection sites.

RéSUMé: Le Canada a été un pionnier dans l'adoption de l'approche de réduction des méfaits liés à la consommation de drogues pour les personnes utilisatrices de drogues par injection. Aujourd'hui, le Canada compte 39 sites d'injection supervisée répartis sur l'ensemble du territoire. La littérature scientifique démontre sans équivoque que ces sites présentent de nombreux avantages pour la santé des personnes utilisatrices de drogues par injection, notamment en réduisant les risques de maladies transmises par le sang, de surdoses et de décès. Toutefois, l'absence de lignes directrices claires sur les emplacements optimaux pour l'implantation de ces sites et le phénomène du « pas dans ma cour ¼ ("Not In My Back Yard") représentent des défis pour les sites existants et futurs. Plusieurs gouvernements canadiens ont introduit des politiques pour pallier l'absence de lignes directrices nationales en matière de santé publique et de planification communautaire. Ces politiques visent à limiter l'exposition aux sites d'injection supervisée et à la consommation de drogues pour les populations vulnérables, comme les enfants. Cependant, il y a un véritable manque de connaissances quant aux impacts en matière de santé publique des sites d'injection supervisée pour les communautés locales, qui ont tendance à être défavorisées. La littérature existante n'aborde pas les impacts élargis et différentiels de ces sites pour les populations vulnérables et défavorisées résidant à proximité, particulièrement sur l'utilisation des transports actifs, la détresse psychologique, la perception de sécurité et la cohésion sociale. En outre, la recherche existante, qui se concentre principalement sur l'évaluation de l'acceptabilité sociale avant l'implantation des sites et sur les impacts sur la criminalité après l'implantation des sites, se heurte à d'importantes limites méthodologiques. Ce commentaire fait état de la littérature existante et formule des recommandations pour de futures recherches sur les impacts en matière de santé publique des sites d'injection supervisée.

COVID-19 and views of imprisonment in a sample of prison tourists.

The COVID-19 pandemic has exposed large segments of the global population to the experience of restricted freedoms. In Canada, COVID-19-related measures led to a decrease of mobility within the country, prohibiting access to public and private spaces for prolonged periods of time. This study addresses the effects of the pandemic and related restrictions on views of imprisonment, drawing on a sample of individuals who took part in a tour of the HI Ottawa Jail Hostel (N = 102) in pre- and peri-COVID-19 contexts. The results provide some support for the hypothesis that the uncertainty and existential threat brought about by the pandemic may have contributed to more stringent support for imprisonment and increased punitiveness. However, the results are limited by the small sample size and sample composition. Future directions for research on the impact of the pandemic on public views of imprisonment are discussed.

La pandémie de COVID-19 a eu pour effet d'exposer une grande partie de la population mondiale à vivre avec des restrictions de libertés individuelles. Au Canada, les mesures liées à la COVID-19 ont entraîné une diminution de la mobilité à l'intérieur du pays, limitant donc l'accès aux espaces publics et privés durant des périodes prolongées. Cette étude porte sur les effets de la pandémie et des restrictions connexes sur les perceptions de l'emprisonnement. L'étude s'appuie sur un échantillon de personnes qui ont participé à une visite guidée du HI Ottawa Jail Hostel (N = 102) dans des contextes pré-COVID-19 et durant la pandémie de COVID-19. Les résultats soutiennent, dans une certaine mesure, l'hypothèse que l'incertitude et la menace existentielle provoquées par la pandémie pourraient avoir contribué à une perspective plus sévère face à l'emprisonnement et à une punitivité accrue. Cependant, ces résultats sont limités par la petite taille et la composition de l'échantillon de l'étude. De futurs chantiers de recherche sur l'impact de la pandémie sur l'opinion publique face à l'emprisonnement sont discutés.

A novel low-cost method for assessing intra-urban variation in night time light and applications to public health.

Night time lighting (NTL) pollution is a public health concern given its known impact on a range of health outcomes. The daily cycle of the hue of natural ambient light shifting from relatively blue-white light at noon to relatively yellow-red light at sunset is important for human functioning. Disruptions of the circadian clock can result in melatonin suppression, sleep and mood disorders, and increased risks of cancer in adults. Current measures of intra-urban variation in NTL are based on costly in-person or coarse satellite image-based assessments. The central objective of the current study is to validate a novel low-cost measure of intra-urban NTL variation. Estimates of red, green and blue NTL intensity were derived from a cloud-free night time image of the city of Montreal, Canada, taken from the International Space Station (ISS). The new measures are shown to converge with in-person assessed NTL and to predict known child health-related outcomes. Specifically, the results suggest that ISS-assessed blue NTL is associated with feelings of safety and self-reported health. In conclusion, ISS-based measures of NTL, particularly of blue NTL, are valid indicators of intra-urban variation in NTL for applications in public health. Limitations of, and future directions for, the method are discussed.

Ego-centered relative neighborhood deprivation and reported dietary habits among youth.

Dietary habits are important precursors of childhood obesity. Youths' dietary habits may be constrained by the experience of deprivation due to social (e.g., family purchasing power) and physical (e.g., availability of fast food outlets in low-income neighborhoods) factors limiting dietary choices. This study considers whether a Yitzhaki-based index of ego-centered relative neighborhood deprivation explains dietary outcomes (i.e., reported healthful and unhealthful food consumption), adjusting for absolute deprivation. The Yitzhaki index takes into account the total incomes to which a youth is deprived in relation to a meaningful reference group, and the youth's position in the cumulative income distribution of this meaningful reference group. The study also considers whether the impact of deprivation on dietary outcomes is moderated by the experience of symptoms of depression. There was some indication that reported healthful food consumption was highest for youth who experienced low absolute deprivation (p ≤ 0.01) and low symptoms of depression (p ≤ 0.01), but high relative deprivation (p ≤ 0.001). These youth therefore appear to benefit from being both "better-off", and living among "better-off" individuals. The results for reported unhealthful food consumption were less robust. The results may therefore suggest that youth who are not detrimentally impacted by their relative deprivation, and who have the financial means to access healthful foods, have improved dietary outcomes. The findings suggest that while absolute deprivation plays a key role in explaining healthful food consumption, additional insights can be gleaned from considering youths' relative deprivation and indicators of their well-being.

Feelings of Safety at School, Socioemotional Functioning, and Classroom Engagement.

PURPOSE: Classroom engagement is a key indicator of student motivation, learning potential, and the eventual probability of persisting to high-school completion. This study investigated whether feeling unsafe at school interferes with classroom engagement and simultaneously considered whether this association is mediated by poorer student well-being in the form of experiencing symptoms of depression and demonstrating aggressive behavior problems. METHODS: Data were from the Québec Longitudinal Study of Child Development, an ongoing study that began in 1998 with a population-based cohort of 2,120 Quebec 5-month-old infants. Structural equation modeling was used to test the central hypothesis that concurrent youth self-reported feelings of a lack of safety at school are associated with poorer teacher-reported student classroom engagement (at age 13 years) and the mediating role of emotional and behavioral problems. The model controlled for concurrent measures of victimization, the school safety climate, and earlier measures of students' academic adjustment. RESULTS: The findings support the central hypothesis that youth who feel safer at school are also more engaged in the classroom (p ≤ .05). Students who felt safer demonstrated less depressive symptoms, but this only partly explained the association between feeling safe and being engaged. CONCLUSIONS: Increasing student feelings of safety at school (e.g., by reducing victimization, improving the overall school and neighborhood safety climate) is likely to represent an effective strategy for promoting classroom engagement. Such interventions could also contribute to future academic achievement and high-school completion and decrease symptoms of mental health problems among youth.

Poor, Unsafe, and Overweight: The Role of Feeling Unsafe at School in Mediating the Association Among Poverty Exposure, Youth Screen Time, Physical Activity, and Weight Status.

This study applied socioecological and cumulative risk exposure frameworks to test the hypotheses that 1) the experience of poverty is associated with feeling less safe at school, and 2) feeling less safe is associated with engaging in poorer weight-related behaviors, as well as an increased probability of being overweight or obese. Data were from the ongoing Québec Longitudinal Study of Child Development, initiated in 1998 with a population-based cohort of 2,120 Québec (Canada) infants 5 months of age and their parent or primary caregiver. Measures of youths' (age, 13 years) self-reported feelings of safety, screen time, physical activity, and objectively assessed not overweight/obese (70%), overweight (22%), and obese (8%) weight status were collected in 2011. Family poverty trajectory from birth was assessed by using latent growth modeling. As hypothesized, exposure to poverty was associated with feeling less safe at school and, in turn, with an increased probability of being overweight or obese. The association was most pronounced for youths who experienced chronic poverty. Compared with youths who experienced no poverty and felt unsafe, those who experienced chronic poverty and felt unsafe were nearly 18% more likely to be obese (9.2% vs. 11.2%). Although feeling unsafe was associated with screen time, screen time did not predict weight status.

A child's view: social and physical environmental features differentially predict parent and child perceived neighborhood safety.

Parent and child perceived neighborhood safety predicts child health outcomes such as sleep quality, asthma, physical activity, and psychological distress. Although previous studies identify environmental predictors of parent perceived safety, little is known about predictors of child perceived safety. This study aims to identify the social and physical environmental neighborhood features that predict child and parent perceived neighborhood safety and, simultaneously, to assess the association between child and parent perceptions. Data were from the QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort, an ongoing study of Caucasian children (aged 8-10 years) with a parental history of obesity, and their biological parents from Québec, Canada. Measures of social and physical neighborhood features were collected using a spatial data infrastructure and in-person audits. Structural equation modeling was used to test direct and indirect associations between neighborhood features, child and parent perceived safety. Results suggest that among children (N = 494), trees and lighting were positively associated with perceived neighborhood safety, whereas a high proportion of visible minorities was associated with poorer perceived safety. Parents' perceptions of safety were more strongly tied to indicators of disorder and a lack of community involvement, and to traffic. Child perceived safety was partly explained by parent perceived safety, suggesting moderate concordance between perceptions. Although associated with each other, parent and child perceived safety seemed to be determined by distinct environmental features. Though this study focused on determinants of child and parent perceived safety, future research investigating the impact of neighborhood safety on child health should consider both child and parent perspectives.

The role of the residential neighborhood in linking youths' family poverty trajectory to decreased feelings of safety at school.

Although disadvantaged youth are more likely to be victimized at school, victimization only partly explains their decreased feelings of safety at school. We applied a socioecological approach to test the hypotheses that the experience of poverty is associated with decreased feelings of safety at school, and that residential neighborhood features partly mediate the relationship between poverty and feeling less safe at school. This study draws on the Québec Longitudinal Study of Child Development (QLSCD) which began in 1998 with a representative population-based cohort of 2,120 5-month old infants (49.1% female) and their primary caregiver. The study also includes measures of ego-centred residential neighborhood exposures (based on a 500 m circular buffer zone surrounding the family's residential postal code) derived from a spatial data infrastructure. We used latent growth modeling to estimate youth's family poverty trajectory from age 5 months to 13 years, and structural equation modeling to test our hypotheses. The results suggest that youth experiencing chronic and later-childhood poverty felt less safe at school in part because they lived in neighborhoods that their parents described as being disorderly (e.g., demarked by the presence of garbage, drug use and groups of trouble-makers). These neighborhoods also tended to have less greenery (e.g., trees, parks) and more lone-parent households. Neighborhood features did not help explain the relationship between early-childhood poverty and feeling less safe at school. The findings suggest that targeting residential neighborhood features such as greenery and disorder could improve youth's felt safety at school, particularly for those experiencing chronic and later-childhood poverty.

Fight fire with fire: the effect of perceived anger on punitive intuitions.

The human ability to "mind-read" is fundamental in social interaction (e.g., contributing to the experience of empathy). The present research tests the hypothesis that perceiving anger in others on the basis of facial cues is sufficient to elicit very rapid punitive responses toward crime. The results suggest that individuals are faster to harshly punish criminals who appear to be angry, and that this effect emerges early in the decision-making process. Black criminals receive quicker punitive responses, but the effect of ethnicity is weakened at high levels of perceived anger. The results are discussed in terms of associative processes linking anger to punishment, the human ability to simulate and experience others' emotional responses, and the role of anger in eliciting hostile aggression. The findings also have important policy implications, as they suggest that drumming up anger toward crime could engender punitive intuitions.