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Mark TE, Bair-Merritt MH, Chung SE, Flessa SJ, Trent M, Rothman EF, Matson PA. Discordant and Concordant Substance Use and Daily Partner Violence in Adolescent and Young Adult Relationships With Baseline Dating Violence. J Adolesc Health 2024; 75:69-75. [PMID: 38739051 DOI: 10.1016/j.jadohealth.2024.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Intimate partner violence (IPV) and substance use in adolescents and young adults (AYAs) are significant public health issues in the United States. Together, they can harm emotional regulation and romantic relationship functioning. This study examines the role of concordant and discordant substance use on IPV within AYA relationships. METHODS A prospective cohort of community-recruited AYA women in a heterosexual dating relationship with past-month IPV completed four months of daily surveys via a cell phone. Each day, participants reported any IPV perpetration and/or victimization, their alcohol and drug use, and observed partner substance use. Concordant substance use was coded when the participant and partner used drugs or alcohol on the same day. Discordant use was coded when only the participant or partner used drugs or alcohol on a given day. Alcohol and drug use were modeled separately. Generalized estimating equations accounted for the correlation of repeated measures. RESULTS Participants (N = 143) were 18.2 (1.1) years old, 93% African American race. Discordant alcohol and drug use was associated with same-day victimization, perpetration, and co-occurring violence compared to concordant nonuse. Similarly, concordant alcohol use, drug use, and alcohol/drug use were associated with increased odds of victimization, perpetration, and co-occurring violence compared to concordant nonuse. DISCUSSION Daily data illustrated that dyadic patterns of substance use are associated with IPV. These findings may facilitate the development of effective and developmentally appropriate IPV intervention programs for AYA that also integrate strategies to reduce substance use.
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Affiliation(s)
- Tiffany E Mark
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Megan H Bair-Merritt
- Department of Pediatrics, Boston Medical Center, Boston, University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Shang-En Chung
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sarah J Flessa
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Maria Trent
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Emily F Rothman
- Department of Occupational Therapy, Boston University, Boston, Massachusetts
| | - Pamela A Matson
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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Lyons VH, Myers MG, Cunningham RM, Zimmerman MA, Carter PM, Walton MA, Goldstick J. Experiencing violence and other predictors of within-person same-day use of multiple substances in youth: a longitudinal study in emergency settings. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:218-228. [PMID: 38563511 DOI: 10.1080/00952990.2024.2307546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/06/2024] [Indexed: 04/04/2024]
Abstract
Background: Although experiencing violence is a risk factor for substance use among youth, its association with same-day use of multiple substances (a form of polysubstance use) and mitigating factors is less well understood.Objectives: To identify whether prosocial factors modified the effect of experiencing violence on the frequency of same-day use, and examine gender-specific risk/protective factors for same-day use.Methods: We analyzed longitudinal data from a cohort of youth who use drugs aged 14-24 (n = 599; 58% male) presenting to an urban emergency department between 2009-2011 and assessed biannually for two years. Using Poisson-generalized linear models with person-level fixed effects, we estimated within-person associations between self-reported experiencing violence and same-day use and analyzed gender and peer/parent support as effect modifiers. We adjusted for negative peer influence, parental drug and alcohol use, family conflict, anxiety and depression, and age.Results: Overall, positive parental support corresponded to lower rates of same-day use (rate ratio [RR]:0.93, 95% CI:0.87-0.99) and experiencing violence was associated with higher rates of same-day use (RR:1.25, 95% CI:1.10-1.41). Violence exposure was a risk factor among males (RR:1.42, 95% CI:1.21-1.66), while negative peer influences and parental substance use were risk factors among females (RR:1.63, 95% CI:1.36-1.97 and RR:1.58, 95% CI:1.35-1.83, respectively). Positive peer support reduced the association between violence exposure and same-day use among males (RR:0.69, 95% CI:0.57-0.84, p < .05).Conclusions: Tailored interventions may address gender differences in coping with experiencing violence - including interventions that promote parental support among males and reduce influence from parental substance use among females.
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Affiliation(s)
- Vivian H Lyons
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
- Social Development Research Group, University of Washington, Seattle, WA, USA
| | - Matthew G Myers
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca M Cunningham
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Prevention Research Center of Michigan, University of Michigan, Ann Arbor, MI, USA
| | - Patrick M Carter
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Maureen A Walton
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Jason Goldstick
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
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Raman U, Coupet E, Dodington J. Assault Injury and Community Violence. Pediatr Clin North Am 2023; 70:1103-1114. [PMID: 37865433 DOI: 10.1016/j.pcl.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Community violence happens between unrelated individuals, who may or may not know each other, generally outside the home, and often results in assaultive injuries. Community violence interventions can prevent assaultive injuries and assist victims of community violence. Trauma-informed care is foundational to the success of community violence intervention. Place-based environmental interventions can decrease community violence on the population level, and further research and developments are needed in this area. Substance use is a significant barrier to intervention program involvement and greater research and program development is needed to support substance use treatment of those impacted by community violence.
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Affiliation(s)
- Uma Raman
- Pediatric Critical Care, Yale New Haven Hospital, Yale School of Medicine, 100 York Street, Suite 1F, New Haven, CT 06511, USA
| | - Edouard Coupet
- Yale School of Medicine, Core Faculty, Addiction Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06890, USA
| | - James Dodington
- Yale School of Medicine, Yale New Haven Center for Injury and Violence Prevention, 100 York Street, Suite 1F, New Haven, CT 06511, USA.
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D'Amico EJ, Tucker JS, Dunbar MS, Perez L, Siconolfi D, Davis JP, Pedersen ER, Rodriguez A. Unpacking disparities in substance-related outcomes among racial, ethnic, sexual, and gender minoritized groups during adolescence and emerging adulthood. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:651-656. [PMID: 37523303 PMCID: PMC10400096 DOI: 10.1037/adb0000905] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Alcohol and other drug (AOD) use increases substantially from adolescence to emerging adulthood, and recent longitudinal studies show disparities in AOD-related outcomes by racial and ethnic, as well as sexual and gender minority (SGM), identities. Greater insight is needed into how individual, social, and environmental contexts interact and affect such disparities, as well as why disparate outcomes are found across different domains (e.g., social, educational, economic), even after accounting for intensity of use. This commentary addresses these important and timely issues. METHOD We provide a brief overview of the literature, including our own team's work over the last 14 years, to identify and understand disparities in AOD-related outcomes during adolescence and emerging adulthood across individuals with different racial and ethnic, and sexual and gender, identities. We then discuss paths forward to advance research and build a stronger evidence base, leading to the development and identification of effective interventions that can help mitigate disparities among historically marginalized adolescents and emerging adults. RESULTS Existing research highlights the need for further longitudinal work in several areas, including addressing contextual factors at various levels (e.g., individual, social, environmental) that may contribute to outcomes for different groups of individuals, developing and testing culturally appropriate AOD-related services, giving greater consideration to intersectionality of multiple minority identities, and using novel statistical approaches to help improve the estimation of differences across smaller subgroups of individuals in existing cohorts. CONCLUSIONS To inform prevention programming and policy for improving health and well-being of historically marginalized populations, it is important to continue our efforts to understand disparities in AOD-related outcomes using multidisciplinary, equity, and intersectionality lenses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | - Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - Eric R Pedersen
- University of Southern California, Suzanne Dworak-Peck School of Social Work
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Fischer KR, Traynor T, Stryckman B, Richardson J, Buchanan L, Dezman ZDW. Illicit Fentanyl Exposure Among Victims of Violence Treated at a Trauma Center. J Surg Res 2023; 283:937-944. [PMID: 36915022 DOI: 10.1016/j.jss.2022.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/13/2022] [Accepted: 10/16/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Opioid overdoses and violent injury are leading causes of death in the United States, yet testing for novel opioids like fentanyl remains uncommon. The purpose of this investigation is to characterize a population of victims of violence who test positive for illicit fentanyl. METHODS Retrospective cohort study of patients treated at a level-one trauma center between January 31, 2019 and February 21, 2020. Data were extracted from the electronic medical record. Subjects were included if they had an encounter diagnosis for a violent or intentional injury, using the International Classification of Diseases, v10 (X92-Y09). We excluded patients who received licit fentanyl as a part of their care before testing. Those who tested positive for fentanyl exposure on our standard hospital urine drug screen were considered to have been exposed to illicit fentanyl. Those testing negative for fentanyl were considered controls. RESULTS Of the 1132 patients treated for intentional injuries during the study period, 366 were included in the study (32.3%). Of these, 133 (36.3%) subjects were exposed to illicit fentanyl prehospital. There were no demographic differences between cases and controls. Cases had a lower GCS voice score on arrival (median = 4, interquartile range [IQR] = 4-5 versus median = 5, IQR = 4-5, P = 0.02), higher rates of ventilator usage (32.3% versus 21.5%, P = 0.02), and more intensive care unit admissions (27.1% versus 12.0%, P = 0.005). More than half of cases tested negative for opiates (78/133, 58.6%). Cases had more trauma center encounters (26.3% had ≥2 visits versus 15.5%). CONCLUSIONS Exposure to illicit fentanyl was common among victims of violence in this single-center study. These patients are at increased risk of being admitted to intensive care units and repeated trauma center visits, suggesting fentanyl testing may help identify those who could benefit from violence prevention and substance abuse treatment.
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Affiliation(s)
- Kyle R Fischer
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Timothy Traynor
- University of Maryland School of Medicine, University of Maryland, Baltimore, Baltimore, Maryland
| | - Benoit Stryckman
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Joseph Richardson
- Department of African-American Studies and Anthropology, University of Maryland College Park, Maryland
| | | | - Zachary D W Dezman
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
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Sadler RC, Trangenstein P, Harris A, Buchalski Z, Wojciechowski TW, Furr-Holden CD. Establishing the Relative Accuracy of Using City Directories as Proxies to Define and Reconstruct Historical Alcohol Environments. J Stud Alcohol Drugs 2023; 84:158-170. [PMID: 36799686 PMCID: PMC9948143 DOI: 10.15288/jsad.21-00374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Research on alcohol environments has established that poorer and minoritized communities are frequently overburdened by off-premise outlets (e.g., liquor stores). These outlets have more associated harms, including increased alcohol consumption and crime rates. Little, if any, research has shown how these socio-spatial disparities in exposure have grown or shifted over time, and no studies have established a method for re-creating historical alcohol environments. METHOD Our results suggest that in our study city of Flint, MI, disparities in the alcohol environment have narrowed since 1950. Although liquor stores are still more likely to be located in poorer and more heavily African American neighborhoods, the pattern has become insignificant over time. Furthermore, the number of alcohol outlets per capita has declined. Thus, although the city remains more overburdened with alcohol outlets than its suburbs, the disparity has shrunk. CONCLUSIONS This work has implications for those working in alcohol prevention and policy, as well as in urban planning. Practitioners and researchers can use this method to model alcohol availability over time in their own communities, which helps better inform the discussion on disparities experienced in poor and minoritized neighborhoods.
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Affiliation(s)
- Richard Casey Sadler
- Department of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | | | - Alan Harris
- Department of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | - Zachary Buchalski
- Department of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | | | - C. Debra Furr-Holden
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
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Dyer TV, Feelemyer J, Scheidell JD, Turpin RE, Brewer R, Mazumdar M, Fortune N, Severe M, Cleland CM, Remch M, Mayer K, Khan MR. Estimating the Influence of Incarceration on Subsequent Experience With Violence Among Black Men Who Have Sex With Men in the HPTN061 Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP16327-NP16350. [PMID: 34107789 PMCID: PMC10091627 DOI: 10.1177/08862605211021970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Black men who have sex with men (BMSM) are disproportionately incarcerated in the United States. Incarceration is a barrier to health equity and may be a risk factor for experiences of interpersonal violence. However, the effect of incarceration on experienced violence among BMSM is understudied. We examined associations between recent incarceration on subsequent experiences of race- or sexuality-based violence, intimate partner violence, or community violence. We analyzed data from the HPTN 061 study. Analysis includes data on 1,169 BMSM recruited from 6 U.S. cities who were present at baseline as well as 6- and 12-month follow-up interview. We tested if self-reported incarceration between baseline and 6 months was associated with self-reported outcomes between 6 and 12 months using logistic regression with inverse probability of treatment weighting and multiple imputation methods. Experienced outcomes included violence due to race or sexuality, intimate partner violence and aggression, and community violence (i.e., gang violence, robbery, shooting). Approximately 14% reported incarceration between baseline and 6 months and 90% reported experiencing violence between 6 and 12 months. In adjusted analyses, incarceration was associated with subsequent race- or sexuality-based violence [aOR (adjusted odds ratio) range: 1.25-1.41, 95% CI (confidence interval) range: 1.00-1.74], experiences of physical abuse and aggression from intimate partners (aOR: 2.35; 95% CI: 1.50, 3.70) and community violence (OR 1.82; 95% CI: 1.23, 2.72). Recent incarceration experience increased risk of exposure to future violence in this population. Mixed methods research examining mediating paths between and downstream effects of incarceration and violence on the wellbeing and health of BMSM is needed. We implore researchers to study violence and incarceration among BMSM. Practitione should implement strategies such as trauma-informed interventions, and policies strengthening the social and economic support needs of Black populations.
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Affiliation(s)
- Typhanye V. Dyer
- University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Rodman E. Turpin
- University of Maryland School of Public Health, College Park, MD, USA
| | | | - Medha Mazumdar
- New York University School of Medicine, New York, NY, USA
| | - Nicole Fortune
- University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Molly Remch
- University of North Carolina, Chapel Hill, NC, USA
| | | | - Maria R. Khan
- New York University School of Medicine, New York, NY, USA
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Kimball AA, Torrone EA, Bernstein KT, Grey JA, Bowen VB, Rickless DS, Learner ER. Predicting Emergence of Primary and Secondary Syphilis Among Women of Reproductive Age in US Counties. Sex Transm Dis 2022; 49:177-183. [PMID: 34694275 PMCID: PMC10955329 DOI: 10.1097/olq.0000000000001573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Syphilis, a sexually transmitted infection that can cause severe congenital disease when not treated during pregnancy, is on the rise in the United States. Our objective was to identify US counties with elevated risk for emergence of primary and secondary (P&S) syphilis among women of reproductive age. METHODS Using syphilis case reports, we identified counties with no cases of P&S syphilis among women of reproductive age in 2017 and 1 case or more in 2018. Using county-level syphilis and sociodemographic data, we developed a model to predict counties with emergence of P&S syphilis among women and a risk score to identify counties at elevated risk. RESULTS Of 2451 counties with no cases of P&S syphilis among women of reproductive age in 2017, 345 counties (14.1%) had documented emergence of syphilis in 2018. Emergence was predicted by the county's P&S syphilis rate among men; violent crime rate; proportions of Black, White, Asian, and Hawaiian/Pacific Islander persons; urbanicity; presence of a metropolitan area; population size; and having a neighboring county with P&S syphilis among women. A risk score of 20 or more identified 75% of counties with emergence. CONCLUSIONS Jurisdictions can identify counties at elevated risk for emergence of syphilis in women and tailor prevention efforts. Prevention of syphilis requires multidisciplinary collaboration to address underlying social factors.
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Affiliation(s)
- Anne A. Kimball
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth A. Torrone
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kyle T. Bernstein
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jeremy A. Grey
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Virginia B. Bowen
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - David S. Rickless
- Geospatial Research, Analysis, and Services Program, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA
| | - Emily R. Learner
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Leeper SC, Patel MD, Lahri S, Beja-Glasser A, Reddy P, Martin IB, van Hoving DJ, Myers JG. Assault-injured youth in the emergency centres of Khayelitsha, South Africa: A prospective study of recidivism and mortality. Afr J Emerg Med 2021; 11:379-384. [PMID: 34527508 PMCID: PMC8430267 DOI: 10.1016/j.afjem.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 06/08/2021] [Accepted: 07/11/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Violence is a major cause of death worldwide among youth. The highest mortality rates from youth violence occur in low and middle-income countries (LMICs). We sought to identify risk factors for violent re-injury and emergency centre (EC) recidivism among assault-injured youth in South Africa. METHODS A prospective follow up study of assault injured youth and controls ages 14-24 presenting for emergency care was conducted in Khayelitsha, South Africa from 2016 to 2018. Sociodemographic and behavioral factors were assessed using a questionnaire administered during the index EC visit. The primary outcomes were return EC visit for violent injury or death within 15 months. We used multivariable logistic regression to compute adjusted odds ratios (OR) and 95% confidence intervals (CI) of associations between return EC visits and key demographic, social, and behavioral factors among assault-injured youth. RESULTS Our study sample included 320 assault-injured patients and 185 non-assault-injured controls. Of the assault-injured, 80% were male, and the mean age was 20.8 years. The assault-injured youth was more likely to have a return EC visit for violent injury (14%) compared to the control group (3%). The non-assault-injured group had a higher mortality rate (7% vs 3%). All deaths in the control group were due to end-stage HIV or TB-related complications. The strongest risk factors for return EC visit were prior criminal activity (OR = 2.3, 95% CI = 1.1-5.1), and current enrollment in school (OR = 2.1, 95% CI = 1.0-4.6). Although the assault-injured group reported high rates of binge drinking (73%) at the index visit, this was not found to be a risk factor for violence-related EC recidivism. DISCUSSION Our findings suggest that assault-injured youth in an LMIC setting are at high risk of EC recidivism and several sociodemographic and behavioral factors are associated with increased risk. These findings can inform targeted intervention programs.
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Affiliation(s)
- Sarah C. Leeper
- University of Maryland Medical Center, Emergency Medicine, Cheverly, MD, USA
| | - Mehul D. Patel
- University of North Carolina at Chapel Hill School of Medicine, Department of Emergency Medicine, Chapel Hill, NC, USA
| | - Sa'ad Lahri
- Khayelitsha Hospital, Khayelitsha, Cape Town, South Africa
- University of Stellenbosch, Division of Emergency Medicine, Tygerberg, Cape Town, South Africa
| | | | - Priscilla Reddy
- Human Sciences Research Council Pretoria, HSRC Bldg, Arcadia, Pretoria, South Africa
| | - Ian B.K. Martin
- Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, WI, USA
| | - Daniël J. van Hoving
- University of Stellenbosch, Division of Emergency Medicine, Tygerberg, Cape Town, South Africa
| | - Justin G. Myers
- University of North Carolina at Chapel Hill School of Medicine, Department of Emergency Medicine, Chapel Hill, NC, USA
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Mattson CM, Kaylor R, Koehler TJ, Ydenberg M, Grill J, Stork BR. Gun Violence and Firearm Injuries in West Michigan: Targeting Prevention. West J Emerg Med 2021; 22:488-497. [PMID: 34125018 PMCID: PMC8203015 DOI: 10.5811/westjem.2021.3.49255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 03/25/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Firearm-related deaths and injuries are ongoing public health issues in the United States. We reviewed a series of gun violence- and firearm-related injuries treated at a multi-campus community healthcare system in West Michigan to better understand the demographic and clinical characteristics of these injuries. We also studied hospital charges, and payers responsible, in an effort to identify stakeholders and opportunities for community- and hospital-based prevention. METHODS We performed a retrospective review of firearm injuries treated at Mercy Health Muskegon (MHM) between May 1, 2015 and June 30, 2019. Demographic data, injury type, Injury Severity Score (ISS), anatomic location and organ systems involved, length of stay (LOS), mortality, time of year, and ZIP code in which the injury occurred were reviewed, as were hospital charges and payers responsible. RESULTS Of those reviewed, 307 firearm-related injuries met inclusion criteria for the study. In 69.4% of cases the injury type was attempted murder or intent to do bodily harm. Accidental and self-inflicted injuries accounted for 25% of cases. There was a statistically significant difference in the mechanism of injury between Black and White patients with a higher proportion of Black men injured due to gun violence (P < 0.001). Median ISS was 8 and the most commonly injured organ system was musculoskeletal. Median LOS was one day. Self-inflicted firearm injuries had the highest rate of mortality (50%) followed by attempted murder (7%) and accidental discharge (3.1%; P < 0.001). Median hospital charge was $8,008. In 68% of cases, Medicaid was the payer. MHM received $4.98 million dollars in reimbursement from Medicaid; however, when direct and indirect costs were taken into account, a loss of $12,648 was observed. CONCLUSION Findings from this study reveal that young, Black men are the primary victims of gun violence-related injuries in our West Michigan service area. Hospital care of firearm-related injuries at MHM was predominantly paid for by Medicaid. Multiple stakeholders stand to benefit from funding and supporting community- and hospital-based prevention programs designed to reduce gun violence and firearm-related injuries in our service area.
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Affiliation(s)
| | - Ryan Kaylor
- Naval Medical Center, Department of Emergency Medicine, San Diego, California
| | - Tracy J Koehler
- Mercy Health, Department of Scholarly Activity Support, Muskegon, Michigan
| | - Marc Ydenberg
- Mercy Health, Department of Emergency Medicine, Muskegon, Michigan
| | - Justin Grill
- Mercy Health, Department of Emergency Medicine, Muskegon, Michigan
| | - Brian R Stork
- University of Michigan, Department of Urology, Ann Arbor, Michigan
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11
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Carter PM, Zimmerman MA, Cunningham RM. Addressing Key Gaps in Existing Longitudinal Research and Establishing a Pathway Forward for Firearm Violence Prevention Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:367-384. [PMID: 34086512 PMCID: PMC8186821 DOI: 10.1080/15374416.2021.1913741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The main purpose of this article and this special section is to encourage greater attention to the key gaps that exist in our understanding of the epidemiology of adolescent firearm violence and to provide a pathway forward for future longitudinal research that will inform prevention efforts. This increased attention is especially salient given: (a) firearms are the leading cause of death for adolescents and emerging adults in the United States, with the majority of these deaths due to interpersonal violence; (b) significant health and social disparities with regards to the populations that are most affected by interpersonal firearm violence have been documented; and, (c) limitations in federal research funding during the past 30 years have created a deficit of knowledge about key risk and protective factors necessary to inform evidence-based prevention efforts. We discuss the implications of the articles in this special edition for existing and novel prevention programs. We also identify key considerations for future epidemiological research, including the need for a greater focus on collecting longitudinal data among nationally representative samples enriched with subgroups of at-risk youth, the need to examine the role of protective factors and mediating variables within existing and novel theoretical models of firearm risk behaviors, the need to examine key factors across all levels of the socio-ecological model, and the need to incorporate novel and innovative research designs, methods and analyses.
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Affiliation(s)
- Patrick M Carter
- Firearm Safety among Children and Teens Consortium, University of Michigan School of Medicine
- Department of Emergency Medicine, University of Michigan School of Medicine
- Department of Health Behavior/Health Education, University of Michigan School Public Health
- Youth Violence Prevention Center, University of Michigan School of Public Health
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine
| | - Marc A Zimmerman
- Firearm Safety among Children and Teens Consortium, University of Michigan School of Medicine
- Department of Health Behavior/Health Education, University of Michigan School Public Health
- Youth Violence Prevention Center, University of Michigan School of Public Health
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine
| | - Rebecca M Cunningham
- Firearm Safety among Children and Teens Consortium, University of Michigan School of Medicine
- Department of Emergency Medicine, University of Michigan School of Medicine
- Department of Health Behavior/Health Education, University of Michigan School Public Health
- Youth Violence Prevention Center, University of Michigan School of Public Health
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine
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Zvolensky MJ, Garey L, Rogers AH, Schmidt NB, Vujanovic AA, Storch EA, Buckner JD, Paulus DJ, Alfano C, Smits JA, O'Cleirigh C. Psychological, addictive, and health behavior implications of the COVID-19 pandemic. Behav Res Ther 2020; 134:103715. [PMID: 32891956 PMCID: PMC7451060 DOI: 10.1016/j.brat.2020.103715] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/07/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,HEALTH Institute, University of Houston, Houston, TX, USA,Corresponding author. Dept of Psychology, 3695 Cullen Blvd, Room 126, University of Houston, Houston, TX, 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H. Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Candice Alfano
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
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Sokol RL, Carter PM, Goldstick J, Miller AL, Walton MA, Zimmerman MA, Cunningham RM. Within-Person Variability in Firearm Carriage Among High-Risk Youth. Am J Prev Med 2020; 59:386-393. [PMID: 32430221 PMCID: PMC7483893 DOI: 10.1016/j.amepre.2020.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Youth who carry firearms-and peers that surround them-are at increased risk for violent injuries. Because firearm carriage behaviors can change over time within an individual, it is important to identify individual and social-contextual determinants that explain this within-person variability in carriage. METHODS The authors identified individual and social-contextual determinants of firearm carriage in the past 6 months using multilevel logistic models on 5 waves of panel data from the Flint Youth Injury Study (n=597; ages 14-24 years), collected in 2009-2011 and analyzed in 2019. RESULTS Regarding within-person effects, when an individual had more positive peer affiliations than their average, their odds of carrying a firearm decreased (OR=0.88; 95% CI=0.81, 0.96). Conversely, an individual's odds of carrying a firearm increased when they had more negative peer affiliations (OR=1.08, 95% CI=1.02, 1.14), experienced more victimization (OR=1.03, 95% CI=1.01, 1.05), perceived greater community violence (OR=1.12, 95% CI=1.05, 1.21), or exhibited greater retaliatory attitudes (OR=1.10, 95% CI=1.01, 1.19) than their average. CONCLUSIONS Peer affiliations, victimization, community violence perceptions, and retaliatory attitudes explain within-person variability in firearm carriage. Strategies for reducing carriage among youth should consider individual- and environmental-level interventions to address these individual and social-contextual determinants.
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Affiliation(s)
- Rebeccah L Sokol
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
| | - Patrick M Carter
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan; University of Michigan Injury Prevention Center, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan; Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Jason Goldstick
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan; Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Maureen A Walton
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan; Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan; University of Michigan Injury Prevention Center, Ann Arbor, Michigan; Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Rebecca M Cunningham
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan; Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, Ann Arbor, Michigan; Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan; Department of Emergency Medicine, Hurley Medical Center, Flint, Michigan
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14
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Oliphant SN, Mouch CA, Rowhani-Rahbar A, Hargarten S, Jay J, Hemenway D, Zimmerman M, Carter PM. A scoping review of patterns, motives, and risk and protective factors for adolescent firearm carriage. J Behav Med 2019; 42:763-810. [PMID: 31367939 PMCID: PMC7182091 DOI: 10.1007/s10865-019-00048-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/23/2019] [Indexed: 12/14/2022]
Abstract
Firearm carriage is a key risk factor for interpersonal firearm violence, a leading cause of adolescent (age < 18) mortality. However, the epidemiology of adolescent firearm carriage has not been well characterized. This scoping review examined four databases (PubMed; Scopus; EMBASE; Criminal Justice Abstracts) to summarize research on patterns, motives, and underlying risk/protective factors for adolescent firearm carriage. Of 6156 unique titles, 53 peer-reviewed articles met inclusion criteria and were reviewed. These studies mostly examined urban Black youth, finding that adolescents typically carry firearms intermittently throughout adolescence and primarily for self-defense/protection. Seven future research priorities were identified, including: (1) examining adolescent carriage across age, gender, and racial/ethnic subgroups; (2) improving on methodological limitations of prior research, including disaggregating firearm from other weapon carriage and using more rigorous methodology (e.g., random/systematic sampling; broader population samples); (3) conducting longitudinal analyses that establish temporal causality for patterns, motives, and risk/protective factors; (4) capitalizing on m-health to develop more nuanced characterizations of underlying motives; (5) increasing the study of precursors for first-time carriage; (6) examining risk and protective factors beyond the individual-level; and, (7) enhancing the theoretical foundation for firearm carriage within future investigations.
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Affiliation(s)
- Stephen N Oliphant
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Gerald R. Ford School of Public Policy, University of Michigan, 735 S State St, Ann Arbor, MI, 48109, USA
| | - Charles A Mouch
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Ali Rowhani-Rahbar
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Health Sciences Bldg, F-262, Seattle, WA, 98195, USA
- Harborview Injury Prevention and Research, Center University of Washington, 401 Broadway, 4th Floor, Seattle, WA, 98122, USA
| | - Stephen Hargarten
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Emergency Medicine and Comprehensive Injury Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
| | - Jonathan Jay
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, 3rd & 4th Floors, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - David Hemenway
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, 3rd & 4th Floors, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Marc Zimmerman
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Health Behavior and Health Education, University of Michigan School Public Health, 1415 Washington Heights 3790A SPH I, Ann Arbor, MI, 48109, USA
- Youth Violence Prevention Center, Univ. of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Emergency Medicine, Univ. of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI, 48109, USA
| | - Patrick M Carter
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
- Department of Health Behavior and Health Education, University of Michigan School Public Health, 1415 Washington Heights 3790A SPH I, Ann Arbor, MI, 48109, USA.
- Youth Violence Prevention Center, Univ. of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Department of Emergency Medicine, Univ. of Michigan Injury Prevention Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI, 48109, USA.
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