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Peña S, Wilkinson C, Aresi G, Barrett L, Boniface S, Fitzgerald N, Norambuena P, Paradis C, Román F, Sierralta P. Alcohol policy changes during the first three-months of the COVID-19 pandemic: Development and application of a classification scheme. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104373. [PMID: 38537492 DOI: 10.1016/j.drugpo.2024.104373] [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: 10/22/2023] [Revised: 01/31/2024] [Accepted: 02/22/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Policy changes in response to the COVID-19 pandemic have impacted on alcohol control. This study describes the development and application of a classification scheme to map alcohol policy changes during the first three-months of the COVID-19 pandemic in five countries and/or subnational jurisdictions. METHOD A pre-registered systematic review of policy decisions from March to May 2020, in Australia/New South Wales, Canada/Ontario, Chile, Italy and the United Kingdom. One author extracted the data for each jurisdiction using a country-specific search strategy of government documents. We coded policy changes using an adapted WHO classification scheme, whether the policy was expected to tighten or loosen alcohol control, have mainly immediate or delayed impact on consumption and harm and impact the general population versus specific populations. We present descriptive statistics of policy change. RESULTS We developed a classification scheme with four levels. Existing policy options were insufficient to capture policy changes in alcohol availability, thus we added seventeen new sub-categories. We found 114 alcohol control policies introduced across the five jurisdictions, covering five (out of ten) WHO action areas. The majority aimed to change alcohol availability, by regulating the operation of alcohol outlets. All countries introduced closures to on-premise alcohol outlets and, except Chile, allowed off-sales via take away or home delivery. We also observed several pricing policies introducing subsidies to support the alcohol industry. Seventy-four percent of policy changes were expected to tighten alcohol control and 12.3 % to weaken control. Weakening policy changes were mostly related to retail mode switching or expansion (allowing take away or home delivery). CONCLUSION Alcohol control policies during the first three months of the COVID-19 pandemic were targeted primarily at alcohol availability and about one tenth might weaken alcohol control. Temporary changes to alcohol retail during the COVID-19 pandemic, if made permanent, could significantly expand alcohol availability.
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Affiliation(s)
- Sebastián Peña
- Finnish Institute for Health and Welfare, Helsinki, Finland; Facultad de Medicina, Universidad Diego Portales, Santiago, Chile.
| | | | - Giovanni Aresi
- CERISVICO Research Centre on Community Development and Organisational Quality of Life, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Liz Barrett
- University of New South Wales, Sydney, Australia
| | - Sadie Boniface
- Institute of Alcohol Studies, London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Niamh Fitzgerald
- Institute for Social Marketing & Health, University of Stirling, United Kingdom; SPECTRUM Consortium, United Kingdom
| | - Pablo Norambuena
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile; Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | | | - Francisca Román
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile; Universidad de La Frontera, Temuco, Chile
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Burris S. Legal Epidemiology: Growth, and Growing Pains. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:1-2. [PMID: 37966949 DOI: 10.1097/phh.0000000000001836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Affiliation(s)
- Scott Burris
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, Pennsylvania
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Montez JK, Hayward MD, Zajacova A. Trends in U.S. Population Health: The Central Role of Policies, Politics, and Profits. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:286-301. [PMID: 34528482 PMCID: PMC8454055 DOI: 10.1177/00221465211015411] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Recent trends in U.S. health have been mixed, with improvements among some groups and geographic areas alongside declines among others. Medical sociologists have contributed to the understanding of those disparate trends, although important questions remain. In this article, we review trends since the 1980s in key indicators of U.S. health and weigh evidence from the last decade on their causes. To better understand contemporary trends in health, we propose that commonly used conceptual frameworks, such as social determinants of health, should be strengthened by prominently incorporating commercial, political-economic, and legal determinants. We illustrate how these structural determinants can provide new insights into health trends, using disparate health trajectories across U.S. states as an example. We conclude with suggestions for future research: focusing on structural causes of health trends and inequalities, expanding interdisciplinary perspectives, and integrating methods better equipped to handle the complexity of causal processes driving health trends and inequalities.
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The Growing Field of Legal Epidemiology. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 26 Suppl 2, Advancing Legal Epidemiology:S4-S9. [PMID: 32004217 DOI: 10.1097/phh.0000000000001133] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Kavanagh MM, Meier BM, Pillinger M, Huffstetler H, Burris S. Global Policy Surveillance: Creating and Using Comparative National Data on Health Law and Policy. Am J Public Health 2020; 110:1805-1810. [PMID: 33058711 PMCID: PMC7661970 DOI: 10.2105/ajph.2020.305892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2020] [Indexed: 11/04/2022]
Abstract
Throughout the world, laws play an important role in shaping population health. Law making is an intervention with measurable effects yet often unfolds without evaluation or monitoring. Policy surveillance-the systematic, scientific collection and analysis of laws of public health significance-can help bridge this gap by capturing important features of law in numeric form in structured longitudinal data sets.Currently deployed primarily in high-income countries, methods for cross-national policy surveillance hold significant promise, particularly given the growing quality and accessibility of global health data. Global policy surveillance can enable comparative research on the implementation and health impact of laws, their spread, and their political determinants. Greater transparency of status and trends in law supports health policy advocacy and promotes public accountability. Collecting, coding, and analyzing laws across countries presents numerous challenges-especially in low-resource settings.With insights from comparative politics and law, we suggest methods to address those challenges. We describe how longitudinal legal data have been used in limited, but important, ways for cross-national analysis and propose incorporating global policy surveillance into core global public health practice.
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Affiliation(s)
- Matthew M Kavanagh
- Matthew M. Kavanagh is with the Department of International Health, Georgetown University, Washington, DC. Matthew M. Kavanagh and Mara Pillinger are with the Georgetown University O'Neill Institute for National and Global Health Law, Washington, DC. Benjamin Mason Meier and Hanna Huffstetler are with the Department of Public Policy, University of North Carolina at Chapel Hill. Scott Burris is with the Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA
| | - Benjamin Mason Meier
- Matthew M. Kavanagh is with the Department of International Health, Georgetown University, Washington, DC. Matthew M. Kavanagh and Mara Pillinger are with the Georgetown University O'Neill Institute for National and Global Health Law, Washington, DC. Benjamin Mason Meier and Hanna Huffstetler are with the Department of Public Policy, University of North Carolina at Chapel Hill. Scott Burris is with the Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA
| | - Mara Pillinger
- Matthew M. Kavanagh is with the Department of International Health, Georgetown University, Washington, DC. Matthew M. Kavanagh and Mara Pillinger are with the Georgetown University O'Neill Institute for National and Global Health Law, Washington, DC. Benjamin Mason Meier and Hanna Huffstetler are with the Department of Public Policy, University of North Carolina at Chapel Hill. Scott Burris is with the Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA
| | - Hanna Huffstetler
- Matthew M. Kavanagh is with the Department of International Health, Georgetown University, Washington, DC. Matthew M. Kavanagh and Mara Pillinger are with the Georgetown University O'Neill Institute for National and Global Health Law, Washington, DC. Benjamin Mason Meier and Hanna Huffstetler are with the Department of Public Policy, University of North Carolina at Chapel Hill. Scott Burris is with the Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA
| | - Scott Burris
- Matthew M. Kavanagh is with the Department of International Health, Georgetown University, Washington, DC. Matthew M. Kavanagh and Mara Pillinger are with the Georgetown University O'Neill Institute for National and Global Health Law, Washington, DC. Benjamin Mason Meier and Hanna Huffstetler are with the Department of Public Policy, University of North Carolina at Chapel Hill. Scott Burris is with the Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA
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Hyshka E, Anderson-Baron J, Pugh A, Belle-Isle L, Hathaway A, Pauly B, Strike C, Asbridge M, Dell C, McBride K, Tupper K, Wild TC. Principles, practice, and policy vacuums: Policy actor views on provincial/territorial harm reduction policy in Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 71:142-149. [DOI: 10.1016/j.drugpo.2018.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 12/20/2018] [Accepted: 12/27/2018] [Indexed: 02/06/2023]
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Moeller K. Sisters are never alike? Drug control intensity in the Nordic countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:141-145. [PMID: 31427212 DOI: 10.1016/j.drugpo.2019.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/03/2019] [Accepted: 06/06/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Nordic countries - Denmark, Finland, Norway, and Sweden - have traditionally had different approaches to drug control policies. From the late 1980s to the early 1990s, Sweden and Norway were the most restrictive countries. Prior research has described how Nordic control policies became more repressive after this, but no research has examined this claim using the intensity of implementation as a measure. METHODS This study uses data collated by the EMCDDA to examine drug control intensity from 2000 to 2016. The four countries are compared on three measures: seizure numbers relative to total population, seizures numbers by type of drug relative to population, and cannabis seizures relative to the number of annual cannabis users. Standard bivariate tests for statistical significance are used to compare control intensity over time and between countries. RESULTS Compared to an earlier period from the late 1980s to the early 1990s, Denmark maintained the level of drug seizures to population from 2000 to 2016. Finland increased intensity by 176 percent but remained at the lowest level in the region. Norway increased by 18 percent and is currently the country with the highest enforcement intensity. Sweden reduced overall intensity by 57 percent, which decreases the level for the region by 22 percent. Sixty to seventy percent of all seizures in every country was for cannabis. Accounting for cannabis prevalence rates changes the ranking of enforcement intensity in the countries. CONCLUSION Drug control intensity in the Nordic countries has harmonized over time. The disparity between the extremes of low control intensity in Finland and high intensity in Sweden has been reduced. Denmark is still comparatively lenient to users when considering high cannabis prevalence rates and Norway has taken the position as the strictest country on all control intensity measures.
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Affiliation(s)
- Kim Moeller
- Malmö University, Department of Criminology, Jan Waldenströms gata 25, 214 28 Malmö, Sweden.
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Watson TM, Hyshka E, Bonato S, Rueda S. Early-Stage Cannabis Regulatory Policy Planning Across Canada's Four Largest Provinces: A Descriptive Overview. Subst Use Misuse 2019; 54:1691-1704. [PMID: 31076006 DOI: 10.1080/10826084.2019.1608249] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Observing and documenting major shifts in drug policy in a given jurisdiction offer important lessons for other settings worldwide. After nearly a century of prohibition of non-medical use and sale of cannabis, Canada federally legalized the drug in October 2018. Across this geographically large and diverse country, there is a patchwork of cannabis policies as the provinces and territories have developed their own regulatory frameworks. Objectives: As drug policy transitions are often studied well after implementation, we document early stage cannabis regulatory policy planning in the four most populous provinces of Québec, Ontario, Alberta, and British Columbia. Methods: In June 2018, we systematically searched peer-reviewed and gray literature (such as web content, reports, and policy documents authored by varied authorities and organizations) to identify key aspects of the evolving provincial cannabis legalization frameworks. In the absence of peer-reviewed studies, we reviewed primarily gray literature. Results: For each of the four provinces examined, we provide a succinct overview of early-stage public consultation, plans for cannabis distribution and retail, other key regulatory features, endorsements of a public health approach to legalization, general alignment with alcohol policy, and contentious or standout issues. Conclusions/Importance: Our review clearly illustrates that cannabis legalization in Canada is not unfolding as monolithic policy, despite a federal framework, but with divergent approaches. The public health outcomes that will result from the different provincial/territorial regulatory systems remain to be measured and will be closely monitored.
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Affiliation(s)
| | - Elaine Hyshka
- b School of Public Health , University of Alberta , Edmonton , Canada
| | - Sarah Bonato
- a Centre for Addiction and Mental Health , Toronto , Canada
| | - Sergio Rueda
- a Centre for Addiction and Mental Health , Toronto , Canada.,c Department of Psychiatry, Institute of Medical Science, Institute of Health Policy, Management and Evaluation , University of Toronto , Toronto , Canada
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Stevens A, Zampini GF. Drug policy constellations: A Habermasian approach for understanding English drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 57:61-71. [DOI: 10.1016/j.drugpo.2018.03.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 12/20/2017] [Accepted: 03/27/2018] [Indexed: 01/01/2023]
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Houborg E, Bjerge B, Frank VA. Editorial: Comparing drug policies. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 56:128-130. [PMID: 29861169 DOI: 10.1016/j.drugpo.2018.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Hughes CE, Barratt MJ, Ferris JA, Maier LJ, Winstock AR. Drug-related police encounters across the globe: How do they compare? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 56:197-207. [PMID: 29699837 DOI: 10.1016/j.drugpo.2018.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 03/01/2018] [Accepted: 03/04/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Drug law enforcement subsumes the majority of drug policy expenditure across the globe. Fuelled by knowledge that much of this investment is ineffective or counter-productive there have been increasing calls for cross-national comparisons to identify where policing approaches differ and what types of approaches may be more effective. Yet, to date cross-national comparison of drug law enforcement has proven a methodologically hazardous affair. Using a new drug policing module added to the 2017 Global Drug Survey, this study seeks to provide the first cross-national comparison of the incidence, nature and intensity of illicit drug-related police encounters amongst people who use drugs. METHODS The Global Drug Survey was administered in late 2016. Across 26 countries including Australia, Germany, Italy, Mexico, Switzerland, the UK and the USA a total of 45,942 people who had recently used drugs completed the drug policing module. Key variables assessed included the incidence and frequency of drug-related police encounters in the last 12 months that involved: a) being stopped and searched; b) encountering a drug detection dog; c) being given a caution or warning; d) being charged and arrested; and e) paying a bribe. Multi-level models were used to control for pre-existing national differences in drug use prevalence and non-drug specific policing (including the total number of police personnel in each country). RESULTS Drug-related police encounters were most commonly reported in Italy and Scotland. Conversely, police encounters were most likely to lead to arrest in Norway, Finland and Sweden. The type and locations of encounters further differed across countries, with for example stop and search most reported in Greece and Colombia, and encounters with drug detection dogs most reported in Scotland, Italy, UK and Australia. Multi-level models showed that the incidence of reported policing encounters continued to differ significantly across countries after controlling for pre-existing national differences in drug use prevalence and policing, and that drug policing encounters were 4 to 14 times more common in some nations than others. CONCLUSION The findings unearth significant cross-national differences in the incidence and nature of drug-related policing of people who use drugs. This suggests that there may be opportunities for countries to learn from each other about how and why they differ, and the potential benefits of switching to lower intensity modes of drug policing.
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Affiliation(s)
- Caitlin E Hughes
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia.
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia; National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
| | - Jason A Ferris
- Institute for Social Science Research, The University of Queensland, St Lucia, QLD, Australia
| | | | - Adam R Winstock
- Institute of Epidemiology & Health Care, Faculty of Population Health Sciences, University College London, UK; Global Drug Survey Ltd, London, UK
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Ritter A, Stevens A. Improving knowledge on law enforcement in drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 41:89-90. [PMID: 28257909 DOI: 10.1016/j.drugpo.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alison Ritter
- National Drug and Alcohol Research Centre, University of NSW, Australia
| | - Alex Stevens
- School of Social Policy, Sociology and Social Research, University of Kent, Australia
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