Journal of urban health : bulletin of the New York Academy of Medicine
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In October 2012, Bellevue Hospital Center (Bellevue) in New York City was temporarily closed as a result of Hurricane Sandy, the largest hurricane in US history. Bellevue's primary care office-based buprenorphine program was temporarily closed and later relocated to an affiliate public hospital. Previous research indicates that the relationships between disaster exposure, substance use patterns, psychiatric symptoms, and mental health services utilization is complex, with often conflicting findings regarding post-event outcomes (on the individual and community level) and antecedent risk factors. ⋯ Our findings highlight the relative resilience of buprenorphine as an office-based treatment modality for patients encountering a disaster with associated unanticipated service disruption. In responding to future disasters, triaging patient contact and priority based on a history of red-flag behaviors, rather than a history of psychiatric comorbidity, will likely optimize resource allocation, especially among recently enrolled patients. Additionally, patients endorsing new-onset psychiatric manifestations following disasters may be an especially high-risk group for poor outcomes, warranting further study.
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Comparative Study
Witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents.
Witnessing violence has been linked to maladaptive coping behaviors such as smoking, alcohol consumption, and marijuana use. However, more research is required to identify mechanisms in which witnessing violence leads to these behaviors. The objectives of this investigation were to examine the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents, to identify whether exhibiting depressive symptoms was a mediator within this relationship, and to determine if those who had adult support in school were less likely to engage in risky health behaviors. ⋯ However, among girls who witnessed a violent death, having an adult at school for support was protective against alcohol consumption. When we used propensity score matching, findings were consistent with the main analyses among boys only. This study adds insight into how witnessing violence can lead to adoption of adverse health behaviors.
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In the USA, homicide is a leading cause of death for young males and a major cause of racial disparities in life expectancy for men. There are intense debate and little rigorous research on the effects of firearm sales regulation on homicides. ⋯ Using Uniform Crime Reporting data from police through 2012, the law's repeal was associated with increased annual murders rates of 0.93 per 100,000 (+16%). These estimated effects translate to increases of between 55 and 63 homicides per year in Missouri.
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Comparative Study
Support for a comprehensive background check requirement and expanded denial criteria for firearm transfers: findings from the firearms licensee survey.
Federal and state policies on eligibility to purchase and possess firearms and background check requirements for firearm transfers are undergoing intensive review and, in some cases, modification. Our objective in this third report from the Firearms Licensee Survey (FLS) is to assess support among federally licensed firearms retailers (gun dealers and pawnbrokers) for a background check requirement on all firearm transfers and selected criteria for denying the purchase of handguns based on criminal convictions, alcohol abuse, and serious mental illness. The FLS was conducted by mail during June-August, 2011 on a random sample of 1,601 licensed dealers and pawnbrokers in 43 states who were believed to sell at least 50 firearms annually. ⋯ Support again increased with sales of inexpensive handguns and denied sales and decreased with sales of tactical (assault-type) rifles. In this survey, which was conducted prior to mass shootings in Aurora, Colorado; Oak Creek, Wisconsin; Newtown, Connecticut; and elsewhere, licensed firearm sellers exhibited moderate support for a comprehensive background check requirement and very strong support for additional criteria for denial of handgun purchases. In both cases, support was associated with the intensity of respondents' exposure to illegal activities.
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African-American youth are disproportionately affected by parental incarceration and the consequences of parental substance use. Many adapt to the loss of their parents to prison or drug addiction by engaging in sex-risk behavior, particularly the sex trade. These youth may engage in this risky behavior for a number of reasons. ⋯ The sample for this study reported a mean age of 19; 28 % reported having traded sex for money; 30 % had a father currently in prison; and 7 % reported having a mother currently in prison. Maternal incarceration and paternal substance use were associated with a higher likelihood of trading sex for money. Given the potential health risks associated with trading sex for money, understanding correlates of this behavior has important implications for the health of this vulnerable population of youth and urban health in general.