Suchergebnisse

AbstractSchool‐shootings can enormously impact U.S. gun policy, but very little is known about the community mental health impact of school‐shootings. We used difference‐in‐differences and event study analyses to compare stress‐related ED visits in zip‐codes within 5 miles (exposed) and in zip‐codes 10–15 miles from (control) school‐shootings before and after school‐shootings using data from California, 2005–2011. School‐shootings and fatal school‐shootings were associated with annual increases of 0.7 and 1.5 stress‐related ED visits per 1000 people, increases of 7% and 14%, respectively, compared to pre‐shooting utilization. These previously unmeasured costs of school‐shootings reinforce calls to prevent gun violence, especially in schools.

Abstract
Extreme risk protection orders (ERPOs), which allow for the temporary restriction of firearm access for individuals at substantial risk of harming themselves and/or others, are a promising policy tool to address increasing rates of firearm-related suicide, homicide, and mass shootings. Social workers frequently assess clients at risk of firearm-related harm, positioning social workers to play a key role in ERPO implementation. This study sought to understand social workers' perspectives on ERPOs. Authors invited 6,910 licensed social workers in Washington state to participate in a survey in May and June of 2021 about facilitators and barriers to their willingness to counsel clients' family members, contact law enforcement, or independently file ERPOs for clients at risk of harm to self (HTS) or others (HTO). Of the 1,381 survey participants, most were willing to counsel (96 percent for HTS; 96 percent HTO), contact law enforcement (84 percent for HTS; 87 percent for HTO), or independently file an ERPO (78 percent for HTS; 79 percent for HTO). Common barriers associated with willingness were lack of understanding about the ERPO process and concerns with involving the legal system/law enforcement. Key facilitators included training social workers about ERPOs and availability of legal experts for consultations. Social workers are willing to incorporate ERPOs into their practice for clients, but remaining barriers need to be addressed to support the practice.

Objectives. To determine differences among US states in how driving under the influence of alcohol (DUI) laws activate federal firearm possession and purchase prohibitions. Methods. We performed primary legislative research to characterize DUI laws in each state. The primary outcome was the number of DUI convictions an individual must be convicted of in each state to activate the federal firearm possession and purchase prohibition. We also determined the time interval in which previous DUI convictions count for future proceedings. Results. Forty-seven states had DUI laws that activated the federal prohibition of firearm possession and purchase for a threshold number of repeated DUIs. Variation exists among states in the number of convictions (1–4) and length of liability period (5 years–lifetime) required to prohibit firearm possession and purchase. Conclusions. Variation in state laws on DUI results in differences in determining who is federally prohibited from possessing and purchasing firearms. Future research should explore whether these federal prohibitions arising from DUI convictions are enforced and whether an association exists between stricter DUI policies and reduction in firearm crimes, injuries, and deaths.

Poverty is an important predictor of child maltreatment. Social policies that strengthen the economic security of low-income families, such as the Earned Income Tax Credit (EITC), may reduce child maltreatment by impeding the pathways through which poverty leads to it. We used variations in the presence and generosity of supplementary EITCs offered at the state level and administrative child maltreatment data from the National Child Abuse and Neglect Data System (NCANDS) to examine the effect of EITC policies on state-level rates of child maltreatment from 2004 through 2017. Two-way fixed effects models indicated that a 10-percentage point increase in the generosity of refundable state EITC benefits was associated with 241 fewer reports of neglect per 100,000 children (95% Confidence Interval [CI] [−449, −33]). An increase in EITC generosity was associated with fewer reports of neglect both among children ages 0–5 (−324 per 100,000; 95% CI [−582, −65]) and children ages 6–17 (−201 per 100,000; 95% CI [−387, −15]). Findings also suggested associations between the EITC and reductions in other types of maltreatment (physical abuse, emotional abuse); however, those did not gain statistical significance. Economic support policies may reduce the risk of child maltreatment, especially neglect, and improve child wellbeing.

Corollary victims represent approximately 20% of all intimate partner homicides (IPH), and many are children. We used National Violent Death Reporting System (NVDRS) data (2003–2017) to compare all IPH incidents with a child corollary victim (n = 227) to all IPH incidents where a child was present but not killed (n = 350). We examined risk factors for child fatality during an IPH. For each risk factor, we calculated the odds ratio for child death during the IPH, adjusting for multiple comparisons. Perpetrator history of suicidal behavior, rape of the intimate partner victim, a non-biological child of the perpetrator living in the home, and perpetrator job stressors increased odds while prior separation of the IPV victim from the perpetrator decreased the odds of a child death during an IPH incident. To our knowledge, this is the first case-control study using live-controls within NVDRS and can help direct prevention efforts for child death during IPH.

Rural adolescents are at risk for firearm-related injury and death. In response, professional organizations have called for communication between adolescents, parents, and providers about firearms. A shared understanding of firearms between providers and families can facilitate effectiveness of health interventions. However, few studies engage adolescents in identifying their perception of common firearm terminology. The current study aimed to understand how adolescents in rural communities defined firearm-related terms including firearm, carrying, and handling, and differences in terms based on prior firearm training. Data were from a mixed methods community-based participatory study of 93 adolescents from rural Washington state. Thematic qualitative coding identified themes for firearm (gun, weapon, projectile, and tool), carrying (on you/your person, transportation, and holding), and handling (actively using, safe use, and holding) and differences between those with prior firearms training. Findings provide insight into perceptions of firearm-related terms for adolescents, an often-neglected voice, and inform rural policy and prevention efforts.

Pertussis is a common vaccine-preventable disease (VPD) worldwide. Its reported incidence has increased steadily in the United States, where it is endemic. Tetanus is a rare but potentially fatal VPD. Foreign-born adults have lower tetanus–diphtheria–pertussis (Tdap) and tetanus–diphtheria (Td) vaccination coverage than do U.S.-born adults. We studied the association of migration-related, socio-demographic, and access-to-care factors with Tdap and Td vaccination among foreign-born adults living in the United States. The 2012 and 2013 National Health Interview Survey data for foreign-born respondents were analyzed. Multivariable logistic regression was conducted to calculate prevalence ratios and 95% confidence intervals, and to identify variables independently associated with Tdap and Td vaccination among foreign-born adults. Tdap and Td vaccination status was available for 9316 and 12,363 individuals, respectively. Overall vaccination coverage was 9.1% for Tdap and 49.8% for Td. Younger age, higher education, having private health insurance (vs. public insurance or uninsured), having visited a doctor in the previous year, and region of residence were independently associated with Tdap and Td vaccination. Among those reporting a doctor visit, two-thirds had not received Tdap. This study provides further evidence of the need to enhance access to health care and immunization services and reduce missed opportunities for Tdap and Td vaccination for foreign-born adults in the United States. These findings apply to all foreign-born, irrespective of their birthplace, citizenship, language and years of residence in the United States. Addressing vaccination disparities among the foreign-born will help achieve national vaccination goals and protect all communities in the United States.