Accidents & Violence, Author Interviews, Pediatrics, Race/Ethnic Diversity / 26.11.2020 Interview with: Dr. Monika K. Goyal, MD Associate Division Chief, Emergency Medicine Children’s National Hospital Department of Pediatrics, School of Medicine and Health Sciences The George Washington University Washington, District of Columbia What is the background for this study? Response: There has been growing attention to the disproportionate use of police force in communities of color. Therefore, we sought to investigate whether Black and Hispanic teenagers have higher rates of death due to police shootings when compared to white youth. (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 21.08.2020 Interview with: Ashwini Sehgal, MD Professor, Department of Medicine, School of Medicine Professor, Department of Bioethics, School of Medicine Professor, Department of Population and Quantitative Health Sciences, School of Medicine Director and Duncan Neuhauser Professor of Community Health Improvement, Center for Reducing Health Disparities, Case Western School of Medicine What is the background for this study? Response: News media and politicians frequently discuss the high toll of deaths from firearms and drug overdoses. They usually mention the numbers of deaths, citing figures like 40,000 firearm deaths last year, or death rates such as 20 overdose deaths per 100,000 population. But for most people, it's hard to grasp the real meaning of both the large absolute numbers and the small annual rates.  So in a new study published in the American Journal of Medicine, I used official death certificate data to calculate the chance that an American child will die from a gunshot or a drug overdose over the course of a lifetime. (more…)
Accidents & Violence, Author Interviews, PTSD, Surgical Research / 20.11.2019 Interview with: Michael A. Vella, M.D., M.B.A. Assistant Professor of Surgery Division of Acute Care Surgery and Trauma University of Rochester School of Medicine and Dentistry What is the background for this study? Response: There is a lot of (appropriate) focus on the mortality statistics related to gun violence, but sometimes we forget about the large number of survivors of gunshot wounds.  We wanted to specifically look at the long term physical and mental health outcomes in this patient population. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 29.10.2019 Interview with:   Carole Stipelman MD MPH Associate Professor of Pediatrics Physician Informatics Team Medical Director, University Pediatric Clinic Salt Lake City, Utah What is the background for this study? What are the main findings? 
  • Guns are the second leading cause of death in children and adolescents.
  • 6 million children live in homes with at least one gun that is loaded and unlocked.
  • Safe storage of guns increases when physicians speak with parents about how to prevent children from having access to guns. However, these conversations happen infrequently.
Accidents & Violence, Author Interviews, Technology / 26.03.2019 Interview with: Cynthia Lum, PhD Professor of Criminology Law and Society George Mason University What is the background for this study? Response: Body-worn cameras (BWCs) are one of the most rapidly diffusing technologies in policing today, costing agencies and their municipalities millions of dollars. Recent estimates by the Bureau of Justice statistics indicate that over 60% of local police departments have already acquired BWCs. This adoption has been propelled by highly publicized officer-involved shootings and other death-in-custody events in this decade, as well as more generally by continuing concerns regarding police-citizen relationships, particularly within communities of color. All of these contexts prompt the need to better understand the impacts and effects of BWCs as they diffuse rapidly into policing. Specifically, do BWCs achieve the expectations that citizens, communities, and the police have of them? This article provides a narrative review of 70 studies, representing over 110 findings, about what we know from research across six important Body-worn cameras domains: (1) the impact of BWCs on officer behavior; (2) officer attitudes about BWCs; (3) the impact of BWCs on citizen behavior; (4) citizen and community attitudes about BWCs; (5) the impact of BWCs on criminal investigations; and (6) the impact of BWCs on law enforcement organizations. (more…)
Accidents & Violence, Author Interviews, JAMA, Johns Hopkins, Surgical Research / 30.10.2018 Interview with: “Me holding USP gun” by Nghị Trần is licensed under CC BY 2.0Faiz Gani, PhD Postdoctoral research fellow Department of Surgery Johns Hopkins University School of Medicine What is the background for this study? What are the main findings?  Response: Firearm related injuries are a leading cause of injury and death in the United States, yet, due to combination of factors, limited data exist that evaluate these injuries, particularly among younger patients (patients younger than 18 years). The objective of this study was to describe emergency department utilization for firearm related injuries and to quantitate the financial burden associated with these injuries. In our study of over 75,000 emergency department visits, we observed that each year, over 8,300 children and adolescents present to the emergency department for the treatment / management of a gunshot injury. Within this sub-population of patients, we observed that these injuries are most frequent among patients aged 15-17 years and while these injuries decreased over time initially, were observed to increase again towards the end of the time period studied. In addition to describing the clinical burden of these injuries, we also sought to describe the financial burden associated with these injuries. For patients discharged from the emergency department, the average (median) charge associated with their care was $2,445, while for patients admitted as inpatients for further care, the average (median) charge was $44,966. Collectively these injuries resulted in $2.5 billion in emergency department and hospital charges over the time period studied. This translates to an annual financial burden of approximately $270 million. (more…)
Accidents & Violence, Author Interviews, CDC, Race/Ethnic Diversity / 21.09.2018 Interview with: Dr. Kameron Sheats PhD Licensed Psychologist; Behavioral Scientist Centers for Disease Control and Prevention What is the background for this study? Response: This study updates literature on racial disparities in violence between black and white youth using data capturing different severity levels in violent outcomes such as homicide versus assault. This study also seeks to increase the understanding of the impact of these disparities by examining associations between disparities in childhood adversity (e.g., child abuse and neglect, exposure to violence, household challenges) and adult health conditions. (more…)
Accidents & Violence, Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Surgical Research / 12.09.2018 Interview with: Adil Haider, MD, MPH, FACS Kessler Director for the Center for Surgery and Public Health Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health Deputy Editor of JAMA Surgery What is the background for this study? Response: Firearm-related mortality is a public health issue. However, in the US, due in part to lack of funding, there is not enough research to inform the debate about firearms. The question our group sought to answer was to understand if the presence of a semi-automatic weapon increased the number of victims killed or hurt during an active shooter incident. We chose to focus on these incidents given the availability of an FBI database detailing these active shooter incidents based on a strict definition and the similarities between such incidents that make a comparison valid. (more…)
Accidents & Violence, Author Interviews, JAMA / 03.08.2018 Interview with: Dr. Angela Sauaia, MD, PhD Professor of Public Health and Surgery University of Colorado Denver Statistical Editor, Journal of Trauma and Acute Care Surgery Statistical Consultant, Department of Surgery Denver Health Medical Center What is the background for this study? What are the main findings?  Response: As injury researchers we monitor national trends in injury. The CDC WISQARS (Web-based Injury Statistics Query and Reporting System) is one of the few available open sources of injury data we can use. During the 1980’s and 1990’s, we saw much improvement in deaths due to most injury mechanisms, such as car accidents fatalities. Our study shows, however, that recent trends seem to be eroding these promising survival gains. Both violent and unintentional injuries alike seem to be increasing, especially since 2014. We are unclear about the causes of this recent increase in trauma-related deaths, but it is an alarming trend. (more…)
Accidents & Violence, Author Interviews, JAMA / 30.07.2018 Interview with: “GUNS” by Jessica Spengler is licensed under CC BY 2.0Kendrin R. Sonneville, ScD, RD Assistant Professor Department of Nutritional Sciences University of Michigan School of Public Health What is the background for this study? What are the main findings? Response: The results from this come out of MyVoice, a text message cohort of youth ages 14-24 representing every state in the country ( Each week we ask the youth in our cohort a series of open-ended to questions, with the goal of gathering the real-time opinions and experiences of youth across the U.S. This study reports the results of questions we asked MyVoice paritpatns between 07/2017 and 01/2018 about guns and gun control.  (1) What are your thoughts about having guns in your home? (2) Do you think gun control laws would affect mass shootings? Why? (3) Who, if anyone, should NOT be allowed to own guns? We found that about one-third of youth in our diverse sample were “against” guns in the home, and the remaining two-thirds were either “pro” or “conditionally pro” guns in the home, stating that gun ownership is acceptable under certain conditions, such as proper storage, or kept away from children. Youth in our sample largely believed that gun control laws could decrease mass shootings, but one-third felt that gun control laws would not be enough to impact mass shootings. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics, University of Pittsburgh / 05.07.2018 Interview with: Alison JCulyba, MD, PhD, MPH Assistant Professor of Pediatrics UPMC Children’s Hospital of Pittsburgh University of Pittsburgh School of Medicine What is the background for this study? What are the main findings? Response: Homicide is the third leading cause of death among adolescents, and disproportionately affects minority youth in under-resourced urban communities. Most research on youth violence focuses on risk factors, such as weapon carrying and substance abuse. We know much less about factors that protect youth from violence. Future orientation, defined as hopes and plans for the future, is linked to many important positive outcomes for youth, including doing well in school and avoiding illicit substances. However, there has been very little research to examine whether future orientation may also protect youth from violence. To study links between future orientation and violence perpetration, we surveyed over 850 male youth in lower resource neighborhoods in Pittsburgh as part of a community-based sexual violence prevention study. We found that youth with positive future orientation were significantly less likely to report threatening someone with a weapon or injuring someone with a weapon in the past nine months. (more…)
Accidents & Violence, Author Interviews, BMJ, Race/Ethnic Diversity / 08.05.2018 Interview with: “police” by istolethetv is licensed under CC BY 2.0Anthony L. Bui, MPH M.D. Candidate, David Geffen School of Medicine at UCLA Matthew M. Coates, MPH Associate, Harvard Medical School, Department of Global Health and Social Medicine Ellicott C. Matthay, MPH Ph.D. Candidate, Division of Epidemiology, University of California, Berkeley School of Public Health What is the background for this study? What are the main findings? Response: Protests after recent deaths from encounters with law enforcement, the Black Lives Matter movement, and activism over social media platforms have raised the profile of the problem of police violence. Several studies have suggested that the public health community has a duty to address these deaths as a public health problem. These studies have also pointed out that although there is a lack of officially reported statistics on police violence, other journalistic and crowd-sourced efforts such as “The Counted” from The Guardian,, U.S. Police Shootings Database,, and Mapping Police Violence have relatively complete documentation of deaths from police violence. To help frame the issue as a public health problem, we calculated years of life lost (YLLs) attributed to deaths from encounters with law enforcement. YLLs are, a metric that measures premature deaths, by age, gender, and race/ethnicity. To do this, we followed established methods, subtracting the age of each death from a corresponding standard life expectancy. For example, if an individual who died at age 25 had a life expectancy of 75, their YLL would be 50.  (more…)
Accidents & Violence, Addiction, Author Interviews, JAMA / 14.03.2018 Interview with: Dr. Laura Dwyer-Lindgren PhD Assistant Professor at IHME Institute for Health Metrics and Evaluation What is the background for this study? What are the main findings?  Response: This study in the latest in a series of studies IHME has conducted on health and disease on the county level in the United States. We analyzed data provided by the National Center for Health Statistics, the U.S. Census Bureau, and other sources. Main findings include:
  • Nearly 550,000 deaths were attributed to drug use over the 35 years. Nationally, the age-standardized death date increased 238% between 1980 and 2000, and 112% between 2000 and 2014. The death rate from drug use disorders increased in every county, but some counties in Kentucky, West Virginia, Ohio, Indiana, and eastern Oklahoma has increases exceeding 5000%.
  • There were more than a quarter million deaths in the U.S. due to alcohol use; Western counties generally has higher levels than those in other parts of area of the nation, with especially high death rates in Wisconsin, North Dakota, South Dakota, Nebraska, Montana, New Mexico, Arizona, Utah, and Alaska.
  • Neatly 1.3 million suicides were recorded, with especially high rates in Alaska, Nevada, South Dakota, Utah, New Mexico, Arizona, Montana, North Dakota, Oregon, Wyoming and one county in Maryland. While the national death rate due to suicide decreased between 1980 and 2014, there was an increase in the death rate due to suicide in most counties.
  • More than three quarters of a million deaths by homicide occurred in the US between 1980 and 2015. Nationally, the age-standardized death rate due to homicide decreased by about 35% between 1980 and 2000, and by nearly 16% between 2000 and 2014. Counties with the largest decreases were found in Virginia, Florida, Texas, California and New York. 
Accidents & Violence, Author Interviews / 06.11.2017 Interview with: Yi Zuo Lead Biostatistician Center for Clinical Translational Epidemiology and Comparative Effectiveness Research Preventive Medicine & Epidemiology Department of Medicine Boston University School of Medicine Boston, MA 02118 What is the background for this study? Response: Non-fatal firearm injuries constitute approximately 70% of all firearm trauma injuries in the United States. However, patterns of severity of those injuries are poorly understood. (more…)
Accidents & Violence, Author Interviews, JAMA / 20.10.2017 Interview with: Michael Siegel, MD, MPH Professor, Department of Community Health Sciences Boston University School of Public Health Boston, MA 02118 What is the background for this study? Response: A central question in the debate about public policies to reduce firearm violence is whether easier access to concealed handguns increases or decreases the rate of firearm-related homicides. Previous studies on the impact of concealed carry permitting laws have yielded inconsistent results. Most of these studies were conducted more than a decade ago. This study provided a reexamination of this research question with more recent data, up to and including the year 2015. While all states allow certain persons to carry concealed handguns, there are 3 major variations in permitting policy. In 9 states, law enforcement officials have wide discretion over whether to issue concealed carry permits; these are referred to as “may issue” states because police chiefs can deny a permit if they deem the applicant to be at risk of committing violence, even if there is not a criminal history. In 29 states, there is little or no discretion; these are referred to as “shall-issue” states because permits must be issued if requisite criteria are met. In an additional 12 states, no permit is necessary to carry a concealed handgun. (more…)
Accidents & Violence, Author Interviews, JAMA / 19.09.2017 Interview with: Professor Michael Siegel, MD, MPH Department of Community Health Sciences Boston University School of Public Health Boston, MA 02118 What is the background for this study? What are the main findings? Response: Each year, more than 1,800 people in the U.S. are killed by their intimate partners. Approximately half of these homicides are committed using firearms. While federal law prohibits people subject to domestic violence restraining orders from possessing firearms, there is no requirement that they surrender guns already in their possession. To close this loophole, several states have enacted laws that not only prohibit gun possession by people subject to restraining orders, but which also explicitly require that they relinquish weapons that they already have. If you are unclear as to the laws of your state, then you should contact a local law firm, such as this nyc lawyer, to discuss your current circumstances. In this study, we investigated the impact of state domestic violence-related firearm laws and rates of intimate partner homicide, using data from all 50 states over a 25-year period, 1991-2015. (more…)
Accidents & Violence, Author Interviews, CDC, Emory, Gender Differences, Race/Ethnic Diversity / 21.07.2017 Interview with: EmikoPetrosky MD M.P.H Science Officer, National Violent Death Reporting System at Centers for Disease Control and Prevention Centers for Disease Control and Prevention Emory University Rollins School of Public Health What is the background for this study? Response: Homicide is one of the leading causes of death for women aged 44 years and younger. In 2015, 3,519 girls and women died by homicide in the United States.  It is the 5th leading cause of death for women under 45 years age (defining women as 18-44 years of age). The National Violent Death Reporting System (NVDRS) links together data from death certificates, coroner/medical examiner reports, and law enforcement reports, resulting in more information about the circumstances of death than what is available elsewhere. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 09.05.2017 Interview with: Monika Goyal, M.D., M.S.C.E. Assistant Professor of Pediatrics & Emergency Medicine Director of Research, Division of Emergency Medicine and Attending Physician Children’s National Health System The George Washington University What is the background for this study? What are the main findings? Response: As pediatric emergency clinicians, unfortunately, many of us have cared for a number of children who have been victims of gun violence. We wanted to investigate whether gun laws may make a difference in the rates of firearm-related morbidity and mortality in children. We specifically were interested in emergency department visits because they relate directly to the care we provide to pediatric patients. Our main findings from our five-year study were that children are affected by gun violence nationally and, specifically, we saw regional differences in emergency department visits made by children who were victims of firearm violence. Overall, firearm-related visits by patients 21 and younger to emergency departments remained consistent over time at a rate of 65 per every 100,000 visits until 2013, when they decreased slightly to 51 per 100,000 visits. We also found that regions with more strict gun laws had lower rates of emergency department visits by children for gun violence compared with those regions with less stringent laws. We used the Brady Score, which looks at various state gun laws and assigns a score, to measure strictness. Then, based on state-level scores, we created regional composite scores. (more…)
Abuse and Neglect, Author Interviews, BMJ, Exercise - Fitness, Mental Health Research / 02.04.2017 Interview with: Tine Vertommen, Criminologist Faculty of Medicine and Health Sciences Universiteitsplein 1 Antwerp, Belgium What is the background for this study? What are the main findings? Response: A recent prevalence study into interpersonal violence against child athletes in the Netherlands and Belgium showed that 6% experienced severe sexual violence, 8% experienced severe physical violence, and 9% of respondents experienced severe psychological violence in sport (Vertommen et al., 2016). While general literature has repeatedly shown that exposure to interpersonal violence during childhood is associated with mental health problems in adulthood, this relationship has not yet been demonstrated in (former) athletes. Thus, the objective of the current study is to assess the long-term consequences of these experiences on adult mental health and quality of life. (more…)
Accidents & Violence, Annals Internal Medicine, Author Interviews / 01.02.2017 Interview with: Joan A. Reid, Ph.D., LMHC Assistant Professor Criminology Program DAV 266 University of South Florida St. Petersburg What is the background for this study? What are the main findings? Response: Firearm-associated homicide and suicide are leading causes of death among American youth (i.e., 10-24 years old), with disproportionately high rates observed among male youth of color. Notably, gun violence and psychological problems are often conflated in public discourse regarding gun violence and prevention. However, few studies have assessed the impact of exposure to violence, either as a witness or a victim, when exploring the association between gun-carrying behavior and psychological distress. (more…)
Accidents & Violence, Author Interviews, Pediatrics, University of Pennsylvania / 12.01.2017 Interview with: Daniel Romer, PhD Annenberg Public Policy Center University of Pennsylvania Philadelphia, Pennsylvania What is the background for this study? What are the main findings? Response: We have been studying trends in health compromising behaviors in popular films that were released since 1950, and in 2013 we reported that films rated PG-13 had just passed the rate of portrayed gun violence shown in popular R-rated films in 2012. In this report, we updated the trends in gun violence through 2015 and found that the trend has continued. In addition, we noted the strong contribution to this trend of films with comic book heroes whose heavy use of guns omits the harmful and otherwise realistic consequences of blood and suffering. (more…)
Accidents & Violence, Author Interviews, JAMA / 15.11.2016 Interview with: Ted Alcorn, MHS, MA Everytown for Gun Safety Brooklyn, New York What is the background for this study? Response: Two decades ago, opponents of gun violence prevention recognized that they could curb the development and enactment of effective laws if they halted scientific research on which good policy would be grounded or justified. So they adopted a strategy of intimidation towards the leading federal agencies funding research on this topic and generating data on which analysis relied. Journalists that observed the pattern and scientists that lived through it often described the “chilling effect” this had on the field of gun violence prevention research. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 15.11.2016 Interview with: Katherine P. Theall, PhD Associate Professor Global Community Health and Behavioral Services Tulane University School of Public Health and Tropical Medicine New Orleans, Louisiana What is the background for this study? What are the main findings? Response: There are stark health disparities in the U.S. by socioeconomic position as well as between racial and ethnic groups. Many of these health disparities may have a root cause in childhood and be driven by social risk factors. The authors report each neighborhood stressor was associated with biological stress as measured by shortened telomere length and cortisol functioning. Many children are exposed to violence and a greater understanding of the effect on children’s health is critical because social environmental conditions likely contribute to health disparities. Socioeconomically disadvantaged communities have a higher exposure to violence. Limitations of the study include its lack of applicability to other demographic groups. The study also cannot establish causality. (more…)
Addiction, Author Interviews, CDC, Pediatrics / 12.10.2016 Interview with: Steven A. Sumner, MD, MSc Centers for Disease Control and Prevention National Center for Injury Prevention and Control, Division of Violence Prevention Atlanta GA What is the background for this study? What are the main findings? Response: In 2014, CDC was invited to Wilmington, Delaware, to conduct a study because the city had been experiencing a high level of homicides and shootings. Our investigation looked at multiple risk factors for youth violence involvement across a wide variety of areas of young people’s lives. For example, youth who had previously experienced a gunshot wound injury were 11 times more likely to later commit a gun crime than youth who had not been similarly injured. Study investigators looked at histories of violence victimization, educational problems, unemployment histories, child welfare experiences, and prior criminal involvement. The more adverse life experiences a young person had, the more likely they were to commit firearm violence. (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 26.07.2016 Interview with: Ted Miller, PhD Senior Research Scientist II Pacific Institute for Research and Evaluation Calverton, Maryland What are the main findings? Response: Police use of undue force is an enduring tinderbox issue in America. We tried to solve it by passing the 14th Amendment after the civil war, thru the civil rights movement, the riots of the 1960s, the Rodney King riot. The discussion has focused on racial disparities in per capita rates of deaths, stops, and arrests. This article digs deeper. Its aims are to use health data sets to examine nonfatal injuries inflicted during police action and apply better denominators. Looking at nonfatal injuries is especially important as shootings with firearms or tasers account for virtually all deaths but few other injuries in police encounters. This study measures exposure as the sum of arrests plus traffic stops with search plus stops on the street. Those data come from FBI arrest reports, state arrest reports, and the 2011 Police-Public Contact Survey. Blacks have long had the highest per capita rates of stops and arrests. We believe this study is the first to assess the probability of being arrested when stopped. Those probabilities also are skewed, with police arresting 85% of Blacks and 82% of Hispanics who are stopped, well above the 71% of Whites and Native Americans and 61% of Asian-Americans. Arrest probabilities do not differ by sex or age group. The study used a newspaper census of deaths and took injury counts from the 2012 Health Care Cost and Utilization Program nationwide samples, counting people whose injuries resulted from “legal intervention.” In 2012, US police killed or injured an estimated 55, 400 people during stops and arrests. The daily toll was 3 deaths and 150 hospital-treated injuries. In 1 in 11 US homicides and legal intervention deaths, a police officer pulled the trigger. Surprisingly, the probability that a serious injury was fatal did not vary by race. Nor did the ratio of serious and fatal injuries to stops and arrests. Teenagers and to a lesser extent young adults were less likely than people age 30 and over to die or suffer a hospital-treated injury when stopped or arrested. (more…)
Accidents & Violence, Author Interviews, Karolinski Institute, Social Issues / 15.04.2016 Interview with: Zheng Chang, PhD Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Medical Research: What is the background for this study? What are the main findings? Dr. Chang: More than 30 million people are released from prison worldwide every year. Despite reported decreases in violence in many countries, repeat offending remains high across many high-income and middle-income countries. Because there is considerable inconsistency and inefficiency in identifying those who are at high risk of reoffending and most in need of interventions, we developed and validated a clinical prediction rule to determine this risk in released prisoners. We did a cohort study of 47 326 prisoners released in Sweden between 2001 and 2009. We developed a 14-item model to predict violent reoffending, which includes modifiable risk factors and has been externally validated. The model showed good measures of discrimination and calibration. The study uses the methods to develop the prediction model on the basis of TRIPOD guidelines, and it is a brief, easy to use, and scalable tool. This tool has also been translated into a freely available web application (OxRec). (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 08.03.2016 Interview with: Alison Culyba, MD MPH Adolescent Medicine Advanced Research Fellow Craig-Dalsimer Division of Adolescent Medicine Children’s Hospital of Philadelphia PhD Candidate, Epidemiology Department of Epidemiology and Biostatistics Perelman School of Medicine at the University of Pennsylvania What is the background for this study? What are the main findings? Dr. Culyba: Youth violence is a major public health problem. Homicide is the second leading cause of death among all adolescents in the U.S., and the number one cause of death among African American adolescents. Prom prior research, we know that where you live and where you spend time has a major impact on health, and that making changes to environments, such as greening vacant lots and remediating abandoned buildings, can significantly reduce crime. However, much less is known about the relationship between adolescent’s immediate surroundings and the risk of homicide. The goal of this study was to examine associations between neighborhood environmental features, such as streets, buildings, and natural surroundings and adolescent homicide. We conducted a population-based case control study of 143 adolescents, ages 13 to 20, who were victims of homicides in Philadelphia and 155 matched controls in the same range, who were outdoors in Philadelphia at the same time that the homicides occurred. To assess features in the immediate environments of homicide victims and control individuals, trained field staff stood on the street corner of each homicide and control location and took a series of photographs that we stitched together into 360-degree high resolution panoramas, which we assessed for environmental features. After accounting for many individual and neighborhood contextual factors, we found that the odds of homicide was significantly lower in locations with street lighting, pedestrian infrastructure, public transportation, parks, and maintained vacant lots. (more…)
Accidents & Violence, Author Interviews / 03.02.2016 Interview with: Erin Grinshteyn, PhD Assistant Professor University of Nevada-Reno School of Community Health Science Medical Research: What is the background for this study? What are the main findings? Dr. Grinshteyn: Gun deaths are a serious public health issue in the United States. This paper compared the US to 22 other high-income nations, and found that Americans are ten times more likely to be killed by a gun than their counterparts in the developed world. Gun homicide rates are 25 times higher in the U.S. and, while the overall suicide rate is on par with other high-income nations, the U.S. gun suicide rate is eight times higher. Ninety percent of women, 91% of all children aged 0 to 14 years, and 92% of youth aged 15 to 24 years who were killed by firearms were in the United States. (more…)
Accidents & Violence, Author Interviews, Mental Health Research, PLoS / 17.11.2015 Interview with: Simone Ullrich, PhD Senior Lecturer in Forensic Mental Health Violence Prevention Research Unit Queen Mary University of London Medical Research: What is the background for this study? What are the main findings? Dr. Ullrich: There are currently thought to be more than three hundred risk assessment instruments used by professionals such as psychiatrists, psychologists, and probation officers to assess the risks of violence and sexual offending among psychiatric patients, prisoners, and the general population. In some mental health services the hospital does not get paid unless staff have carried out a risk assessment on their patients. Producing risk assessment instruments has become an ‘industry’ and new instruments are being produced annually, on every form of violence and criminal activity. The Queen Mary research group believe that none of these instruments have any advantage over those produced before. Furthermore, their best predictions for future violence get 30% wrong. Professor Coid and colleagues believe that no further progress can be made because researchers have been too obsessed with predicting the future of whether a patient will be violent rather than looking for the causes of why they become violent. All previous studies have used special statistical techniques which are designed to measure predictive accuracy. The Queen Mary research group say there is nothing wrong with being accurate or measuring accuracy, but there is no point in trying to develop new instruments which can never improve on getting it right more than 70% of the time. It may be helpful to know that your patient has a high or low risk of being violent if you release them from hospital, but this is not going to tell you what you should do to stop them being violent. Furthermore, if the risk assessment says that their risk is high then it is likely that you will not release them. The problem is that professionals will always play safe and, although there is a good chance (around 30%) that they are totally wrong, the patient will not be released. This is probably one of the most important reasons why patients are staying longer and longer in secure mental health services. These instruments achieve little more than making healthcare professionals risk averse. The National Institute for Health Research (NIHR) funded a study where 409 male and female patients who were discharged from medium secure services in England and Wales were followed up after release into the community. They received assessments with two ‘state of the art’ assessment instruments, the HCR-20 which aims to guide clinicians in their assessment of violence, and the SAPROF, another instrument aimed to guide clinicians on which factors protect patients from becoming violent. Both instruments were developed on the basis of predictive statistics. Measures were taken with these instruments prior to release into the community, then after 6 and 12 months following discharge. Information on violence was gathered via individual case notes and a search of the police national computer. By 6 months following discharge, 54 (14%) had committed a violent act, between 6 and 12 months 43 (13%) had been violent. The authors used two methods to investigate the associations between these risk/ protective factors and violence. They first tested the standard approach of risk assessment for the factors that occurred in the past 6 months which were then used to statistically predict violence in the following 6 months (predictive model). They then used a second approach which looked at the co-occurrence of the risk/ protective factors and violence within the same 6 month time window (causal model). Using the traditional approach and looking at accuracy, the predictive model produced statistical coefficients of low size, suggesting that the risk and protective factors were poor in identifying who would be violent and who would not. Because many associations between the factors and violence were weak, few appeared useful in identifying those which should be targeted to manage future violence. Surprisingly, symptoms of major mental disorder did not show an association with violence, even though most of the patients in the study suffered from major mental disorder. It might have been expected that some patients would relapse, with more symptoms, leading to violence. When the researchers used a causal approach aiming to confirm which risk and protective factors resulted in violence, the findings were very different. Symptoms of major mental disorder, the patients’ living condition, and whether they were taking medication were highly important factors. Secondly, the effects of risk and protective factors on violence were much bigger using the causal approach. For example, the effects of violent thoughts and ruminations, being in an unstable life situation, were about 3 times stronger using the causal model. The effects of being under stress and unable to cope were more than 4 times stronger than using the traditional predictive approach. They concluded that the causal approach was much better in identifying the key factors that need to be considered in the assessment and management of violence. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Race/Ethnic Diversity / 04.11.2015

Bindu Kalesan PhD MPH Director Evan’s Center for Translational Epidemiology and Comparative Effectiveness Research Assistant Professor of Medicine Preventive Medicine & Epidemiology Department of Medicine Boston University School of Medicine Boston, MA Interview with: Bindu Kalesan PhD MPH Director Evan’s Center for Translational Epidemiology and Comparative Effectiveness Research Assistant Professor of Medicine Preventive Medicine & Epidemiology Department of Medicine Boston University School of Medicine Boston, MA 02118  Medical Research: What is the background for this study? What are the main findings? Dr. Kalesan: Firearm injuries are one of the 3 major causes of death in children in the US. for every 7 pediatric firearm deaths there are 8 children non-fatally injured by a gun. Those that survive will live with disability and severe morbidity. From our earlier studies, we found that this burden of survivorship and injury is different according to race/ethnicity. There is also evidence that Injury related hospitalizations are also associated low-income households and neighborhoods. In the background of gun (violence) control, frequently comparisons are drawn between firearm injuries and motor vehicle accidents. In this study we use nationally representative hospitalization data and compared pediatric firearm-related hospitalization and pedestrian motor vehicle accident hospitalizations to assess whether the risk of firearm related hospitalizations among minorities varies depending on the neighborhood they live. We found that black children were at substantially greater risk of firearm hospitalization as compared to pedestrian motor vehicle hospitalization. This greater risk of firearm hospitalization among black children persisted across neighborhoods. Simply put, the risk of firearm hospitalization versus pedestrian motor vehicle hospitalization among black children was high, regardless of whether they lived in low income or high income neighborhoods.We also found that all minority race children (black, Hispanic and other race) as compared to white children were at a greater likelihood of homicide-firearm hospitalization than of pedestrian motor vehicle hospitalization and all minority race children were significantly less likely to be hospitalized for unintentional firearm than pedestrian injuries in comparison to white children. Therefore, overall we found a minority race disadvantage regardless of whether they lived in high and low-income neighborhoods. (more…)