Lethal use of force surveillance: practical considerations for open-source database linkage

Currently, there remains no reliable and timely government tracking in the USA of deaths caused by law enforcement. Federal efforts to track these events are insufficient, generally missing as many as half of community deaths that occur annually because of law enforcement's lethal use of force. The dearth of accurate data on these events limits the ability to accurately quantify their burden and effectively identify opportunities for intervention and policy change. The most reliable data sources on law enforcement related deaths among community members in the USA are publicly run (such as those run by the Washington Post and The Guardian newspapers) or crowdsourced systems, such as Fatal Encounters and Mapping Police Violence, which draw on both traditional and non-traditional sources of reporting and provide open-source access to users. We used successive deterministic and probabilistic linkage to merge these four databases. After exclusions, we found a total of 6333 deaths identified from 2013 to 2017. While most cases were identified by multiple databases, each database also found unique cases during their years of operation. The methodology described here emphasises the importance of these non-traditional data sources and can serve as a helpful resource to improve data accessibility and timeliness for public health agencies and others seeking to expand their study, understanding and response to this growing public health crisis.

Trends in the Use of Face Coverings in Publicly Accessible Spaces During the COVID-19 Pandemic, King County, Washington, November 2020-May 2021

OBJECTIVES

Appropriate face covering use at public venues can help mitigate the transmission of SARS-CoV-2 in the absence of widespread vaccination and provide protection when viral variants become more infectious. The objective of this study was to evaluate compliance with a statewide face mask mandate by examining trends in face covering use in publicly accessible spaces in King County, Washington.

METHODS

From November 27, 2020, through May 11, 2021, we conducted a repeated cross-sectional observational study of face covering use across publicly accessible venues (eg, grocery and convenience stores, airport, transit center, post office). Trained observers recorded perceived sex, estimated age group, and face covering use. We calculated estimates of overall face covering use and prevalence ratios (PRs) with 95% CIs.

RESULTS

We observed 9865 people in 53 unique venues during 229 observation intervals during 6 observation periods. Correct face covering use was 87.2% overall and lowest at semi-outdoor venues such as transit hubs (78.1%) and the pick-up curb of Seattle-Tacoma International Airport (69.0%). Correct face covering use was lowest among men (PR = 1.42; 95% CI, 1.27-1.58) and among people aged 2-11 years (PR = 2.74; 95% CI, 2.37-3.17) and 12-17 years (PR = 1.36; 95% CI, 1.07-1.72). Compliance declined among adults aged ≥60 years and among younger age groups before vaccine eligibility.

CONCLUSIONS

Overall compliance with the statewide face mask mandate in King County was high. Layered mitigation strategies, including but not limited to the use of face coverings, and methods to assess adherence to them are crucial to preventing SARS-CoV-2 transmission.

The adverse effects of policing on population health: A conceptual model

While negative encounters between police and the community are not a new trend, recent high profile deaths of unarmed people of color have gained widespread national attention and ignited new movements demanding reform, accountability, and progress. Increasingly over the past few decades, researchers have examined the most extreme cases of lethal use of force, describing the context of these violent encounters, situational and personal characteristics, and underlying risk factors. More recent research has aimed to define the broader and more nuanced adverse effects that policing can have on population health. We propose a holistic and multidisciplinary model for the relationship between policing and population health in the U.S. that incorporates contextual, situational, and individual-level factors while also recognizing the direct and vicarious mechanisms by which policing exposures can negatively affect population health. The model captures the short and long term health effects of policing and the cyclic nature by which those effects at the individual, community, and systemic levels can influence each other. We consider the unique qualities of different communities that may influence these pathways, the historical trends of the criminal justice and policing systems, and recommend applications of the model in policing agencies, medicine, and research.

Field-based evaluation of malaria outbreak detection and response in Mudzi and Goromonzi districts, Zimbabwe - 2017

National-level evaluations may fail to identify capacity improvements for detecting and responding to outbreaks which begin and are first detected at the local level. In response to this issue, we conducted a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe. We visited eleven clinics in Mudzi and Goromonzi districts. Twenty-one interviews were conducted with key informants from the provincial (n = 2), district (n = 7), and clinic (n = 12) levels. Interviews focused on surveillance system activities, preparedness, data quality, timeliness, stability, and usefulness. Main themes were captured utilising standard qualitative data analysis techniques. While the surveillance system detects malaria outbreaks at all levels, we identified several gaps. Clinics experience barriers to timely and reliable reporting of outbreaks to the district level and staff cross-training. Stability of resources, including transportation (33% of informants, n = 7) and staff capacity (48% of informants, n = 10), presented barriers. Strengthening these surveillance barriers may improve staff readiness to detect malaria outbreaks, resulting in timelier outbreak response and a reduction in malaria outbreaks, cases, and deaths. By focusing at the local level, our assessment approach provides a framework for identifying and addressing gaps that may be overlooked when utilising tools that evaluate surveillance capacity at the national level.

An Academic-Practice Partnership at the University of Washington School of Public Health: The Student Epidemic Action Leaders (SEAL) Team

In 2015, the University of Washington School of Public Health, Department of Epidemiology established the Student Epidemic Action Leaders (SEAL) team to provide public health students with experience in field epidemiology in state and local public health communicable disease divisions. The University of Washington Department of Epidemiology developed the SEAL team in collaboration with the Washington State Department of Health to offer public health graduate students opportunities to contribute to the real-time needs of public health agencies during a communicable disease event and/or preparedness event. The SEAL team combines classroom and field-based training in public health practice and applied epidemiology. During the first 2 years of the SEAL team (2016-2018), 34 SEALs were placed at 4 agencies contributing more than 1300 hours of assistance on 24 public health projects.

Norovirus outbreak associated with a natural lake used for recreation - Oregon, 2014

In July 2014, Multnomah County public health officials investigated a norovirus outbreak among persons visiting Blue Lake Regional Park in Oregon. During the weekend of the reported illnesses (Friday, July 11-Sunday, July 13) approximately 15,400 persons visited the park. The investigation identified 65 probable and five laboratory-confirmed cases of norovirus infection (70 total cases). No hospitalizations or deaths were reported. Analyses from a retrospective cohort study revealed that swimming at Blue Lake during July 12-13 was significantly associated with illness during July 13-14 (adjusted relative risk = 2.3; 95% confidence interval [CI] = 1.1-64.9). Persons who swam were more than twice as likely to become ill compared with those who did not swim in the lake. To control the outbreak, Blue Lake was closed for 10 days to prevent further illness. This investigation underscores the need for guidance for determining when to reopen untreated recreational water venues (e.g., lakes) associated with outbreaks, and communication tools to inform the public about the risks associated with swimming in untreated recreational water venues and measures that can prevent illness.

Home renovation, family history of atopy, and respiratory symptoms and asthma among children living in China

OBJECTIVES

To investigate the association of indoor air pollution with the respiratory health of children, we evaluated the associations of children's respiratory symptoms with asthma and recent home renovation.

METHODS

We conducted a cross-sectional survey in a school recruitment sample of 31,049 children aged 2 to 14 years in 25 districts of 7 cities of northeast China in 2008-2009. The children's parents completed standardized questionnaires characterizing the children's histories of respiratory symptoms and illness, recent home renovation information, and other associated risk factors.

RESULTS

The effects of home renovation in the past 2 years were significantly associated with cough, phlegm, current wheeze, doctor-diagnosed asthma, and current asthma. The associations we computed when combining the status of home renovation and family history of atopy were higher than were those predicted from the combination of the separate effects. However, the interactions between home renovation and family history of atopy on a multiplicative scale were not statistically significant (P>.05).

CONCLUSIONS

Home renovation is associated with increases in the prevalence of respiratory symptoms and asthma in children. The effects of different renovation materials on child respiratory health should be studied further.

Obesity enhanced respiratory health effects of ambient air pollution in Chinese children: the Seven Northeastern Cities study

OBJECTIVE

Experimental data suggest that obesity enhances the effects of ambient air pollutants on exacerbation of asthma; however, there is little supporting epidemiological evidence. The aim of present study is to evaluate whether obesity modifies the association between ambient air pollution and respiratory symptoms and asthma in children.

METHODS

In Northeast China, 30 056 children aged 2-14 years were selected from 25 districts of seven cities. Parents of the children completed questionnaires that characterized the children's histories of respiratory symptoms and illness, and associated risk factors. Overweight and obesity were calculated with an age and sex-specific body mass index (BMI, kg m(-2)), with BMIs of greater than the 85th and 95th percentiles defining overweight and obesity, respectively. Average annual ambient exposure to particulate matter with an aerodynamic diameter 10 μm (PM(10)), sulfur dioxide (SO(2)), nitrogen dioxides (NO(2)) and ozone (O(3)) was estimated from data collected at monitoring stations in each of the 25 study districts.

RESULTS

We observed consistent and significant interactions between exposure and obesity on respiratory symptoms and asthma. The associations between each pollutant's yearly concentrations and respiratory symptoms and asthma were consistently larger for overweight/obese children than for normal-weight children, with odds ratios (ORs) ranging from 1.17 per 31 μg m(-3) for PM(10) on wheeze (95% confidence interval (CI): 1.01, 1.36) to 1.50 per 10 μg m(-3) for NO(2) on phlegm (95% CI: 1.21, 1.87) and cough (95% CI: 1.24, 1.81).

CONCLUSION

These results showed that overweight/obesity enhanced respiratory health effects of air pollution in the study children.