1
|
Williams J, Royer J, Lauer E, Kurth NK, Horner-Johnson W, McDermott S, Levy A, Hall JP. Injury-related emergency department use among people with intellectual and developmental disabilities insured by Medicaid from 2010 to 2016. Inj Prev 2024; 30:138-144. [PMID: 37945329 DOI: 10.1136/ip-2023-045043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/08/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Data on non-fatal injuries and visits to the emergency department (ED) for injuries are not readily available. The objective of this paper is to describe injury-related ED visits for people with intellectual and developmental disabilities who are covered by the Medicaid insurance programme. METHODS We aggregated 2010-2016 Medicaid claims data from eight states. Using these data, we identified individuals with intellectual and developmental disabilities and then determined an all-cause ED visit rate, ED visit due to injury rate and admission from ED due to injury rate. Data were stratified by sex and age group. Results were compared with national rates. RESULTS Medicaid members with intellectual and developmental disabilities visited EDs at approximately 1.8 times the rate of the general population. The ED visit rate due to injury was approximately 1.5 times that observed in the population overall. When ED visits due to injury data were stratified by age and sex, the largest discrepancy was observed in women ages 45-64, who visited EDs due to injury at a rate 2.1 times that of women of the same age in the general population. The admission rate from ED due to injury increased over the study period most notably in the older age groups. CONCLUSIONS While rates and patterns of ED utilisation among Medicaid members with intellectual and developmental disabilities vary by age and gender, our findings suggest this group visits the ED due to injury at rates well above the general population.
Collapse
Affiliation(s)
- Jessica Williams
- Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Julie Royer
- Health and Demographics Division, South Carolina Revenue and Fiscal Affairs, Columbia, South Carolina, USA
| | - Emily Lauer
- Department of Family Medicine & Community Health, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Noelle K Kurth
- Institute for Health and Disability Policy Studies, University of Kansas College of Liberal Arts and Sciences, Lawrence, Kansas, USA
| | - Willi Horner-Johnson
- Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon, USA
| | - Suzanne McDermott
- Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health & Health Policy, New York, New York, USA
| | - Anna Levy
- Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon, USA
| | - Jean P Hall
- Research and Training Center on Independent Living and the Institute for Health and Disability Policy Studies, University of Kansas College of Liberal Arts and Sciences, Lawrence, Kansas, USA
| |
Collapse
|
2
|
Martin CL, Richardson D, Richey M, Nocera M, Cantrell J, McClure ES, Martin AT, Marshall SW, Ranapurwala S. Twenty-five year occupational homicide mortality trends in North Carolina: 1992-2017. Inj Prev 2024:ip-2023-044991. [PMID: 38355295 DOI: 10.1136/ip-2023-044991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 12/02/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Determining industry of decedents and victim-perpetrator relationships is crucial to inform and evaluate occupational homicide prevention strategies. In this study, we examine occupational homicide rates in North Carolina (NC) by victim characteristics, industry and victim-perpetrator relationship from 1992 to 2017. METHODS Occupational homicides were identified from records of the NC Office of the Chief Medical Examiner system and the NC death certificates. Sex, age, race, ethnicity, class of worker, manner of death, victim-perpetrator relationship and industry were abstracted. Crude and age-standardised homicide rates were calculated as the number of homicides that occurred at work divided by an estimate of worker-years (w-y). Rate ratios and 95% CIs were calculated, and trends over calendar time in occupational homicide rates were examined overall and by industry. RESULTS 456 homicides over 111 573 049 w-y were observed. Occupational homicide rates decreased from 0.82 per 100 000 w-y for the period 1992-1995 to 0.21 per 100 000 w-y for the period 2011-2015, but increased to 0.32 per 100 000 w-y in the period 2016-2017. Fifty-five per cent (252) of homicides were perpetrated by strangers. Taxi drivers experienced an occupational homicide rate that was 110 times (95% CI 76.52 to 160.19) the overall occupational homicide rate in NC; however, this rate declined by 76.5% between 1992 and 2017. Disparities were observed among workers 65+ years old, racially and ethnically minoritised workers and self-employed workers. CONCLUSION Our findings identify industries and worker demographics that experienced high occupational homicide fatality rates. Targeted and tailored mitigation strategies among vulnerable industries and workers are recommended.
Collapse
Affiliation(s)
- Chelsea L Martin
- Department of Epidemiology, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David Richardson
- Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, California, USA
| | - Morgan Richey
- National Foundation for the Centers for Disease Control and Prevention Inc, Atlanta, Georgia, USA
| | - Maryalice Nocera
- University of North Carolina Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - John Cantrell
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth S McClure
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amelia T Martin
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephen W Marshall
- Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - Shabbar Ranapurwala
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
3
|
Davies M, Lawrence T, Edwards A, McKay C, Lecky FE, Stokes KA, Williams S. Sport-related major trauma incidence in young people and adults in England and Wales: a national registry-based study. Inj Prev 2024; 30:60-67. [PMID: 37875378 PMCID: PMC10850652 DOI: 10.1136/ip-2023-044887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/24/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES Data on sport and physical activity (PA) injury risk can guide intervention and prevention efforts. However, there are limited national-level data, and no estimates for England or Wales. This study sought to estimate sport and PA-related major trauma incidence in England and Wales. METHODS Nationwide, hospital registry-based cohort study between January 2012 and December 2017. Following Trauma Audit and Research Network Registry Research Committee approval, data were extracted in April 2018 for people ≥16 years of age, admitted following sport or PA-related injury in England and Wales. The population-based Active Lives Survey was used to estimate national sport and PA participation (ie, running, cycling, fitness activities). The cumulative injury incidence rate was estimated for each activity. Injury severity was described by Injury Severity Score (ISS) >15. RESULTS 11 702 trauma incidents occurred (mean age 41.2±16.2 years, 59.0% male), with an ISS >15 for 28.0% of cases, and 1.3% were fatal. The overall annual injury incidence rate was 5.40 injuries per 100 000 participants. The incidence rate was higher in men (6.44 per 100 000) than women (3.34 per 100 000), and for sporting activities (9.88 per 100 000) than cycling (2.81 per 100 000), fitness (0.21 per 100 000) or walking (0.03 per 100 000). The highest annual incidence rate activities were motorsports (532.31 per 100 000), equestrian (235.28 per 100 000) and gliding (190.81 per 100 000). CONCLUSION Injury incidence was higher in motorsports, equestrian activity and gliding. Targeted prevention in high-risk activities may reduce admissions and their associated burden, facilitating safer sport and PA participation.
Collapse
Affiliation(s)
- Madeleine Davies
- Institute of Sport, Exercise and Health, UCL, London, UK
- Department for Health, University of Bath, Bath, UK
| | - Tom Lawrence
- National Institute for Health and Care Excellence, London, UK
- Division of Population Health, Trauma Audit and Research Network, The University of Manchester, Manchester, UK
| | - Antoinette Edwards
- Division of Population Health, Trauma Audit and Research Network, The University of Manchester, Manchester, UK
| | - Carly McKay
- Department for Health, University of Bath, Bath, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Fiona E Lecky
- Division of Population Health, Trauma Audit and Research Network, The University of Manchester, Manchester, UK
- Centre for Urgent and Emergency Care Research, University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK
- Rugby Football Union, London, UK
| | | |
Collapse
|
4
|
Derrett S, Owen HE, Barson D, Maclennan B, Samaranayaka A, Harcombe H, Wyeth EH. New Zealand's Prospective Outcomes of Injury Study-10 years on (POIS-10): descriptive outcomes to 12 years post-injury. Inj Prev 2024:ip-2023-045058. [PMID: 38195656 DOI: 10.1136/ip-2023-045058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND The 'Prospective Outcomes of Injury Study-10 years on' (POIS-10) aims to contribute to improving long-term disability, health and well-being outcomes for injured New Zealanders. This brief report describes recruitment, characteristics and key outcomes to 12 years post-injury. METHODS Between 2007 and 2009, the study recruited 2856 people, including 566 Māori, from New Zealand's Accident Compensation Corporation's entitlement claims register. People experienced a range of injury types, causes and settings; 25% had been hospitalised for their injury. POIS-10 data were primarily collected via interviewer-administered structured questionnaires. RESULTS Of the original participants, 2068 (92%) were eligible for follow-up in POIS-10. Of these, 1543 (75%) people participated between March 2020 and July 2021, including 240 Māori. Half of the participants (n=757; 50%) reported ongoing problems attributed to their injury 12 years earlier. Most reported difficulties with items assessing disability (WHO Disability Assessment Schedule II). For health-related quality of life (HRQoL), measured using the EQ-5D-5L, the prevalence of problems was higher 12 years post-injury compared with 12 months post-injury for four of five dimensions. Importantly, the prevalence of problems did not reduce to pre-injury levels for any HRQoL dimension. DISCUSSION POIS-10 highlights the importance of early post-injury interventions to improve health, disability and well-being outcomes of injured New Zealanders.
Collapse
Affiliation(s)
- Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | - Helen E Owen
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | - David Barson
- Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Brett Maclennan
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| | | | - Helen Harcombe
- Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Otago, New Zealand
| |
Collapse
|
5
|
Austin AE, Naumann RB, DiPrete BL, Geary S, Proescholdbell SK, Jones-Vessey K. Pregnancy-associated homicide, suicide and unintentional opioid-involved overdose deaths, North Carolina 2018-2019. Inj Prev 2024:ip-2023-045112. [PMID: 38195655 DOI: 10.1136/ip-2023-045112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Rates of death due to homicide, suicide and overdose during pregnancy and the first year postpartum have increased substantially in the USA in recent years. The aims of this study were to use 2018-2019 data on deaths identified for review by the North Carolina Maternal Mortality Review Committee (NC-MMRC), data from the North Carolina Violent Death Reporting System (NC-VDRS) and data from the Statewide Unintentional Drug Overdose Reporting System (NC-SUDORS) to examine homicide, suicide and unintentional opioid-involved overdose deaths during pregnancy and the first year postpartum. METHODS We linked data from the 2018-2019 NC-MMRC to suicide and homicide deaths among women ages 10-50 years from the 2018-2019 NC-VDRS and to unintentional opioid-involved overdose deaths among women ages 10-50 years from the 2018-2019 NC-SUDORS. We conducted descriptive analyses to examine the prevalence of demographic characteristics and the circumstances surrounding each cause of death. RESULTS From 2018 to 2019 in North Carolina, there were 23 homicides, nine suicides and 36 unintentional opioid-involved overdose deaths (9.7, 3.8 and 15.1 per 100 000 live births, respectively) during pregnancy and the first year postpartum. Most homicide deaths (87.0%) were by firearm, and more than half (52.5%) were related to intimate partner violence. More than two-thirds of women who died by suicide had a current mental health problem (77.8%). Less than one-fourth (22.2%) of those who died by unintentional opioid-involved overdose had a known history of substance use disorder treatment. CONCLUSION Our approach to quantifying and describing these causes of pregnancy-associated death can serve as a framework for other states to inform data-driven prevention.
Collapse
Affiliation(s)
- Anna E Austin
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebecca B Naumann
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Bethany L DiPrete
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shana Geary
- Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, North Carolina, USA
| | - Scott K Proescholdbell
- Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, North Carolina, USA
| | - Kathleen Jones-Vessey
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| |
Collapse
|
6
|
Omaki E, Shields W, Rouhizadeh M, Delgado-Barroso P, Stefanos R, Gielen A. Understanding the circumstances of paediatric fall injuries: a machine learning analysis of NEISS narratives. Inj Prev 2023; 29:384-388. [PMID: 37399309 PMCID: PMC10528494 DOI: 10.1136/ip-2023-044858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/09/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES Falls are the leading cause of non-fatal injury among young children. The aim of this study was to identify and quantify the circumstances contributing to medically attended paediatric fall injuries among 0-4 years old. METHODS Cross-sectional data for falls among kids under 5 years recorded between 2012 and 2016 in the National Electronic Injury Surveillance System was obtained. A sample of 4546 narratives was manually coded for: (1) where the child fell from; (2) what the child fell onto; (3) the activities preceding the fall and (4) how the fall occurred. A natural language processing model was developed and subsequently applied to the remaining uncoded data to yield a set of 91 325 cases coded for what the child fell from, fell onto, the activities preceding the fall, and how the fall occurred. Data were descriptively tabulated by age and disposition. RESULTS Children most often fell from the bed accounting for one-third (33%) of fall injuries in infants, 13% in toddlers and 12% in preschoolers. Children were more likely to be hospitalised if they fell from another person (7.4% vs 2.6% for all other sources; p<0.01). After adjusting for age, the odds of a child being hospitalised following a fall from another person were 2.1 times higher than falling from other surfaces (95% CI 1.6 to 2.7). CONCLUSIONS The prevalence of injuries due to falling off the bed, and the elevated risk of serious injury from falling from another person highlights the need for more robust and effective communication to caregivers on fall injury prevention.
Collapse
Affiliation(s)
- Elise Omaki
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wendy Shields
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Masoud Rouhizadeh
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | | | - Ruth Stefanos
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrea Gielen
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
7
|
Wan R, Xia J, Duan F, Min L, Liu T. Global burden and trends of transport injuries from 1990 to 2019: an observational trend study. Inj Prev 2023; 29:418-424. [PMID: 37549986 PMCID: PMC10579470 DOI: 10.1136/ip-2023-044915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Transport injuries (TIs) are a major cause of global disability-adjusted life-years (DALYs) and mortality. In this study, we aimed to assess the global burden and trends of TIs from 1990 to 2019. METHODS We assessed the annual age-standardised incidence rate (ASIR) and age-standardised DALYs rate of TIs by sex, age, Social Development Index (SDI) and geographical region from 1990 to 2019 from the Global Burden of Disease Study 2019. The changing trends were described by estimated annual percentage changes (EAPCs). RESULTS Globally, in 2019, the ASIR and age-standardised DALYs rates of TIs were 134 6.06/100 000 (95% UI 11 42.6/100 000-157 5.57/100 000) and 97 7.91/100 000 (86 8.91/100 000-107 6.81/100 000), respectively. From 1990 to 2019, the global ASIR of TIs presented significant upwards trends with the EAPC (0.25%, 95% CI 0.19% to 0.31%), and it was significantly increased in the age groups of 15-49 (0.37%, 95% CI 0.29% to 0.45%), 50-69 (0.40%, 95% CI 0.36% to 0.44%) and 70+ (0.22%, 95% CI 0.17% to 0.28%). Prominent increases in ASIR were detected in middle-SDI areas (0.72%, 95% CI 0.57% to 0.87%), low-middle SDI areas (0.66%, 95% CI 0.59% to 0.72%) and low-SDI areas (0.21%, 95% CI 0.17% to 0.26%). The global age-standardised DALYs rate presented downwards trends with the EAPC (-1.27%, 95% CI -1.35% to -1.2%), and it was significantly decreased in all age groups and SDI areas. CONCLUSION Globally, TIs still cause a serious burden, and the incidence has significantly increased, especially in people above the age of 14 and in middle-SDI and low-SDI areas, thus necessitating more attention and health interventions.
Collapse
Affiliation(s)
- Rui Wan
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jun Xia
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fangfang Duan
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li Min
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Tan Liu
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| |
Collapse
|
8
|
Uzzi M, Aune KT, Marineau L, Jones FK, Dean LT, Jackson JW, Latkin CA. An intersectional analysis of historical and contemporary structural racism on non-fatal shootings in Baltimore, Maryland. Inj Prev 2023; 29:85-90. [PMID: 36301795 PMCID: PMC9877125 DOI: 10.1136/ip-2022-044700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/05/2022] [Indexed: 02/03/2023]
Abstract
Introduction Non-fatal shooting rates vary tremendously within cities in the USA. Factors related to structural racism (both historical and contemporary) could help explain differences in non-fatal shooting rates at the neighbourhood level. Most research assessing the relationship between structural racism and firearm violence only includes one dimension of structural racism. Our study uses an intersectional approach to examine how the interaction of two forms of structural racism is associated with spatial non-fatal shooting disparities in Baltimore, Maryland. Methods We present three additive interaction measures to describe the relationship between historical redlining and contemporary racialized economic segregation on neighbourhood-level non-fatal shootings. Results Our findings revealed that sustained disadvantage census tracts (tracts that experience contemporary socioeconomic disadvantage and were historically redlined) have the highest burden of non-fatal shootings. Sustained disadvantage tracts had on average 24 more non-fatal shootings a year per 10 000 residents compared with similarly populated sustained advantage tracts (tracts that experience contemporary socioeconomic advantage and were not historically redlined). Moreover, we found that between 2015 and 2019, the interaction between redlining and racialized economic segregation explained over one-third of non-fatal shootings (approximately 650 shootings) in sustained disadvantage tracts. Conclusion These findings suggest that the intersection of historical and contemporary structural racism is a fundamental cause of firearm violence inequities in Baltimore. Intersectionality can advance injury prevention research and practice by (1) serving as an analytical tool to expose inequities in injury-related outcomes and (2) informing the development and implementation of injury prevention interventions and policies that prioritise health equity and racial justice.
Collapse
Affiliation(s)
- Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Gun Violence Solutions, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kyle T Aune
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lea Marineau
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Forrest K Jones
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - John W Jackson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
9
|
Geller AI, Ehlman DC, Lovegrove MC, Budnitz DS. National estimates of emergency department visits for medication-related self-harm: United States, 2016-2019. Inj Prev 2022; 28:545-552. [PMID: 35922136 PMCID: PMC10249045 DOI: 10.1136/ip-2022-044620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Medication poisoning is a common form of self-harm injury, and increases in injuries due to self-harm, including suicide attempts, have been reported over the last two decades. METHODS Cross-sectional (2016-2019) data from 60 emergency departments (EDs) participating in an active, nationally representative public health surveillance system were analysed and US national estimates of ED visits for medication-related self-harm injuries were calculated. RESULTS Based on 18 074 surveillance cases, there were an estimated 269 198 (95% CI 222 059 to 316 337) ED visits for medication-related self-harm injuries annually in 2016-2019 compared with 1 404 090 visits annually from therapeutic use of medications. Population rates of medication-related self-harm ED visits were highest among persons aged 11-19 years (58.5 (95% CI 45.0 to 72.0) per 10 000) and lowest among those aged ≥65 years (6.6 (95% CI 4.4 to 8.8) per 10 000). Among persons aged 11-19 years, the ED visit rate for females was four times that for males (95.4 (95% CI 74.2 to 116.7) vs 23.0 (95% CI 16.4 to 29.6) per 10 000). Medical or psychiatric admission was required for three-quarters (75.1%; 95% CI 70.0% to 80.2%) of visits. Concurrent use of alcohol or illicit substances was documented in 40.2% (95% CI 36.8% to 43.7%) of visits, and multiple medication products were implicated in 38.6% (95% CI 36.8% to 40.4%). The most frequently implicated medication categories varied by patient age. CONCLUSIONS Medication-related self-harm injuries are an important contributor to the overall burden of ED visits and hospitalisations for medication-related harm, with the highest rates among adolescent and young adult females. These findings support continued prevention efforts targeting patients at risk of self-harm.
Collapse
Affiliation(s)
- Andrew I Geller
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- US Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Daniel C Ehlman
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maribeth C Lovegrove
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel S Budnitz
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- US Public Health Service Commissioned Corps, Rockville, Maryland, USA
| |
Collapse
|
10
|
Pear VA, Pallin R, Schleimer JP, Tomsich E, Kravitz-Wirtz N, Shev AB, Knoepke CE, Wintemute GJ. Gun violence restraining orders in California, 2016-2018: case details and respondent mortality. Inj Prev 2022; 28:465-471. [PMID: 35654574 PMCID: PMC9510437 DOI: 10.1136/injuryprev-2022-044544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
Background Gun violence restraining orders (GVROs), implemented in California in 2016, temporarily prohibit individuals at high risk of violence from purchasing or possessing firearms and ammunition. We sought to describe the circumstances giving rise to GVROs issued 2016–2018, provide details about the GVRO process and quantify mortality outcomes for individuals subject to these orders (‘respondents’). Methods For this cross-sectional description of GVRO respondents, 2016–2018, we abstracted case details from court files and used LexisNexis to link respondents to mortality data through August 2020. Results We abstracted information for 201 respondents with accessible court records. Respondents were mostly white (61.2%) and men (93.5%). Fifty-four per cent of cases involved potential harm to others alone, 15.3% involved potential harm to self alone and 25.2% involved both. Mass shooting threats occurred in 28.7% of cases. Ninety-six and one half per cent of petitioners were law enforcement officers and one-in-three cases resulted in arrest on order service. One-year orders after a hearing (following 21-day emergency/temporary orders) were issued in 53.5% of cases. Most (84.2%) respondents owned at least one firearm, and firearms were removed in 55.9% of cases. Of the 379 respondents matched by LexisNexis, 7 (1.8%) died after the GVRO was issued: one from a self-inflicted firearm injury that was itself the reason for the GVRO and the others from causes unrelated to violence. Conclusions GVROs were used most often by law enforcement officers to prevent firearm assault/homicide and post-GVRO firearm fatalities among respondents were rare. Future studies should investigate additional respondent outcomes and potential sources of heterogeneity.
Collapse
Affiliation(s)
- Veronica A Pear
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Rocco Pallin
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Julia P Schleimer
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Elizabeth Tomsich
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Nicole Kravitz-Wirtz
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Aaron B Shev
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Christopher E Knoepke
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.,Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Garen J Wintemute
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| |
Collapse
|
11
|
Bramajo ON. An Age-Period-Cohort Approach to Analyse Late-Life Depression Prevalence in Six European Countries, 2004-2016. Eur J Popul 2022; 38:223-245. [PMID: 35228766 PMCID: PMC8865500 DOI: 10.1007/s10680-022-09610-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/24/2022] [Indexed: 12/20/2022]
Abstract
Late-life depression is a condition that affects an ever-growing share of the population in ageing societies. While depression prevalence varies across countries for a myriad of reasons, generational factors, expressed in the shared experience of birth cohorts, may also play a part in such differentials. This paper describes the presence of age, period, and cohort (APC) effects in late-life depression prevalence trends (for adults aged 50 and above) for selected countries in Europe, using the Survey of Health and Ageing and Retirement of Europe (SHARE). We analysed six countries during the 2004-2016 period: Denmark, Sweden, and Germany, with a lower baseline prevalence, and Italy, Spain, and France, with a higher baseline prevalence. By applying a set of APC statistical models to visualise linear and nonlinear effects, we found that all countries followed a J-shaped curve when describing the transversal and longitudinal age trajectories of late-life depression. We also found a combination of nonlinear effects present in Germany, France and Sweden in males, indicating that younger male cohorts had a higher relative risk of depression. In females, we found nonlinear cohort effects, indicating that younger and older cohorts presented a higher risk of depression in Sweden and Germany and a lower risk in Spain. The presence of an increased risk for younger male cohorts may be indicative of a new trend in some countries, which may reduce the sex gap in prevalence. Future analysis should focus on the causes and mechanisms that lead to differential risks across cohorts.
Collapse
|
12
|
DiMaggio CJ, Bukur M, Wall SP, Frangos SG, Wen AY. Injuries associated with electric-powered bikes and scooters: analysis of US consumer product data. Inj Prev 2019; 26:524-528. [PMID: 31712276 DOI: 10.1136/injuryprev-2019-043418] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Powered, two-wheeled transportation devices like electric bicycles (E-bikes) and scooters are increasingly popular, but little is known about their relative injury risk compared to pedal operated bicycles. METHODS Descriptive and comparative analysis of injury patterns and trends associated with E-bikes, powered scooters and pedal bicycles from 2000 to 2017 using the US National Electronic Injury Surveillance System. RESULTS While persons injured using E-bikes were more likely to suffer internal injuries (17.1%; 95% CI 5.6 to 28.6) and require hospital admission (OR=2.8, 95% CI 1.3 to 6.1), powered scooter injuries were nearly three times more likely to result in a diagnosis of concussion (3% of scooter injuries vs 0.5% of E-bike injuries). E-bike-related injuries were also more than three times more likely to involve a collision with a pedestrian than either pedal bicycles (OR=3.3, 95% CI 0.5 to 23.6) or powered scooters (OR=3.3, 95% CI 0.3 to 32.9), but there was no evidence that powered scooters were more likely than bicycles to be involved in a collision with a pedestrian (OR=1.0, 95% CI 0.3 to 3.1). While population-based rates of pedal bicycle-related injuries have been decreasing, particularly among children, reported E-bike injuries have been increasing dramatically particularly among older persons. CONCLUSIONS E-bike and powered scooter use and injury patterns differ from more traditional pedal operated bicycles. Efforts to address injury prevention and control are warranted, and further studies examining demographics and hospital resource utilisation are necessary.
Collapse
Affiliation(s)
- Charles J DiMaggio
- Department of Surgery, NYU Langone Health, NYU School of Medicine, New York City, New York, USA .,Division of Trauma, Emergency General Surgery, & Surgical Critical Care, Bellevue Hosptial Center, New York City, New York, USA
| | - Marko Bukur
- Department of Surgery, NYU Langone Health, NYU School of Medicine, New York City, New York, USA.,Division of Trauma, Emergency General Surgery, & Surgical Critical Care, Bellevue Hosptial Center, New York City, New York, USA
| | - Stephen P Wall
- Ronald O. Perelman Department of Emergency Medicine, NYU Langone Health, NYU School of Medicine, New York City, New York, USA
| | - Spiros G Frangos
- Department of Surgery, NYU Langone Health, NYU School of Medicine, New York City, New York, USA.,Division of Trauma, Emergency General Surgery, & Surgical Critical Care, Bellevue Hosptial Center, New York City, New York, USA
| | - Andy Y Wen
- Department of Pediatrics, Division of Critical Care, NYU Langone Health, NYU School of Medicine, New York City, New York, USA
| |
Collapse
|
13
|
Schleimer JP, Kravitz-Wirtz N, Pallin R, Charbonneau AK, Buggs SA, Wintemute GJ. Firearm ownership in California: A latent class analysis. Inj Prev 2019; 26:456-462. [PMID: 31601624 DOI: 10.1136/injuryprev-2019-043412] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/08/2019] [Accepted: 09/11/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine whether firearm ownership and ownership-related motivations and practices can be classified into reasonably distinct types. METHODS Cross-sectional data on firearm owners (n=429) were obtained from the 2018 California Safety and Well-Being Survey, a state-representative web-based survey. We conducted a latent class analysis using six self-reported indicators of firearm ownership: (1) number of firearms owned, (2) types of firearms owned, (3) primary reason for firearm ownership, (4) firearm storage, (5) loaded handgun carrying and (6) high-capacity magazine ownership. RESULTS We identified five markedly different classes of firearm ownership. There were two classes of single-firearm owners and three classes of multiple-firearm owners. Only members of one class (9% of owners) were likely to have carried a loaded handgun and to own high-capacity magazines or assault-type weapons. Members of this class were also likely to own 5+ firearms, own for protection against people, and store a firearm in the least secure manner (loaded and unlocked). CONCLUSION There were distinct classes of firearm ownership in California, and all higher-risk behaviours studied were exhibited disproportionately by members of a single class. This latent class structure, which may help identify higher-risk groups of firearm owners, could inform future research on risk assessment and on focused interventions to reduce firearm injury and death.
Collapse
Affiliation(s)
- Julia P Schleimer
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Nicole Kravitz-Wirtz
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Rocco Pallin
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Amanda K Charbonneau
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Shani A Buggs
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| | - Garen J Wintemute
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
| |
Collapse
|