Social costs of untreated opioid dependence.
(25/708)
Using cost-of-illness methodology applied to a comprehensive survey of 114 daily opiate users not currently in or seeking treatment for their addiction, we estimated the 1996 social costs of untreated opioid dependence in Toronto (Ontario, Canada). The survey collected data on social and demographic characteristics, drug use history, physical and mental health status, the use of health care and substance treatment services, drug use modality and sex-related risks of infectious diseases, sources of income, as well as criminality and involvement with the law enforcement system. The annual social cost generated by this sample, calculated at Canadian $5.086 million, is explained mostly by crime victimization (44.6%) and law enforcement (42.4%), followed by productivity losses (7.0%) and the utilization of health care (6.1%). Applying the $13,100 cost to the estimated 8,000 to 13,000 users and 2.456 million residents living in Toronto yields a range of social cost between $43 and $69 per capita. (+info)
Deaths and injuries from house fires.
(26/708)
BACKGROUND: We sought to define the factors associated with house fires and related injuries by analyzing the data from population-based surveillance. METHODS: For 1991 through 1997, we linked the following data for Dallas: records from the fire department of all house fires (excluding fires in apartments and mobile homes), records of patients transported by ambulance, hospital admissions, and reports from the medical examiner of fatal injuries. RESULTS: There were 223 injuries (91 fatal and 132 nonfatal) from 7190 house fires, for a rate of 5.2 injured persons per 100,000 population per year. Rates of injury related to house fires were highest among blacks (relative risk, 2.8; 95 percent confidence interval, 2.1 to 3.6) and in people 65 years of age or older (relative risk, 2.6; 95 percent confidence interval, 1.9 to 3.5). Census tracts with low median incomes had the highest rates of injury related to house fires (relative risk as compared with census tracts with high median incomes, 8.1; 95 percent confidence interval, 2.5 to 32.0). The rate of injuries was higher for fires that began in bedrooms or living areas (relative risk, 3.7); that were started by heating equipment, smoking, or children playing with fire (relative risk, 2.6); or that occurred in houses built before 1980 (relative risk, 6.6). Injuries occurred more often in houses without functioning smoke detectors (relative risk, 1.5; 95 percent confidence interval, 1.0 to 2.4). The prevalence of functioning smoke detectors was lowest in houses in the census tracts with the lowest median incomes (P<0.001). CONCLUSIONS: Rates of injuries related to house fires are highest in elderly, minority, and low-income populations and in houses without functioning smoke detectors. Efforts to prevent injuries and deaths from house fires should target these populations. (+info)
Identifying 'non-medical' datasets to monitor community health and well-being.
(27/708)
BACKGROUND: The aim of the study was to identify 'non-medical' datasets holding routinely collected information that might be used to measure and monitor the wider determinants of community health and well-being. METHODS: An expert panel discussion, involving public health and environmental health academics and professionals with expertise in a variety of backgrounds (including environmental health, housing, transport, community safety, public health, primary and secondary care), and interrogation of the Office for National Statistics database were carried out for the West Midlands region. The aim was to identify routinely collected 'non-medical' datasets containing information on the following factors: physical environment, crime, housing and homelessness, social services, socio-economic environment including employment, lifestyles, education, leisure and culture, transport and accidents. RESULTS: Fifty-six datasets were identified. Although 43 (77 per cent) were collected at least annually, few (17; 30 per cent) held data that were disaggregated and routinely available at the sub-local authority level. CONCLUSIONS: This study has identified a number of datasets that hold information relevant to health. However, no single dataset is likely to provide information on all dimensions of health and the determinants of health, and local agencies should consider carefully the strengths and weaknesses of each. Through the development of inter-sectoral working and multi-agency involvement at the local level there is now considerable scope to improve the quality of many of these datasets and to promote their use in the measurement and monitoring of community health. (+info)
"They're doing people a service"-qualitative study of smoking, smuggling, and social deprivation.
(28/708)
OBJECTIVES: To examine the behaviour and attitudes related to smoking and contraband tobacco products among smokers in two socially deprived areas. DESIGN: Cross sectional study with qualitative semistructured interviews, augmented by smokers' day grid. SETTING: Two areas of socioeconomic deprivation in Edinburgh. PARTICIPANTS: 50 male and 50 female smokers aged 25-40 years randomly selected from general practitioners' lists from two health centres, each located in an area of deprivation. RESULTS: Most smokers wanted to quit but felt unable to because of the importance of smoking in their daily routine and their addiction to nicotine. Strategies for maintaining consumption levels in the face of increasing cigarette prices and low income included purchasing contraband cigarettes and tobacco. Vendors were contacted through social networks, family, and friends as well as common knowledge of people and places, particularly pubs where contraband was available. Most users of contraband considered that smugglers were providing a valuable service. Purchasing contraband tobacco was viewed as rational in the face of material hardship. Many smokers criticised the government for its high tobacco taxation and the lack of local services to help them to stop smoking. CONCLUSIONS: Smokers in deprived areas perceive a lack of support to help them to stop smoking. Cigarette and tobacco smuggling is therefore viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettes. Smokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to deal with the material and personal factors that make it difficult for them to quit. (+info)
Victim and offender self-reports of alcohol involvement in crime.
(29/708)
Research suggests that a decreasing share of violent crime is attributable to offenders who had been drinking alcoholic beverages. Surveys of victims indicate that the rate of alcohol-involved violent crimes (i.e., crimes in which the perpetrators had been drinking, as perceived by the victims) decreased 34 percent from 1993 to 1998, whereas the rate of non-alcohol-involved violence decreased 22 percent. Surveys of some offenders also suggest that alcohol's role in violence is decreasing. The decrease in alcohol-involved violence is consistent with declines in other measures of alcohol use and misuse, including per capita alcohol consumption and alcohol involvement in traffic crashes. In contrast, violent offenders in State prisons are increasingly likely to report having used alcohol before committing their offenses, possibly illustrating the effect of more severe sanctions for alcohol-involved offenses. (+info)
Self-reported alcohol use and abuse by arrestees in the 1998 Arrestee Drug Abuse Monitoring Program.
(30/708)
Data collected in the Arrestee Drug Abuse Monitoring (ADAM) program on alcohol and other drug use among arrestees provide a valuable opportunity to examine the relationship between alcohol use and violence. The data are used to explore the combined use of alcohol and other drugs among offenders and the relationships between substance use and the offenders' demographic characteristics and offenses. These findings are used to identify changes in the offenders' alcohol and other drug use over time. (+info)
Molecular investigation of transmission of human immunodeficiency virus type 1 in a criminal case.
(31/708)
Very few criminal cases involving human immunodeficiency virus type 1 (HIV-1) transmission have been described. We report on an HIV-1 transmission case with a child being infected by an HIV-1-positive man. The objective was to determine through molecular epidemiology and phylogenetic analyses whether HIV-1 from the HIV-1-positive man could be the source of infection in the HIV-1-positive child, as claimed by the authorities. We conducted genetic analysis of three different parts of the HIV-1 genome (gag, pol, and env) by PCR, direct-sequencing, and phylogenetic analyses. We used maximum likelihood, maximum parsimony, and neighbor-joining methods for the phylogenetic analyses to investigate whether the sequences from the man and the child were related. We found that the viral sequences from the man and the child formed separate clusters in all of the phylogenetic analyses compared to the local controls. A unique amino acid deletion was identified in the C2-V3-C3 region of the env gene in the virus from the man and the child. These results were used in the criminal court to elucidate whether the virus from the man was related to the virus from the child. In summary, the results from the phylogenetic analyses, the sequence distances between the virus from the man and the virus from the child, and the identification of the unique molecular fingerprint in the env gene together indicated that the virus from the man and the virus from the child were epidemiologically linked. (+info)
Association between behaviour at age 3 years and adult criminality.
(32/708)
BACKGROUND: The continuity in antisocial behaviour into adulthood from middle childhood is well established but it is not clear whether this is also true of the pre-school period. AIMS: To determine whether pre-school behaviour problems increase the risk of later criminal convictions and add to risk associated with family and social circumstances. METHOD: The records of adult convictions were traced for a general population sample (n=828) initially assessed at age 3 years. RESULTS: The risk of having any adult conviction was related to soiling, daytime enuresis, activity level and management difficulties, and that of having an adult violent offence to recent-onset daytime enuresis, management difficulties and temper tantrums. The only other predictors of later convictions were the child's gender and social competence at age 3 years. CONCLUSIONS: The presence of specific behaviour problems in the pre-school period places the child at increased risk of being convicted of an adult offence. Family and social circumstances at age 3 years did not predict later convictions. (+info)