Rose A. Cheney

Mortality trends in Philadelphia: Age- and cause-specific death rates 1870–1930

This article examines the decline in mortality which occurred in Philadelphia in the late nineteenth and early twentieth centuries. Age- and cause-specific mortality rates accounting for the decline are isolated and the relative importance of several variables in explaining the reduction of overall mortality levels is assessed. By using small areas within the city we are able to establish the impact of particular innovations on specific causes of death.

Religious social capital: Its measurement and utility in the study of the social determinants of health

As a social determinant of health, religiosity remains not well understood, despite the prevalence of religious activity and prominence of religious institutions in most societies. This paper introduces a working measure of Religious Social Capital and presents preliminary associations with neighborhood social capital and urban stressors. Religious social capital is defined as the social resources available to individuals and groups through their social connections with a religious community. Domains covered include group membership, social integration, values/norms, bonding/bridging trust as well as social support. Cross-sectional data come from a convenience sample of 104 community dwelling adults residing in a single urban neighborhood in a large US city, who also provided information on neighborhood social capital, and experiences of urban stressors. Results suggest that religious social capital is a valid construct that can be reliably measured. All indicators of religious social capital were higher among those who frequently attended religious services, with the exception of bridging trust (trust of people from different religious groups). A weak, inverse, association was also observed between religious and neighborhood social capital levels. Levels of religious social capital were correlated with higher levels of reported urban stressors, while neighborhood social capital was correlated with lower urban stressor levels. A significant percent of the sample was unaffiliated with a religious tradition and these individuals were more likely to be male, young and more highly educated. Social capital is a promising construct to help elucidate the influence of religion on population health.

Neighborhood Blight, Stress, and Health: A Walking Trial of Urban Greening and Ambulatory Heart Rate

We measured dynamic stress responses using ambulatory heart rate monitoring as participants in Philadelphia, Pennsylvania walked past vacant lots before and after a greening remediation treatment of randomly selected lots. Being in view of a greened vacant lot decreased heart rate significantly more than did being in view of a nongreened vacant lot or not in view of any vacant lot. Remediating neighborhood blight may reduce stress and improve health.

Reducing firearm violence: a research agenda

In the United States, firearms are involved in tens of thousands of deaths and injuries each year. The magnitude of this problem prompted the National Academy of Sciences (NAS) to issue a report in 2004 detailing the strengths and limitations of existing research on the relationship between firearms and violence. In response, a multidisciplinary group of experts in the field of firearms and violence formed the National Research Collaborative on Firearm Violence. The Collaborative met for 2 days in June 2005 to (1) critically review the main findings of the NAS report and (2) define a research agenda that could fill research and data gaps and inform policy that reduces gun-related crime, deaths and injuries. This article summarizes the Collaborative’s conclusions and identifies priorities for research and funding.

The Healthy Brains and Behavior Study: objectives, design, recruitment, and population coverage

Violence is increasingly viewed as a public health issue that may be ameliorated by health‐based interventions. The Healthy Brains and Behavior Study (HBBS) aims to identify environmental and biological risk factors for aggression in late childhood and to reduce aggression through psychological and nutritional treatments. Utilizing a cross‐disciplinary collaborative research approach, the HBBS has both human and animal components. The human component has two stages consisting of risk assessment followed by treatment. The risk assessment is based on 451 community‐residing children aged 11–12 years and their caregivers, during which genetic, brain imaging, neuroendocrine, psychophysiology, environment toxicology, neurocognitive, nutrition, psychological, social and demographic risk variables are collected. Children who met criteria (N = 219) for problematic aggressive behaviors were assigned to one of four treatment groups: cognitive‐behavior therapy (CBT) alone, nutritional supplements alone, both CBT and nutrition, or treatment‐as‐usual. Treatment duration was 12 weeks and all children whether in treatment or not were followed‐up at three, six, and 12 months. The animal component assessed the effects of dietary omega‐3 fatty acids on the development of aggression. This study contributes knowledge on how biological factors interact with social factors in shaping proactive and reactive aggression and assesses the efficacy of treatment approaches to reduce childhood aggression. Copyright

Evaluating the Effect of State Regulation of Federally Licensed Firearm Dealers on Firearm Homicide

Effective federal regulation of firearm dealers has proven difficult. Consequently, many states choose to implement their own regulations. We examined the impact of state-required licensing, record keeping of sales, allowable inspections, and mandatory theft reporting on firearm homicide from 1995 to 2010. We found that lower homicide rates were associated with states that required licensing and inspections. We concluded that firearm dealer regulations might be an effective harm reduction strategy for firearm homicide.

A randomised controlled feasibility trial of alcohol consumption and the ability to appropriately use a firearm.

Objective: To show the feasibility of using a controlled trial to investigate the effect of alcohol on firearm use. Methods: Randomised, blinded, placebo-controlled trial in the Firearm Usage and Safety Experiments (FUSE) Lab. Treatment subjects (male, 21–40-year-old, non-habitual drinkers, with no professional firearms training) received alcohol; control subjects received placebo alcohol. The AIS PRISim Firearm Simulator, including real pistols retrofitted to discharge compressed air cartridges that simulate firearm recoil and sound, was used to measure firearm performance. Accuracy and speed for target shooting, reaction time scenarios, and scenarios requiring judgement about when to use a gun were measured. Results: 12 subjects enrolled in the trial, completing 160 training scenarios. All subjects in the alcohol arm reached target alcohol level. 33% of placebo subjects reported alcohol consumption. Mechanical malfunction of the simulator occurred in 9 of 160 (5.6%) scenarios. Intoxicated subjects were less accurate, slower to fire in reaction time scenarios, and quicker to fire in scenarios requiring judgement relative to controls. Conclusions: The feasibility of a randomised, controlled trial exploring the relationship between alcohol consumption and firearm use was shown. The hypothesis that alcohol consumption worsens accuracy and retards judgement about when to use a gun should be tested. Larger trials could inform policies regarding firearm use while intoxicated.

The case for enhanced Data collection of Gun type

BACKGROUND National surveillance systems have differentiated long guns into rifles and shotguns but fail to do so for handgun type. We sought to determine whether specific gun type data could be collected and whether knowledge of specific gun types (rifle, shotgun, pistol, revolver) could be used to distinguish gun homicide victims with respect to important injury parameters such as number of wounds. METHODS Data on gun fatalities over a 5-year period in three communities were abstracted from medical examiner/coroner, police, and crime laboratory records. RESULTS Gun type was obtained for 92% of 490 guns linked to 405 gun homicides. Handguns were associated with more wounds per gun than long guns (p = 0.001) and more entry wounds per gun than long guns (p = 0.002). Among handguns, pistols were associated with more wounds per gun (p < 0.001) and entry wounds per gun (p = 0.001) than revolvers. These same associations were not found among specific long gun types (i.e., rifles and shotguns). CONCLUSION Our findings demonstrate that information about gun type can be obtained and that significant differences exist in wounds per gun between long guns and handguns and between pistols and revolvers. Classification of long guns into rifles and shotguns and handguns into pistols and revolvers should be included in local, regional, and national data collection systems.

Scared safe? Abandoning the use of fear in urban violence prevention programmes

The American College of Surgeons’ (ACS) Committee on Trauma recently released Resources for Optimal Care of the Injured Patient 2014 .1 Now in its sixth edition, Resources enumerates the criteria that US trauma centres must satisfy to achieve ACS verification. Of particular relevance to the field of violence and injury research is Chapter 18, entitled ‘Prevention’. Among the many changes is the addition of criterion 18-5, which states: “Level I and II trauma centers must implement at least two programs that address one of the major causes of injury in the community” (p. 141). Violence is a major cause of injury in the communities served by urban trauma centres,2 ,3 and thus violence is likely to be the focus of many new programmes established to satisfy the criterion. This presents an opportunity to integrate violent injury research into practice as most trauma centres will adopt existing models of hospital-based violence prevention. Given that criterion 18-5 functions as an unfunded mandate, and that resources dedicated to prevention activities are limited in most trauma centres,4 preference will likely be given to injury prevention programmes with relatively low costs. Programmes that use fear appeal are not very …