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1.
Am J Public Health ; 112(1): 144-153, 2022 01.
Article in English | MEDLINE | ID: covidwho-1841232

ABSTRACT

Objectives. To describe associations between neighborhood racial and economic segregation and violence during the COVID-19 pandemic. Methods. For 13 US cities, we obtained zip code-level data on 5 violence outcomes from March through July 2018 through 2020. Using negative binomial regressions and marginal contrasts, we estimated differences between quintiles of racial, economic, and racialized economic segregation using the Index of Concentration at the Extremes as a measure of neighborhood privilege (1) in 2020 and (2) relative to 2018 through 2019 (difference-in-differences). Results. In 2020, violence was higher in less-privileged neighborhoods than in the most privileged. For example, if all zip codes were in the least privileged versus most privileged quintile of racialized economic segregation, we estimated 146.2 additional aggravated assaults (95% confidence interval = 112.4, 205.8) per zip code on average across cities. Differences over time in less-privileged zip codes were greater than differences over time in the most privileged for firearm violence, aggravated assault, and homicide. Conclusions. Marginalized communities endure endemically high levels of violence. The events of 2020 exacerbated disparities in several forms of violence. Public Health Implications. To reduce violence and related disparities, immediate and long-term investments in low-income neighborhoods of color are warranted. (Am J Public Health. 2022;112(1):144-153. https://doi.org/10.2105/AJPH.2021.306540).


Subject(s)
COVID-19/epidemiology , Gun Violence/statistics & numerical data , Race Factors , Residence Characteristics/classification , Social Segregation , Socioeconomic Factors , Violence/statistics & numerical data , Cities/statistics & numerical data , Homicide/statistics & numerical data , Humans , Rape/statistics & numerical data , Residence Characteristics/statistics & numerical data , Theft/statistics & numerical data , United States/epidemiology
2.
Am J Emerg Med ; 51: 262-266, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1827781

ABSTRACT

IMPORTANCE: Considering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic. OBJECTIVE: To identify the incidence and sociodemographic characteristics of self-harm and violence during the COVID19 lockdown and compare with a control group from the previous year. DESIGN: A cross-sectional retrospective observational study. SETTING: Tertiary care teaching hospital. PARTICIPANTS: All patients presenting to the emergency department (ED) with self harm and violence during the COVID-19 lockdown period between March 24-June 30, 2020 and March 24-June 30, 2019. EXPOSURE: The COVID-19 lockdown period. MAIN OUTCOME (S) AND MEASURE (S): The hypothesis being tested was formulated before the study. The null hypothesis tested was a decline in number of self-harm and violence cases during the lockdown. RESULTS: A total of 828 patients were analysed over both the time periods, out of which 30% (248) were females while 70% (580) were males. Increases in self-harm and violence were 12.71% and 95.32% respectively per 1000 ED admissions. A significant correlation was found between the COVID-19 lockdown and the increased incidence (X2 (1, N = 828) = 9.2, p < .05). An increase of violence by known individuals and between partners was seen. Intimate partner violence also increased to 7%. X2 (3, N = 662) = 21.03, p < .05. In the self harm dataset an increase in mortality, ICU admissions and decision to leave against medical advice was noted (X2 (4, N = 166) = 24.49, p < .05). Increase in the use of alcohol prior to acts of self harm and violence was noted. CONCLUSIONS: Increase in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner. TRIAL REGISTRATION: N/A.


Subject(s)
COVID-19/epidemiology , Self-Injurious Behavior/epidemiology , Violence/statistics & numerical data , Adult , Communicable Disease Control , Cross-Sectional Studies , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization , Humans , Incidence , India/epidemiology , Intimate Partner Violence , Male , Middle Aged , Pandemics , Retrospective Studies , Young Adult
3.
Epidemiol Infect ; 150: e31, 2022 01 27.
Article in English | MEDLINE | ID: covidwho-1819637

ABSTRACT

In Ethiopia, the magnitude of violence against girls during COVID-19 in the study area is not known. Therefore, this study aimed to assess the violence and associated factors during COVID-19 pandemic among Gondar city secondary school girls in North West Ethiopia. An institution-based cross-sectional study was conducted from January to February 2021. Data were collected from four public and two private Gondar city secondary schools. Investigators used stratified simple random sampling to select participants and the investigators used roster of the students at selected schools. Investigators collected the data using self-reported history of experiencing violence (victimisation). Investigators analysed data using descriptive statistics and multivariable logistic regression. Investigators invited a total of 371 sampled female students to complete self-administered questionnaires. The proportion of girls who experienced violence was 42.05% and psychological violence was the highest form of violence. Having a father who attended informal education (AOR = 1.95, 95% CI 1.08-3.51), ever use of social media 1.65 (AOR = 1.65, 95% CI 1.02-2.69), ever watching sexually explicit material (AOR = 2.04, 95% CI 1.24-3.36) and use of a substance (AOR = 1.92, 95% CI 1.17-3.15) were significantly associated variables with violence. Almost for every five girls, more than two of them experienced violence during the COVID-19 lockdown. The prevalence of violence might be under reported due to desirability bias. Therefore, it is better to create awareness towards violence among substance users, fathers with informal education and social media including user females.


Subject(s)
COVID-19/complications , Child Abuse/statistics & numerical data , Violence/statistics & numerical data , Adolescent , Adult , COVID-19/epidemiology , COVID-19/psychology , Child , Child, Preschool , Data Collection , Education/statistics & numerical data , Ethiopia/epidemiology , Female , Humans , Social Media/statistics & numerical data , Students , Substance-Related Disorders/complications , Substance-Related Disorders/epidemiology , Young Adult
4.
Saúde Soc ; 30(2): e210001, 2021.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1817571

ABSTRACT

Resumo A violência é um fenômeno sociocultural que viola direitos e acentua desigualdades sociais. Suas implicações são perceptíveis na vida cotidiana e na saúde da população. Sob o referencial teórico da interseccionalidade e da psicologia sócio-histórica, este artigo discute formas de violência produzidas na intersecção de gênero, raça e classe em uma comunidade periférica e em situação de alta vulnerabilidade localizada na cidade de Cubatão/SP, a partir do relato de quatro lideranças comunitárias. Os dados foram obtidos por meio de três pesquisas realizadas anteriormente e concomitantemente ao contexto da pandemia da covid-19, de junho de 2017 a novembro de 2020, extraídos mediante entrevistas e diários de campo para, depois, serem analisados segundo a Hermenêutica de Profundidade. Os resultados apontam para violências estruturais articuladas a raça, classe e gênero, expressas na inacessibilidade a condições dignas de moradia, alimentação e renda básica. A violência contra mulheres, destacada como resultado, aparece intermediada pelo Estado ou pelo tráfico organizado. Os dados sugerem que as violências são agravadas pela ineficiência da operacionalização das políticas públicas, no que tange à promoção do cuidado à população majoritariamente negra e pobre, indicando que a interseccionalidade é uma ferramenta essencial para a análise e o enfrentamento das desigualdades sociais.


Abstract Violence is a socio-cultural phenomenon that violates rights and accentuates social inequalities with noticeable implications in the health and daily life of the population. This article discusses forms of violence produced at the intersection of gender, race and class in a peripheral and highly vulnerable community located in the city of Cubatão, state of São Paulo. The research was guided by the theoretical framework of intersectionality and socio-historical psychology. Data were obtained using three surveys conducted from June, 2017 to November, 2020, partially during COVID-19 pandemic. Interviews and field diaries were conducted, analyzed according to Depth Hermeneutics. The material collected from four community leaders served as the basis for this article. The results point to a structural violence articulated to race, class and gender, expressed in the inaccessibility to decent conditions of housing, food and basic income. The violence against women emphasized as a result appears intermediated by the State or the organized drug trafficking. The data suggest that these forms of violence are aggravated by the inefficiency of the public policy operationalization in promoting care for the mostly black and poor population, indicating that intersectionality can be an essential tool for analysis and confrontation of social inequalities.


Subject(s)
Psychology, Social , Socioeconomic Factors , Violence , Violence Against Women , Intersectionality , COVID-19
5.
Violence Against Women ; 28(9): 2186-2203, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1817041

ABSTRACT

This study explores intimate partner violence (IPV) evolution during the lockdown with a sample of 238 women (44% cohabitating and 56% not cohabitating with the perpetrator), attending five antiviolence centers in Italy (June-September 2020). Questions included 12 items on IPV and, for each item, a question about whether violence increased/stayed the same/decreased during lockdown; an indicator of IPV modifications was constructed. Two distinct patterns, confirmed after adjustment for socio-demographic factors, emerged: IPV increased for 28% of cohabitating and decreased for 56% of non-cohabitating women. Such results suggest the efficacy of physical distancing-strictly controlled by the State-in the prevention of IPV.


Subject(s)
COVID-19 , Intimate Partner Violence , Communicable Disease Control , Female , Humans , Prevalence , Risk Factors , Sexual Partners , Violence
7.
JAMA Netw Open ; 5(4): e229393, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1813430

ABSTRACT

Importance: In the US, the COVID-19 pandemic intensified some conditions that may contribute to firearm violence, and a recent surge in firearm sales during the pandemic has been reported. However, patterns of change in firearm violence in the first year of the COVID-19 pandemic in the US remain unclear. Objective: To quantify the changes in interpersonal firearm violence associated with the pandemic across all 50 US states and the District of Columbia. Design, Setting, and Participants: This population-based cross-sectional study examined 50 US states and the District of Columbia from January 1, 2016, to February 28, 2021. The COVID-19 pandemic period was defined as between March 1, 2020, and February 28, 2021. Statistical analysis was performed from April to December 2021. Main Outcomes and Measures: A 2-stage interrupted time-series design was used to examine the excess burden of firearm-related incidents, nonfatal injuries, and deaths associated with the pandemic while accounting for long-term trends and seasonality. In the first stage, separate quasi-Poisson regression models were fit to the daily number of firearm events in each state. In the second stage, estimates were pooled using a multivariate meta-analysis. Results: In the US (all 50 states and the District of Columbia) during the pandemic period of March 1, 2020, to February 28, 2021, there were 62 485 identified firearm-related incidents, 40 021 firearm-related nonfatal injuries, and 19 818 firearm-related deaths. The pandemic period was associated with 8138 (95% empirical confidence interval [eCI], 2769-12 948) excess incidents (increase of 15.0% [95% eCI, 4.6%-26.1%]), 10 222 (95% eCI, 8284-11 650) excess nonfatal injuries (increase of 34.3% [95% eCI, 26.1%-41.1%]), and 4381 (95% eCI, 2262-6264) excess deaths (increase of 28.4% [95% eCI, 12.9%-46.2%]). The increase in firearm-related violence was more pronounced from June to October 2020 and in Minnesota and New York State. Conclusions and Relevance: In the US, the first year of the COVID-19 pandemic was associated with an excess burden of firearm-related incidents, nonfatal injuries, and deaths, with substantial temporal and spatial variations.


Subject(s)
COVID-19 , Wounds, Gunshot , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Pandemics , Violence , Wounds, Gunshot/epidemiology
8.
Int J Environ Res Public Health ; 19(9)2022 Apr 25.
Article in English | MEDLINE | ID: covidwho-1809902

ABSTRACT

Israel is not isolated from the global migration process. It is required to provide a medical, educational, and socio-cultural response to the integration of tens of thousands of African asylum seekers. This qualitative-phenomenological study collected data from 15 educators as a primary source and learned about their actions to mediate health and educational issues for African asylum seekers. The findings reveal four categories: (1) a healthy lifestyle; (2) emotional-behavioral; (3) learning disabilities and special needs; (4) diseases, vaccines, and medical treatments. It seems that educators are forced to take on roles traditionally entrusted to the state, and they have become agents of socialization who mediate between parents and the Israeli health and education system through personal relationships and individual conversations. This study reveals a dual reality: on the one hand, African asylum seekers experience alienation, exclusion, and violence; on the other hand, they gain a positive point of view when parents see the educators as loyal partners and sources of knowledge who can be consulted to receive help in routine times and during the coronavirus pandemic, a time in which they lost their livelihood, health insurance, and ability to understand the new rules of the lockdowns.


Subject(s)
Refugees , Humans , Israel/epidemiology , Qualitative Research , Violence
9.
BMC Psychiatry ; 22(1): 265, 2022 Apr 14.
Article in English | MEDLINE | ID: covidwho-1808351

ABSTRACT

BACKGROUND: Despite anxiety disorders being the ninth leading cause of disability and associated with social inequities, little attention has been given to how intersections among social determinants of health and chronic stressors such as cumulative lifetime violence affect the likelihood of experiencing anxiety disorders. Our purpose was to explore the relationships among cumulative lifetime violence severity as target and perpetrator, social determinants of health and generalized anxiety disorder in Canadian men. METHODS: Using a community sample of 592 Canadian men who self-identified as having experienced violence, we developed and tested an evidence-based model of generalized anxiety disorder including indicators of cumulative lifetime violence, gender, social location, socio-economic disparity, personal resources and other chronic stressors using logistic regression. RESULTS: Most men (76.4%, n = 452) reported experiences as both target and perpetrator. The model accounted for 50.8% of the variance in anxiety severity χ2 (8) = 264.43, p = .000). The prevalence of probable generalized anxiety disorder was 30.9%, a rate higher than that found among Canadian men in general in the same period. Remarkably, the likelihood of generalized anxiety disorder increased by a factor of 5.30 for each increase of 1 in cumulative lifetime violence severity, and six-fold for feeling overwhelmed by demands of everyday life (aOR = 6.26). Masculine discrepancy stress, having been born in Canada, unemployment, and food insecurity also contributed significantly to increasing the likelihood of generalized anxiety disorder. Both social support and mastery had significant aORs < 1, suggesting possible protective effects. Together these findings delineate characteristics and social determinants that may heighten vulnerability to generalized anxiety disorder and influence its progression among men who have experienced lifetime violence. CONCLUSIONS: These findings are the first evidence that Canadian men with lifetime violence histories are a sub-group disproportionately affected by chronic stressors and socio-economic disparities and that together the presence and/or severity of these factors increases their vulnerability to generalized anxiety disorder. Our results highlight the importance of strengths-based trauma- and violence-informed approaches to care, including practical resources to reduce the stress of everyday life, improve social support, and reinforce personal control and choice.


Subject(s)
Anxiety Disorders , Social Determinants of Health , Anxiety/epidemiology , Anxiety Disorders/epidemiology , Canada/epidemiology , Female , Humans , Male , Violence
10.
Am J Public Health ; 112(5): 706-708, 2022 May.
Article in English | MEDLINE | ID: covidwho-1789252
11.
Child Abuse Negl ; 128: 105602, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1763625

ABSTRACT

The early months of 2022 have already included several distressing world events. From the ongoing COVID-19 pandemic, to protests against vaccine mandates and COVID-19 restrictions, to the Russian invasion of Ukraine. Escalating conflict in Ukraine poses an immediate and growing threat to the lives and well-being of the country's 7.5 million children. Humanitarian needs are multiplying - and spreading by the hour. Children have been killed. Children have been wounded. They are being profoundly traumatized by the violence all around them. Hundreds of thousands of people are on the move, and family members are becoming separated from their loved ones.


Subject(s)
COVID-19 , Adolescent , COVID-19/epidemiology , Child , Family , Humans , Pandemics , Ukraine/epidemiology , Violence
12.
J Assist Reprod Genet ; 39(3): 555-557, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1763420

ABSTRACT

Despite centuries of lessons from history, war endures. Across Earth, during nearly every year from the beginning of the twentieth century to present day, over 30 wars have been fought resulting in 187 million casualties, excluding the most recent conflict, which is the impetus for this essay (Timeline of 20th and 21st century wars). We are, sadly, a war-mongering people. The word "war" word infiltrates our vernacular, e.g., the war on poverty, on drugs, on cancer, on COVID, and, apropos, on terror. How did rational approaches to disagreement and conflict evade the world's progress? Reproductive physicians and scientists are dedicated to safeguard lives and build families. Violence is antithetical to our mission as professionals, and moral integrity as humans. We are deeply concerned for, and stand in unity with, our Ukrainian colleagues-the embryologists, scientists, OBGYN and REI physicians, infertility patients, and all people under siege. Reproductive health services for Ukrainians (as with many other war-torn regions) have collapsed. Deeply disturbing reports have emerged that cite civilian hospitals (including maternity centers) being targeted. Liquid nitrogen supplies are scarce. Pregnant mothers and gestational carriers are at emergent risk of delivering in extremely harsh conditions, cold underground bunkers and refugee queues.


Subject(s)
COVID-19 , Warfare , Female , History, 20th Century , Humans , Mothers , Pregnancy , Violence
13.
Glob Public Health ; 17(5): 784-793, 2022 May.
Article in English | MEDLINE | ID: covidwho-1758549

ABSTRACT

The Seasonal Agricultural Worker Program (SAWP) is a managed migration programme that aims to fill labour shortages in Canada's agricultural industry with Black and Brown workers from the global South. For decades, migrant workers, scholars, and advocate groups have called for fundamental changes to address power imbalances produced by the design of the SAWP. The continued operation of the SAWP during the COVID-19 pandemic has intensified the underlying structural violence that migrant labourers experience. Analysing the SAWP as a case study in how globalised labour processes dehumanise and make workers disposable, we argue that it is one component in a web of social and structural factors rooted in colonialism and racial capitalism, constituting the structural determinants of death. Whereas the structural determinants of health point to health 'inequities' and 'disparities', we advance the concept of structural determinants of death to politicise the numerous and multidimensional forms of violence embedded within state policy and to shed light on their beneficiaries. In doing so, we detail how policies can diminish the agency necessary to avoid death in deadly conditions and, specifically, draw attention to the preventable suffering and death perpetuated by the SAWP.


Subject(s)
COVID-19 , Farmers , Canada/epidemiology , Humans , Pandemics , Seasons , Violence
14.
AMA J Ethics ; 24(3): E239-246, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1748821

ABSTRACT

In 2020, the authors of this article published "Abolition Medicine" as one contribution to international abolitionist conversations responding to widespread anti-Black police violence and inequity laid bare by the COVID-19 pandemic. Over the past year, there has been a surge of efforts to abolish deeply embedded patterns of race-based oppression in policing and incarceration in the United States. In this essay, the authors continue to explore how health care can join these conversations and move toward a praxis of health justice. Using the framework of Ruth Wilson Gilmore's organized abandonment, the article revisits grassroots organizations and efforts that have been engaging in abolitionist health care all along. It also looks to current and emerging abolitionist policies and practices operating at the margins of status quo health care for models of abolition in medicine.


Subject(s)
COVID-19 , Pandemics , Humans , Police , United States , Violence
15.
BMC Public Health ; 22(1): 288, 2022 02 12.
Article in English | MEDLINE | ID: covidwho-1741938

ABSTRACT

BACKGROUND: Globally, concerns have been raised that the priority implementation of public health measures in response to COVID-19 may have unintended negative impacts on a variety of other health and wellbeing factors, including violence. This study examined the impact of COVID-19 response measures on changes in violence against women and children (VAWC) service utilisation across European countries. METHODS: A rapid assessment design was used to compile data including a survey distributed across WHO Europe Healthy Cities Networks and Violence Injury Prevention Focal Points in WHO European Region member states, and a scoping review of media reports, journal articles, and reports. Searches were conducted in English and Russian and covered the period between 1 January 2020 and 17 September 2020. Data extracted included: country; violence type; service sector; and change in service utilisation during COVID-19. All data pertained to the period during which COVID-19 related public health measures were implemented compared to a period before restrictions were in place. RESULTS: Overall, findings suggested that there was a median reported increase in VAWC service utilisation of approximately 20% during the COVID-19 pandemic. Crucially, however, change in service utilisation differed across sectors. After categorising each estimate as reflecting an increase or decrease in VAWC service utilisation, there was a significant association between sector and change in service utilisation; the majority of NGO estimates (95.1%) showed an increase in utilisation, compared to 58.2% of law enforcement estimates and 42.9% of health and social care estimates. CONCLUSIONS: The variation across sectors in changes in VAWC service utilisation has important implications for policymakers in the event of ongoing and future restrictions related to COVID-19, and more generally during other times of prolonged presence in the home. The increased global attention on VAWC during the pandemic should be used to drive forward the agenda on prevention, increase access to services, and implement better data collection mechanisms to ensure the momentum and increased focus on VAWC during the pandemic is not wasted.


Subject(s)
COVID-19 , Child , Female , Humans , Pandemics , Police , SARS-CoV-2 , Violence/prevention & control
16.
Curr Psychiatry Rep ; 24(4): 285-295, 2022 04.
Article in English | MEDLINE | ID: covidwho-1739418

ABSTRACT

PURPOSE OF REVIEW: This paper reviews the literature on the prevalence, risk factors, and effects of traumatic experiences on the mental health outcomes of minority youth in the USA. RECENT FINDINGS: The USA has an increasing number of children and youth from minority backgrounds. Research reveals that traumatic experiences disproportionately affect minority youth. These experiences include historical/generational trauma, immigration and acculturation stressors, natural and manmade disasters, experiences of discrimination, family violence, and community violence. The COVID-19 pandemic has also disproportionately affected minority youth resulting in illness and hospitalizations. Despite the higher incidence of trauma exposure, minority youth are less likely to access medical and mental health care. These disparities are resulting in increasing rates of depression, anxiety, post-traumatic stress, substance use disorders, and suicide in minority youth. Recognizing and understanding the impact of trauma is critical to the healthy development and successful functioning of minority youth, and to the success of our nation.


Subject(s)
COVID-19 , Pandemics , Adolescent , COVID-19/epidemiology , Child , Emigration and Immigration , Humans , Minority Groups , Violence/psychology
17.
Glob Public Health ; 17(5): 652-661, 2022 May.
Article in English | MEDLINE | ID: covidwho-1740669

ABSTRACT

We explored how the COVID-19 pandemic has affected the health and wellbeing of Indigenous gay and bisexual men (GBM) in Guatemala, a group that experiences intersectional stigma and structural barriers to health. Between February and May 2021, we conducted in-depth qualitative interviews via Zoom with key stakeholders (n = 11) working with Indigenous GBM throughout Guatemala. We coded thematically and conducted narrative analysis to identify the most salient themes. Participants described that prior to the COVID-19 pandemic, many Indigenous GBM migrated to urban centres to avoid stigma and violence from families and rural communities. After the onset of COVID-19, many Indigenous GBM lost their jobs and were forced to move back in with families. For Indigenous GBM who returned, participants described a perceived increase in the severity of physical and psychological violence. Participants attributed this increase in severity to retribution from families and communities for having left. Most Indigenous GBM-serving organisations reported a drastic increase in demand for mental health services. Organisations serving Indigenous GBM have an urgent need to scale up their mental health services and find innovative ways to provide these services remotely during the pandemic and beyond. Technology-based mental health interventions that require little 'live' interaction may be appropriate.


Subject(s)
COVID-19 , Sexual and Gender Minorities , Guatemala/epidemiology , Humans , Male , Mental Health , Pandemics , Violence
18.
Prev Med ; 158: 107020, 2022 05.
Article in English | MEDLINE | ID: covidwho-1740318

ABSTRACT

Recent increases in firearm violence in U.S. cities are well-documented, however dynamic changes in the people, places and intensity of this public health threat during the COVID-19 pandemic are relatively unexplored. This descriptive epidemiologic study spanning from January 1, 2015 - March 31, 2021 utilizes the Philadelphia Police Department's registry of shooting victims, a database which includes all individuals shot and/or killed due to interpersonal firearm violence in the city of Philadelphia. We compared victim and event characteristics prior to the pandemic with those following implementation of pandemic containment measures. In this study, containment began on March 16, 2020, when non-essential businesses were ordered to close in Philadelphia. There were 331 (SE = 13.9) individuals shot/quarter pre-containment vs. 545 (SE = 66.4) individuals shot/quarter post-containment (p = 0.031). Post-containment, the proportion of women shot increased by 39% (95% CI: 1.21, 1.59), and the proportion of children shot increased by 17% (95% CI: 1.00, 1.35). Black women and children were more likely to be shot post-containment (RR 1.11, 95% CI: 1.02, 1.20 and RR 1.08, 95% CI: 1.03, 1.14, respectively). The proportion of mass shootings (≥4 individuals shot within 100 m within 1 h) increased by 53% post-containment (95% CI: 1.25, 1.88). Geographic analysis revealed relative increases in all shootings and mass shootings in specific city locations post-containment. The observed changes in firearm injury epidemiology following COVID-19 containment in Philadelphia demonstrate an intensification in firearm violence, which is increasingly impacting people who are likely made more vulnerable by existing social and structural disadvantage. These findings support existing knowledge about structural causes of interpersonal firearm violence and suggest structural solutions are required to address this public health threat.


Subject(s)
COVID-19 , Firearms , Wounds, Gunshot , COVID-19/epidemiology , Child , Female , Humans , Pandemics , Philadelphia/epidemiology , Violence , Wounds, Gunshot/epidemiology
19.
Science ; 375(6585): 1111-1113, 2022 03 11.
Article in English | MEDLINE | ID: covidwho-1735999

ABSTRACT

Investment in gender-responsive social protection systems and evidence is key to a more equal future post-COVID-19.


Subject(s)
COVID-19 , Public Policy , Caregivers , Employment , Female , Gender Equity , Humans , Male , Violence , Women, Working
20.
BMJ Open ; 11(12): e052923, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1723770

ABSTRACT

OBJECTIVES: Explore the association between the first national lockdown associated with the COVID-19 pandemic on admissions for violence and the relationship with deprivation. DESIGN: Population-based longitudinal cohort study. SETTING: North East and North Cumbria (NENC) area of England. PARTICIPANTS: All individuals living in the NENC (total population 3.1 million) admitted 2017/2018, 2018/2019, 2019/2020. MAIN OUTCOME MEASURES: Hospital Episode Statistics were extracted at Lower Layer Super Output Area and the Index of Multiple Deprivation 2019 decile applied. Directly standardised rates were explored for number of accident and emergency (A&E) attendances (per 1000); Alcohol-related admissions using Public Health England (PHE) Fingertips tool (per 100 000, ID 91414) and emergency admissions for violence (including sexual violence) (per 100 000) (ID 11201 classified by International Classification of Diseases (ICD)10 codes X85 to Y09). RESULTS: A&E attendances are higher in NENC compared with England (409.9 per 1000 v 359.2). A&E attendance was 81% higher in 2019/20 in the most deprived compared with the least deprived. Attendances dropped during the first national COVID-19 lockdown and by September 2020 had not returned to 'normal' levels.Admissions related to violence are a third higher in NENC (29% to 34% higher across 3 years) rates 7-10 times higher in most deprived than least deprived areas. Admission rates reduced during the first UK lock down but this bounced back by August higher than any of the previous 12 months. CONCLUSION: Emergency admissions with violence appear to associate with the COVID-19 pandemic being initially higher than before the first national lockdown. This is in the context of overall A&E attendances which are lower post lockdown. Given that emergency admissions with violence have been consistently higher in the NENC compared with England over recent years, we suggest that targeted action is required in NENC to address health inequalities.


Subject(s)
COVID-19 , Cohort Studies , Communicable Disease Control , Emergency Service, Hospital , Hospitalization , Humans , Longitudinal Studies , Pandemics , SARS-CoV-2 , Violence
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