Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014.

STUDY OBJECTIVE: We determine the incidence of and trends in enforcement of the Emergency Medical Treatment and Labor Act (EMTALA) during the past decade. METHODS: We obtained a comprehensive list of all EMTALA investigations conducted between 2005 and 2014 directly from the Centers for Medicare & Medicaid Services (CMS) through a Freedom of Information Act request. Characteristics of EMTALA investigations and resulting citation for violations during the study period are described. RESULTS: Between 2005 and 2014, there were 4,772 investigations, of which 2,118 (44%) resulted in citations for EMTALA deficiencies at 1,498 (62%) of 2,417 hospitals investigated. Investigations were conducted at 43% of hospitals with CMS provider agreements, and citations issued at 27%. On average, 9% of hospitals were investigated and 4.3% were cited for EMTALA violation annually. The proportion of hospitals subject to EMTALA investigation decreased from 10.8% to 7.2%, and citations from 5.3% to 3.2%, between 2005 and 2014. There were 3.9 EMTALA investigations and 1.7 citations per million emergency department (ED) visits during the study period. CONCLUSION: We report the first national estimates of EMTALA enforcement activities in more than a decade. Although EMTALA investigations and citations were common at the hospital level, they were rare at the ED-visit level. CMS actively pursued EMTALA investigations and issued citations throughout the study period, with half of hospitals subject to EMTALA investigations and a quarter receiving a citation for EMTALA violation, although there was a declining trend in enforcement. Further investigation is needed to determine the effect of EMTALA on access to or quality of emergency care.

"Taking the problem to the people": traffic safety from public relations to political theory, 1937-1954.

The slogan "taking the problem to the people" nicely summarizes U.S. traffic safety campaigns of the 1950s. It refers to the goal of awareness and self-discipline for drivers through education and law enforcement. A detailed analysis of the campaigns, however, shows a subtler objective of the motor interests that promoted it. They wanted to overcome political indifference through a civic mobilization of drivers as citizens, persuading drivers to lobby for traffic control. The analysis of their efforts leads us to question the role-or lack of role-of politicians in scientific and technological controversies.

War on Drugs Policing and Police Brutality.

BACKGROUND: War on Drugs policing has failed to reduce domestic street-level drug activity: the cost of drugs remains low and drugs remain widely available. OBJECTIVES: In light of growing attention to police brutality in the United States, this paper explores interconnections between specific War on Drugs policing strategies and police-related violence against Black adolescents and adults in the United States. METHODS: This paper reviews literature about (1) historical connections between race/ethnicity and policing in the United States; (2) the ways that the War on Drugs eroded specific legal protections originally designed to curtail police powers; and (3) the implications of these erosions for police brutality targeting Black communities. RESULTS: Policing and racism have been mutually constitutive in the United States. Erosions to the 4th Amendment to the Constitution and to the Posse Comitatus Act set the foundations for two War on Drugs policing strategies: stop and frisk and Special Weapons and Tactics (SWAT) teams. These strategies have created specific conditions conducive to police brutality targeting Black communities. Conclusions/Importance: War on Drugs policing strategies appear to increase police brutality targeting Black communities, even as they make little progress in reducing street-level drug activity. Several jurisdictions are retreating from the War on Drugs; this retreat should include restoring rights originally protected by the 4th Amendment and Posse Comitatus. While these legal changes occur, police chiefs should discontinue the use of SWAT teams to deal with low-level nonviolent drug offenses and should direct officers to cease engaging in stop and frisk.

Grassroots responsiveness to human rights abuse: history of the Washtenaw Interfaith Coalition for Immigrant Rights.

The purpose of this article is to discuss how a community agency based in Washtenaw County, the Washtenaw Interfaith Coalition for Immigration Rights (WICIR), emerged in response to increasing punitive immigration practices and human rights abuses toward the Latino community. The article discusses how WICIR is engaged in advocacy, community education on immigration issues, and political action toward a more humane immigration reform. Detailed examples of human rights abuses and the WICIR activities described in response to the abuses serve as illustrations of social work advocacy, education, and policy formulation that affect the general public, policymakers, and law enforcement officials.

"Spitting is dangerous, indecent, and against the law!" legislating health behavior during the American tuberculosis crusade.

Tuberculosis was the leading cause of death in early twentieth-century America. Reducing the sputum vector of contagion by changing public behavior initially focused on anti-spitting campaigns. According to most Progressive Era health experts, "promiscuous" spitting was a prime culprit in spreading the disease. Beginning in 1896 in New York, towns and cities throughout America passed anti-spitting legislation, sometimes creating tensions between individual liberty and the need to protect public health, and often highlighting class issues. Progressives viewed anti-spitting legislation in a favorable light because they advocated improving the health and well-being of Americans using state-of-the-art medical knowledge and because they often advocated the use of law and the coercive power of the state to impose order on society.

Change is possible: the history of the international drug control regime and implications for future policymaking.

The article, based upon an extensive literature review, reconstructs and analyzes the parallel evolution of the international drug control regime and the world opiate market, assessing the impact of the former on the latter until the rise of present-day mass markets. It shows that, since its inception, the regime has focused almost entirely on matters of supply. However, that focus has not always meant "prohibition"; until 1961, the key principle of the regime was "regulation." Given the different forms drug control policy has taken in the past, the authors conclude it may be amenable to new forms in the future.

Illegal drugs, anti-drug policy failure, and the need for institutional reforms in Colombia.

This paper is inspired by two anomalies encountered in the study of the illegal drugs industry. First, despite the very high profits of coca/cocaine and poppy/opium/heroin production, most countries that can produce do not. Why, for example, does Colombia face much greater competition in the international coffee, banana, and other legal product markets than in cocaine? And second, though illegal drugs are clearly associated with violence, why is it that illegal drug trafficking organizations have been so much more violent in Colombia and Mexico than in the rest of the world? The answers to these questions cannot be found in factors external to Colombia (and Mexico). They require identifying the societal weaknesses of each country. To do so, the history of the illegal drugs industry is surveyed, a simple model of human behavior that stresses the conflict between formal (legal) and informal (socially accepted) norms as a source of the weaknesses that make societies vulnerable is formulated. The reasons why there is a wide gap between formal and informal norms in Colombia are explored and the effectiveness of anti-drug policies is considered to explain why they fail to achieve their posited goals. The essay ends with reflections and conclusion on the need for institutional change.

Outdoor brothel culture: the un/making of a transsexual stroll in Vancouver's West End, 1975­1984.

In the mid-1970s, following a series of police raids on prostitution inside downtown nightclubs, a community of approximately 200 sex workers moved into Vancouver's West End neighborhood, where a small stroll had operated since the early 1970s. This paper examines the contributions made by three male-to-female (MTF) transsexuals of color to the culture of on-street prostitution in the West End. The trans women's stories address themes of fashion, working conditions, money, community formation, violence, and resistance to well-organized anti-prostitution forces. These recollections enable me to bridge and enrich trans history and prostitution history ­ two fields of inquiry that have under-represented the participation of trans women in the sex industry across the urban West. Acutely familiar with the hazards inherent in a criminalized, stigmatized trade, trans sex workers in the West End manufactured efficacious strategies of harm reduction, income generation, safety planning, and community building. Eschewing the label of "victim", they leveraged their physical size and style, charisma, contempt towards pimps, earning capacity, and seniority as the first workers on the stroll to assume leadership within the broader constituency of "hookers on Davie Street". I discover that their short-lived outdoor brothel culture offered only a temporary bulwark against the inevitability of eviction via legal injunction in July 1984, and the subsequent rise in lethal violence against all prostitutes in Vancouver, including MTF transsexuals.

"Humanitarian aid is never a crime": humanitarianism and illegality in migrant advocacy.

I analyze the case of humanitarian pro-migrant activists in southern Arizona between 2000 and 2010 to explore how contending groups wield law and legality claims in a dynamic policy environment. Humanitarian activists both evade and engage the law. They appeal to a higher law to elude charges that they are acting illegally, while seeking assurances that their actions are within the law. Law enforcement agents rely on the authority and technical neutrality of the law in redefining humanitarian aid as illegal, while expanding their own claims to carry out humanitarian work. This case study of advocacy on behalf of "illegal" migrants highlights how both activists and those who enforce the law redefine legality in strategic ways.

"Stones run it": taking back control of organized crime in Chicago, 1940-1975.

In the 1960s and 1970s African American "supergangs" emerged in Chicago. Many scholars have touted the "prosocial" goals of these gangs but fail to contextualize them in the larger history of black organized crime. Thus, they have overlooked how gang members sought to reclaim the underground economy in their neighborhoods. Yet even as gangs drove out white organized crime figures, they often lacked the know-how to reorganize the complex informal economy. Inexperienced gang members turned to extreme violence, excessive recruitment programs, and unforgiving extortion schemes to take power over criminal activities. These methods alienated black citizens and exacerbated tensions with law enforcement. In addition, the political shelter enjoyed by the previous generation of black criminals was turned into pervasive pressure to break up street gangs. Black street gangs fulfilled their narrow goal of community control of vice. Their interactions with their neighbors, however, remained contentious.

Necropolitics, narcopolitics, and femicide: gendered violence on the Mexico-U.S. border.

In 1993, a group of women shocked Ciudad Juárez, Chihuahua, with the news that dozens of girls and women had been murdered and dumped, like garbage, around the city during the year. As the numbers of murders grew over the years, and as the police forces proved unwilling and unable to find the perpetrators, the protestors became activists. They called the violence and its surrounding impunity "femicide," and they demanded that the Mexican government, at the local, state, and federal levels, stop the violence and capture the perpetrators. Nearly two decades later, the city's infamy as a place of femicide is giving way to another terrible reputation as a place of unprecedented drug violence. Since 2006, more than six thousand people have died in the city, as have more than twenty-eight thousand across the country, in relation to the violence associated with the restructuring of the cartels that control the production and distribution of illegal drugs. In response to the public outcry against the violence, the Mexican government has deployed thousands of troops to Ciudad Juárez as part of a military strategy to secure the state against the cartels. In this essay, I argue that the politics over the meaning of the drug-related murders and femicide must be understood in relation to gendered violence and its use as a tool for securing the state. To that end, I examine the wars over the interpretation of death in northern Mexico through a feminist application of the concept of necropolitics as elaborated by the postcolonial scholar Achille Mbembe. I examine how the wars over the political meaning of death in relation both to femicide and to the events called "drug violence" unfold through a gendering of space, of violence, and of subjectivity. My objective is twofold: first, to demonstrate how the antifemicide movement illustrates the stakes for a democratic Mexican state and its citizens in a context where governing elites argue that the violence devastating Ciudad Juárez is a positive outcome of the government's war against organized crime; and second, to show how a politics of gender is central to this kind of necropolitics.

Watching the detectives: crime programming, fear of crime, and attitudes about the criminal justice system.

Research demonstrates a complex relationship between television viewing and fear of crime. Social critics assert that media depictions perpetuate the dominant cultural ideology about crime and criminal justice. This article examines whether program type differentially affects fear of crime and perceptions of the crime rate. Next, it tests whether such programming differentially affects viewers' attitudes about the criminal justice system, and if these relationships are mediated by fear. Results indicated that fear mediated the relationship between viewing nonfictional shows and lack of support for the justice system. Viewing crime dramas predicted support for the death penalty, but this relationship was not mediated by fear. News viewership was unrelated to either fear or attitudes. The results support the idea that program type matters when it comes to understanding people's fear of crime and their attitudes about criminal justice.

Race, urban governance, and crime control: creating model cities.

In the late 1960s and early 1970s, the city of Seattle received federal Department of Housing and Urban Development "Model cities" funds to address issues of racial disenfranchisement in the city. Premised under the "Great Society" ethos, Model cities sought to remedy the strained relationship between local governments and disenfranchised urban communities. Though police-community relations were not initially slated as an area of concern in the city's grant application, residents of the designated "model neighborhood" pressed for the formation of a law and justice task force to address the issue. This article examines the process and outcome of the two law-and-justice projects proposed by residents of the designated "model neighborhood": the Consumer Protection program and the Community Service Officer project. Drawing on the work of legal geographies scholars, I argue that the failure of each of these efforts to achieve residents' intentions stems from the geographical imagination of urban problems. Like law-and-order projects today, the geographical imagination of the model neighborhood produced a discourse of exceptionality that subjected residents to extraordinary state interventions. The Model cities project thus provides an example of a "history of the present" of mass incarceration in which the geographical imagination of crime helps facilitate the re-creation of a racialized power structure.

Domestic violence, poverty, and social services: does location matter?

Objective. This study investigates whether or not domestic violence agencies are located in areas of need. Recent research indicates that community economic disadvantage is a risk factor for intimate partner violence, but related questions regarding the geographic location of social service agencies have not been investigated.Methods. Using Connecticut as a case study, we analyze the relationship of agency location and police-reported domestic violence incidents and assaults using OLS regression and correcting for spatial autocorrelation.Results. The presence of an agency within a town has no relationship with the rates of domestic violence. However, regional patterns are evident.Conclusion. Findings indicate that programs are not geographically mismatched with need, but neither are programs located in towns with higher rates of incidents or assaults. Future research and planning efforts should consider the geographic location of agencies.