An analysis of suicides among first responders ─ Findings from the National Violent Death Reporting System, 2015-2017.

INTRODUCTION: First responders, including law enforcement officers (LEOs), firefighters, emergency medical services (EMS) clinicians, and public safety telecommunicators, face unique occupational stressors and may be at elevated risk for suicide. This study characterized suicides among first responders and identifies potential opportunities for additional data collection. METHODS: Using suicides identified from the three most recent years of National Violent Death Reporting System data with industry and occupation codes from the NIOSH Industry and Occupation Computerized Coding System (2015-2017), decedents were categorized as first responders or non-first responders based on usual occupation. Chi-square tests were used to evaluate differences in sociodemographic and suicide circumstances between first and non-first responders. RESULTS: First responder decedents made up 1% of all suicides. Over half of first responders (58%) were LEOs, 21% were firefighters, 18% were EMS clinicians, and 2% were public safety telecommunicators. Compared to non-first responder decedents, more first responders served in the military (23% vs. 11%) and used a firearm as the method of injury (69% vs. 44%). Among first responder decedents for whom circumstances were known, intimate partner problems, job problems, and physical health problems were most frequent. Some common risk factors for suicide (history of suicidal thoughts, previous suicide attempt, alcohol/substance abuse problem) were significantly lower among first responders. Selected sociodemographics and characteristics were compared across first responder occupations. Compared to firefighters and EMS clinicians, LEO decedents had slightly lower percentages of depressed mood, mental health problems, history of suicidal thoughts, and history of suicide attempts. CONCLUSIONS: While this analysis provides a small glimpse into some of these stressors, more detailed research may help inform future suicide prevention efforts and interventions. PRACTICAL APPLICATION: Understanding stressors and their relation to suicide and suicidal behaviors can facilitate suicide prevention among this critical workforce.

Investing in the Next Generation of Maternal and Child Health Leaders: The APHA Maternal and Child Health Section Student Fellows Program.

PURPOSE: Practical experience in maternal and child health (MCH) settings is critical for professional development and learning. In 2002, the Maternal and Child Health (MCH) Section of the American Public Health Association (APHA) formalized its inclusion of students in section activities through the establishment of the Student Fellows Program. The Program provides graduate-level students opportunities to learn about MCH and APHA, build professional networks, and develop leadership skills. DESCRIPTION: Since its inception, 18 cohorts of Fellows have benefited. This paper presents findings describing the Program from both written records about Fellow projects and activities recorded in past MCH Section communications as well as an online survey that was distributed to former and current Fellows to assess their perceptions and the benefits of the Student Fellows Program. ASSESSMENT: Eighteen cohorts of Fellows have engaged with Section committees and working groups in diverse ways, including MCH-related research, policy, advocacy, and education. An online survey distributed to 151 participants was answered by 79 to document their perceptions of the Student Fellows Program. Of them, 56 (71%) indicated that the Program was important for their career development, 44 (55%) reported being current members of the APHA MCH Section, and 21 (27%) reported serving in a leadership position in the Section. The Fellows highlighted that networking, mentorship and leadership development were key benefits of the Student Fellows Program. CONCLUSION: After several years of involving students in its programs, the APHA MCH Section established the Student Fellows Program in 2002. The Fellows Program has been important for developing the next generation of MCH leaders. The findings suggest that this Program supports long-term interest and commitment to the field of MCH and contributed to the formation of leadership skills and behaviors of Fellows.

Activity Spaces: Assessing Differences in Alcohol Exposures and Alcohol Use for Parents.

Parental alcohol use and alcohol outlet densities in residential areas are related to risk for child maltreatment. However, some parents spend significant time outside of their residential neighborhood. Thus, we may not be accurately assessing how alcohol environments are related to risks for problematic parenting. Here, we examine how residential environments and activity spaces are related to outlet density and whether drinking events in our sample of parents differ by location (e.g., routine vs. rare locations) and whether their children are present. We conducted semi-structured interviews with 60 parents living in four cities in the San Francisco Bay area who provided information on where they spent time, where they drank, and whether children were present. We constructed measures of activity spaces (e.g., convex hull polygons) and activity patterns (e.g., shortest network distance) and calculated outlet density in each. Density of alcohol outlets for residential Census tract was not related to density of the activity space and activity pattern measures. Alcohol use occurred more frequently (regardless of whether their children were present) inside activity spaces operationalized as convex hull polygons or two standard deviational ellipses. Measures that capture larger activity space areas (e.g., convex hull polygons, two standard deviational ellipses) may better model where people spend time, regardless of whether the location is routine or rare. By continuing to use activity spaces to explore relationships between outlet densities, drinking behaviors, and problems, we can start to ascertain those mechanisms by which outlets may affect local problems.