Mindfulness Reminds Us What Health Care Is For.

Could clinicians help people more if they were buddhas? This article considers what the late Thích Nhâ't Hanh meant in his call to "become buddhas" and applies Nhâ't Hanh's mindfulness practices to managing crises and anxiety in health care settings. This article also considers recovery strategies, techniques for becoming calm, and reminders about why stillness matters for compassionate practice in health care.

Neoliberalization's Propagation of Health Inequity in Urban Rebuilding Processes: The Dependence on Context and Path.

This article will discuss how neoliberal processes during urban redevelopment sustain and increase health inequities through uneven wealth accumulation and development. It will use examples of urban development in Baltimore, Maryland, United States, to highlight how key neoliberal strategies of territorial development, economic development, and place promotion- mediated through the process of creative destruction-result in uneven development and wealth accumulation, which in turn result in health inequities. The history of rebuilding processes in Baltimore offers insight into the context and path-dependency of current neoliberalization rebuilding processes and current health inequities.

Policing, Community Fragmentation, and Public Health: Observations from Baltimore.

Studies show that policing, when violent, and community fragmentation have a negative impact on health outcomes. This current study investigates the connection of policing and community fragmentation and public health. Using an embedded case study analysis, semi-structured interviews were conducted with 21 African-American female and male residents, ages 21-64 years of various neighborhoods of high arrest rates and health and socioeconomic depravation in Baltimore City, MD. Baltimore residents' perceptions of policing, stress, community fragmentation, and solutions are presented. Analysis of the perceptions of these factors suggests that violent policing increases community fragmentation and is a public health threat. Approaches to address this public health threat are discussed.

Application of space-time scan statistics to describe geographic and temporal clustering of visible drug activity.

Knowledge of the geographic and temporal clustering of drug activity can inform where health and social services are needed and can provide insight on the potential impact of local policies on drug activity. This ecologic study assessed the spatial and temporal distribution of drug activity in Baltimore, Maryland, prior to and following the implementation of a large urban redevelopment project in East Baltimore, which began in 2003. Drug activity was measured by narcotic calls for service at the neighborhood level. A space-time scan statistic approach was used to identify statistically significant clusters of narcotic calls for service across space and time, using a discrete Poisson model. After adjusting for economic deprivation and housing vacancy, clusters of narcotic calls for service were identified among neighborhoods located in Southeast, Northeast, Northwest, and West Baltimore from 2001 to 2010. Clusters of narcotic calls for service were identified among neighborhoods located in East Baltimore from 2001 to 2003, indicating a decrease in narcotic calls thereafter. A large proportion of clusters occurred among neighborhoods located in North and Northeast Baltimore after 2003, which indicated a potential spike during this time frame. These findings suggest potential displacement of drug activity coinciding with the initiation of urban redevelopment in East Baltimore. Space-time scan statistics should be used in future research to describe the potential implications of local policies on drug activity.

Race and ethnicity, mental health services and cultural competence in the criminal justice system: are we ready to change?

By the end of 2003, 3.2% of the U.S. adult population or 6.9 million adults were incarcerated, on probation or on parole. While non-whites constitute approximately 25% of the general U.S. population, they represent the majority of the prison (62%) and jail population (57%), a 33% increase since 1980. Approximately 15% of this prison and jail population has active symptoms of serious mental illness with two-thirds likely to have a co-occurring substance use disorder diagnosis. Meanwhile, the lack of adequate mental health and substance abuse treatment within all levels of the criminal justice system continues to exist. This is further exaggerated by the dearth of evidence showing appropriate cultural awareness and competence in delivery of these much needed services to a majority non-white population. This article will review the existing racial disparities present in the criminal justice system, the lack of appropriate psychiatric services, and the effect of cultural dissonance in service provision when services do exist. Policy implications and recommendations are included in the conclusion with a call for action to all agencies directly and indirectly affected by this multifaceted problem.