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Where More Americans Die at the Hands of Police

August 29, 2014 Comments off

Where More Americans Die at the Hands of Police
Source: The Atlantic (Richard Florida)

The death of 18-year-old Michael Brown at the hands of a Ferguson, Missouri, police officer has reintroduced police-related killings as a topic of major national debate. Brown is just the latest in a long line of young, unarmed black men killed by law enforcement agents.

It’s been widely reported that roughly 400 Americans die at the hands of police per year. And yet, that figure is likely a significant underestimate, as Reuben Fischer-Baum details at FiveThirtyEight.

We ask a slightly different question: Where are Americans more likely to die at the hands of police or while under arrest?

With the help of my colleagues Charlotta Mellander and Nick Lombardo of the Martin Prosperity Institute (MPI), we mapped data from two sources: “arrest related deaths” from the Department of Justice’s Bureau of Justice Statistics, and from the FBI’s annual Supplementary Homicide Report (SHR) on “felons killed by police.” We also got input from three leading American criminologists: Alfred Blumstein and Daniel Nagin, my former colleagues at Carnegie Mellon, and John Roman of the Urban Institute.

It’s important to reiterate that both data sources suffer from serious deficiencies, not the least of which is under-reporting. Roman worries about “reporting bias,” particularly the possibility that “more responsible agencies”—those least likely to use force in the first place—”are more likely to report, and less responsible agencies are less likely to report.” But he also adds that what looks like missing data may not be. “It might be that few policing agencies have an officer-involved shooting and the agencies that don’t simply don’t report any data,” he writes in an email.

But, taken together and in light of their limits, the maps are broadly suggestive of the geography of U.S. police killings as well as the states where arrests are likely to result in more deaths. As Roman puts it: “It is important to shine a light on the subject. Because there is such limited data, our ability to define the scope of the problem greatly limits our ability to form an appropriate response.”

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Heat Illness and Death Among Workers — United States, 2012–2013

August 28, 2014 Comments off

Heat Illness and Death Among Workers — United States, 2012–2013
Source: Morbidity and Mortality Weekly Report (CDC)

Exposure to heat and hot environments puts workers at risk for heat stress, which can result in heat illnesses and death. This report describes findings from a review of 2012‒2013 Occupational Safety and Health Administration (OSHA) federal enforcement cases (i.e., inspections) resulting in citations under paragraph 5(a)(1), the “general duty clause” of the Occupational Safety and Health Act of 1970. That clause requires that each employer “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees” (1). Because OSHA has not issued a heat standard, it must use 5(a)(1) citations in cases of heat illness or death to enforce employers’ obligations to provide a safe and healthy workplace. During the 2-year period reviewed, 20 cases of heat illness or death were cited for federal enforcement under paragraph 5(a)(1) among 18 private employers and two federal agencies. In 13 cases, a worker died from heat exposure, and in seven cases, two or more employees experienced symptoms of heat illness. Most of the affected employees worked outdoors, and all performed heavy or moderate work, as defined by the American Conference of Governmental Industrial Hygienists (2). Nine of the deaths occurred in the first 3 days of working on the job, four of them occurring on the worker’s first day. Heat illness prevention programs at these workplaces were found to be incomplete or absent, and no provision was made for the acclimatization of new workers. Acclimatization is the result of beneficial physiologic adaptations (e.g., increased sweating efficiency and stabilization of circulation) that occur after gradually increased exposure to heat or a hot environment (3). Whenever a potential exists for workers to be exposed to heat or hot environments, employers should implement heat illness prevention programs (including acclimatization requirements) at their workplaces.

Unexplained Deaths in Infancy: England and Wales, 2012

August 28, 2014 Comments off

Unexplained Deaths in Infancy: England and Wales, 2012
Source: Office for National Statistics

Key Points

  • 221 unexplained infant deaths occurred in England and Wales in 2012, a rate of 0.30 deaths per 1,000 live births.
  • Almost three-quarters (71%) of these unexplained deaths were recorded as sudden infant deaths, and 29% were recorded as unascertained.
  • Unexplained infant deaths accounted for 8% of all infant deaths occurring in 2012.
  • Eight out of ten unexplained infant deaths occurred in the post-neonatal period (between 28 days and 1 year).
  • Almost two-thirds (64%) of unexplained infant deaths were boys in 2012 (141 deaths).
  • The rate of unexplained infant death was three times higher among low birthweight babies (less than 2,500g) than babies with a normal birthweight (2,500g and over).

CA — The burden of premature opioid-related mortality

August 19, 2014 Comments off

The burden of premature opioid-related mortality
Source: Addiction

Background and Aims
The burden of premature mortality due to opioid-related death has not been fully characterized. We calculated temporal trends in the proportion of deaths attributable to opioids and estimated years of potential life lost (YLL) due to opioid-related mortality in Ontario, Canada.

Design
Cross-sectional study.

Setting
Ontario, Canada.

Participants
Individuals who died of opioid-related causes between January 1991 and December 2010.

Measurements
We used the Registered Persons Database and data abstracted from the Office of the Chief Coroner to measure annual rates of opioid-related mortality. The proportion of all deaths related to opioids was determined by age group in each of 1992, 2001 and 2010. The YLL due to opioid-related mortality were estimated, applying the life expectancy estimates for the Ontario population.

Findings
We reviewed 5935 opioid-related deaths in Ontario between 1991 and 2010. The overall rate of opioid-related mortality increased by 242% between 1991 (12.2 per 1 000 000 Ontarians) and 2010 (41.6 per 1 000 000 Ontarians; P < 0.0001). Similarly, the annual YLL due to premature opioid-related death increased threefold, from 7006 years (1.3 years per 1000 population) in 1992 to 21 927 years (3.3 years per 1000 population) in 2010. The proportion of deaths attributable to opioids increased significantly over time within each age group (P < 0.05). By 2010, nearly one of every eight deaths (12.1%) among individuals aged 25–34 years was opioid-related.

Conclusions
Rates of opioid-related deaths are increasing rapidly in Ontario, Canada, and are concentrated among the young, leading to a substantial burden of disease.

Left in the Dark: International Military Operations in Afghanistan

August 18, 2014 Comments off

Left in the Dark: International Military Operations in Afghanistan
Source: Amnesty International

Thousands of Afghan civilians have been killed since 2001 by international forces, and thousands more have been injured. This report examines the record of accountability for civilian deaths caused by international military operations in the five-year period from 2009 to 2013. In particular, it focuses on the performance of the US government in investigating possible war crimes and in prosecuting those suspected of criminal responsibility for such crimes. Its overall finding is that the record is poor.

Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010

July 31, 2014 Comments off

Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010 (PDF)
Source: National Center for Health Statistics

Objectives—
This report examines heat-related mortality, cold-related mortality, and other weather-related mortality during 2006–2010 among subgroups of U.S. residents.

Methods—
Weather-related death rates for demographic and area-based subgroups were computed using death certificate information. Adjusted odds ratios for weather-related deaths among subgroups were estimated using logistic regression.

Results and Conclusions—
During 2006–2010, about 2,000 U.S. residents died each year from weather-related causes of death. About 31% of these deaths were attributed to exposure to excessive natural heat, heat stroke, sun stroke, or all; 63% were attributed to exposure to excessive natural cold, hypothermia, or both; and the remaining 6% were attributed to floods, storms, or lightning. Weather-related death rates varied by age, race and ethnicity, sex, and characteristics of decedent’s county of residence (median income, region, and urbanization level). Adjustment for region and urbanization decreased the risk of heat-related mortality among Hispanic persons and increased the risk of cold-related mortality among non-Hispanic black persons, compared with non-Hispanic white persons. Adjustment also increased the risk of heat-related mortality and attenuated the risk of cold-related mortality for counties in the lower three income quartiles.

The differentials in weather-related mortality observed among demographic subgroups during 2006–2010 in the United States were consistent with those observed in previous national studies. This study demonstrated that a better understanding of subpopulations at risk from weather-related mortality can be obtained by considering area-based variables (county median household income, region, and urbanization level) when examining weather-related mortality patterns.

Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies

July 22, 2014 Comments off

Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies
Source: PLoS Medicine

Background
The prevalence of class III obesity (body mass index [BMI]≥40 kg/m2) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity.

Methods and Findings
In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios for adults, aged 19–83 y at baseline, classified as obese class III (BMI 40.0–59.9 kg/m2) compared with those classified as normal weight (BMI 18.5–24.9 kg/m2). Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema) on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976–2009). Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences = 238.9 and 132.8 in men and women, respectively), followed by deaths from cancer (rate differences = 36.7 and 62.3 in men and women, respectively) and diabetes (rate differences = 51.2 and 29.2 in men and women, respectively). Within the class III obesity range, multivariable-adjusted hazard ratios for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease, and influenza/pneumonia increased with increasing BMI. Compared with normal-weight BMI, a BMI of 40–44.9, 45–49.9, 50–54.9, and 55–59.9 kg/m2 was associated with an estimated 6.5 (95% CI: 5.7–7.3), 8.9 (95% CI: 7.4–10.4), 9.8 (95% CI: 7.4–12.2), and 13.7 (95% CI: 10.5–16.9) y of life lost. A limitation was that BMI was mainly ascertained by self-report.

Conclusions
Class III obesity is associated with substantially elevated rates of total mortality, with most of the excess deaths due to heart disease, cancer, and diabetes, and major reductions in life expectancy compared with normal weight.

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