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Date: November 25, 2024 Mon
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Results for public health approach
5 results foundAuthor: Foundation for Alcohol Research Education Title: Policy options paper: Preventing alcohol-related family and domestic violence Summary: Family and domestic violence (FDV) often occurs in the home, where one should feel safest, perpetrated by a loved one, with whom one should feel safest. It is sometimes a one off event but is often a pattern of behaviour characterised by one person exerting power and control over another in the context of an intimate partnership or within a family situation. FDV may persist for years and sometimes involves multiple forms of abuse. In Australia at least one woman dies each week at the hands of her partner or ex-partner2 and a significant number of children die as a result of abuse and neglect, although exact figures are not known.3 FDV can happen to anyone regardless of gender, sexuality, class, culture or family type. Some communities are more likely to experience FDV and may find it difficult to access mainstream support that meets their needs. Aboriginal and Torres Strait Islander women; culturally and linguistically diverse (CALD) women; lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people and families; women with a disability; and older and young women, all face significant barriers to identifying FDV, seeking help and accessing culturally appropriate support. The impacts of FDV include complex trauma, physical injuries, poor mental health and the development of behaviours that are harmful to health such as alcohol misuse.4 These impacts are cumulative, with the frequency and severity of abuse being associated with greater physical and mental health impacts on the victim.5 The impacts of trauma may also persist long after the abuse has stopped.6 The effects of violence and abuse also go beyond those directly involved. Witnesses are often traumatised. In many cases it is children who witness these events. This sometimes results in children themselves growing up to use violence. They are also more likely to experience domestic violence themselves. These children can also grow up to experience alcohol and other drug issues in their lives.7 FDV impacts on children whether or not they witness it. It is more difficult to estimate the impacts of FDV on other family members and communities, but again there is significant evidence to suggest that FDV has widespread immediate and intergenerational consequences. FDV, and particularly violence between intimate partners, is not a gender neutral issue. Domestic violence is overwhelmingly perpetrated by men against women.8 This is due to the unequal power dynamics between women and men, the gendered distribution of resources, and an "adherence to rigidly defined gender roles expressed institutionally, culturally, organisationally and individually."9 Child maltreatment is also more likely to be perpetrated by males than females.10 The interplay between alcohol and FDV is complex. Alcohol is a contributing factor to FDV, increasing both the likelihood of violence occurring and the severity of harms.11 Alcohol misuse can cause or exacerbate relationship stressors thereby increasing the probability of violence. Alcohol use can be both a consequence to and precursor of relationship stress and violence. Alcohol use also affects cognitive functioning and physical functioning, 12 affecting the likelihood of perpetration, and making those who are impacted by FDV more vulnerable. Some perpetrators of violence may try to blame the misuse of alcohol and/or drugs or use intoxication as an excuse. This is not the case. Alcohol use and intoxication are never an excuse for violence. Victims may use alcohol as a coping mechanism for dealing with trauma and pain. There are also intergenerational impacts, with children who witness domestic violence being more likely to have problems with alcohol later in life.13 Alcohol is involved in a significant proportion of reported domestic violence and child protection incidents. In 2010-11 there were 29,684 reported incidents of alcohol-related domestic violence to police across four Australian states; Victoria, New South Wales (NSW), Western Australia (WA) and the Northern Territory (NT).14 Due to challenges with data collection across all jurisdictions, as well as under-reporting of these crimes, these figures are likely to be significant underestimates. This equates to approximately half of domestic assaults reported to police involving alcohol. In addition, a carer's alcohol use is a factor for 10,166 children in the child protection system.15 Australia is committed to addressing FDV by being a signatory to the Convention on the Elimination of All Forms of Discrimination Against Women, the Declaration to End Violence Against Women and the Beijing Declaration. 16 The association between alcohol and FDV has been recognised by the World Health Organization (WHO), which has identified action on alcohol misuse as one of several strategies to reduce violence against women and children. 17 , 18 There is also recognition of the association between alcohol and FDV by Australian Governments. National, as well as some state and territory, strategies and frameworks have acknowledged the role of alcohol in FDV and have recognised the need to address alcohol as part of an overall strategy to reduce FDV. However, to date, there has been a lack of coordinated action to bring these strategies together to produce effective policies and programs. This Policy Options Paper draws on the following principles based on the literature of what is known about alcohol-related FDV in Australia and internationally. These principles are: x The consumption of alcohol is never an excuse for violence. x Policies that address gender inequalities and alcohol misuse are critical to reducing FDV. x The WHO socio-ecological model acknowledges that no single factor explains why people engage in violence, instead there are multiple factors, at the individual, relationship, community and societal levels. Responses to FDV need to be targeted at all levels. x No single response is likely to reduce alcohol-related FDV. Australia needs a comprehensive and coordinated approach to address alcohol-related FDV, as part of an overall strategy to reduce violence against women and children. x A public health approach is needed to reduce alcohol-related FDV, with a focus on prevention across the spectrum, including primordial prevention, primary prevention, secondary prevention and tertiary prevention. Details: Deakin, ACT: FARE, 2015. 86p. Source: Internet Resource: Accessed April 3, 2018 at: http://www.fare.org.au/wp-content/uploads/research/FARE-Policy-Options-Paper-Preventing-alcohol-related-FDV.pdf Year: 2015 Country: Australia URL: http://www.fare.org.au/wp-content/uploads/research/FARE-Policy-Options-Paper-Preventing-alcohol-related-FDV.pdf Shelf Number: 149661 Keywords: Alcohol AbuseDomestic ViolenceFamily ViolenceIntimate Partner ViolencePublic Health ApproachViolence Prevention |
Author: Drug Policy Alliance Title: An Overdose Death is Not a Murder: Why Drug-Induced Homicide Laws are Counterproductive and Inhumane Summary: The country is in the middle of a tragic increase in drug overdose deaths. Countless lives have been lost - each one leaving an irreparable rift in the hearts and lives of their families and friends. These tragedies are best honored by implementing evidence-based solutions that help individuals, families, and communities heal and that prevent additional avoidable deaths. This report examines one strategy that the evidence suggests is intensifying, rather than helping, the problem and calls for leaders to turn towards proven measures to address the increasing rates of overdose deaths. In the 1980s, at the height of the draconian war on drugs, the federal government and a host of states passed "drug-induced homicide" laws intended to punish people who sold drugs that led to accidental overdose deaths with sentences equivalent to those for manslaughter and murder. For the first 15-20 years, these laws were rarely used by police or prosecutors, but steadily increasing rates of drug overdose deaths across the country have led the law enforcement community to revive them. Currently, 20 states - Delaware, Colorado, Florida, Illinois, Kansas, Louisiana, Michigan, Minnesota, New Hampshire, New Jersey, North Carolina, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Vermont, Washington, West Virginia, Wisconsin, and Wyoming - have drug-induced homicide laws on the books. A number of other states, while without specific drug-induced homicide statutes, still charge the offense of drug delivery resulting in death under various felony-murder, depraved heart, or involuntary or voluntary manslaughter laws. These laws and prosecutions have proliferated despite the absence of any evidence of their effectiveness in reducing drug use or sales or preventing overdose deaths. In fact, as this report illustrates, these efforts exacerbate the very problem they seek to remediate by discouraging people who use drugs from seeking help and assistance. Although data are unavailable on the number of people being prosecuted under these laws, media mentions of drug-induced homicide prosecutions have increased substantially over the last six years. In 2011, there were 363 news articles about individuals being charged with or prosecuted for drug-induced homicide, increasing over 300 percent to 1,178 in 2016. Based on press mentions, use of drug-induced homicide laws varies widely from state to state. Since 2011, midwestern states Wisconsin, Ohio, Illinois, and Minnesota have been the most aggressive in prosecuting drug-induced homicides, with northeastern states Pennsylvania, New Jersey, and New York and southern states Louisiana, North Carolina, and Tennessee rapidly expanding their use of these laws. Further signaling a return to failed drug war tactics, in 2017 alone, elected officials in at least 13 states - Connecticut, Idaho, Illinois, Maine, Maryland, Massachusetts, New Hampshire, New York, Ohio, South Carolina, Tennessee, Virginia, and West Virginia - introduced bills to create new drug-induced homicide offenses or strengthen existing drug-induced homicide laws. Prosecutors and legislators who champion renewed drug-induced homicide enforcement couch the use of this punitive measure, either naively or disingenuously, as necessary to curb increasing rates of drug overdose deaths. But there is not a shred of evidence that these laws are effective at reducing overdose fatalities. In fact, death tolls continue to climb across the country, even in the states and counties most aggressively prosecuting drug-induced homicide cases. As just one example, despite ten full-time police officers investigating 53 potential drug-induced homicide cases in Hamilton County, Ohio in 2015, the county still recorded 100 more opioid-related overdose deaths in 2016 than in 2015. This should be unsurprising. Though the stated rationale of prosecutors and legislators throughout the country is that harsh penalties like those associated with drug-induced homicide laws will deter drug selling, and, as a result, will reduce drug use and related harms like overdose, we have heard this story before. Drug war proponents have been repeating the deterrence mantra for over 40 years, and yet drugs are cheaper, stronger, and more widely available than at any other time in US history. Supply follows demand, so the supply chain for illegal substances is not eliminated because a single seller is incarcerated, whether for drug-induced homicide or otherwise. Rather, the only effect of imprisoning a drug seller is to open the market for another one. Research consistently shows that neither increased arrests nor increased severity of criminal punishment for drug law violations results in less use (demand) or sales (supply). In other words, punitive sentences for drug offenses have no deterrent effect. Unfortunately, the only behavior that is deterred by drug-induced homicide prosecutions is the seeking of life-saving medical assistance. Increasing, and wholly preventable, overdose fatalities are an expected by-product of drug-induced homicide law enforcement. The most common reason people cite for not calling 911 in the event of an overdose is fear of police involvement. Recognizing this barrier, 40 states and the District of Columbia have passed "911 Good Samaritan" laws, which provide, in varying degrees, limited criminal immunity for drug-related offenses for those who seek medical assistance for an overdose victim. This public health approach to problematic drug use, however, is rendered useless by enforcement of drug-induced homicide laws. People positioned to save lives are unlikely to call 911 if they fear being charged with murder or manslaughter. Jennifer Marie Johnson called 911 when her husband overdosed after she gave him methadone; she is currently serving six years in Minnesota prison for drug-induced homicide. Erik Scott Brown received an enhanced sentence of 23 years in federal prison partly because he failed to call 911 after a friend, whom he had supplied with one tenth of a gram of heroin, fatally overdosed. According to his testimony, the reason he did not call 911 was because drugs were present at the scene. Prosecutors - by their own admissions - want to make "examples" of these types of cases. But elevating punishments for drug-induced homicide charges has a chilling effect on seeking medical assistance and, as a result, leads to more, not fewer, avoidable overdose fatalities. This is especially true when police and prosecutors widely abuse their discretion in investigating and prosecuting drug-induced homicide cases. The vast majority of charges are sought against those in the best positions to seek medical assistance for overdose victims - family, friends, acquaintances, and people who sell small amounts of drugs, often to support their own drug addiction. Despite police and prosecutor promises to go after upper echelon drug manufacturers and distributors, that rarely happens. Out of the 32 drug-induced homicide prosecutions identified by the New Jersey Law Journal in the early 2000s, 25 involved prosecution of friends of the decedent who did not sell drugs in any significant manner. After analyzing the 100 most recent cases of drug-induced homicide in southeastern Wisconsin (as of February 2017), Wisconsin's Fox6 reported that nearly 90 percent of those charged were friends or relatives of the person who died, or the lowest people in the drug supply chain, who were often selling to support their own substance use disorder. A Chicago Tribune review of drug-induced homicide cases between 2011 and 2014 in various Illinois counties showed that the defendant was typically the last person who was with the person who overdosed. Law enforcement must be held accountable for this appalling misuse of discretion; particularly when it discourages the seeking of medical care and wastes resources that could otherwise be spent on interventions that have actually been proven successful at reducing overdose deaths. Unchecked police and prosecutorial discretion in drug-induced homicide cases is particularly ominous given the severity of sentences and the racist history of drug war enforcement. Although rates of drug use and selling are comparable across racial lines, black and Latino people are far more likely to be stopped, searched, arrested, prosecuted, convicted and incarcerated for drug law violations than are white people. When, in response to the overdose crisis, Maine Governor Paul Le Page states that "black dealers" and "guys with the name D-Money, Smoothie, Shifty" are the root of the problem by bringing drugs from places like Brooklyn into his rural state, he lays it bare. Most elected officials and prosecutors advocating a punishment-oriented approach to a public health crisis are more careful with their language than Le Page - targeting "pushers" and "those people" - but the implication is the same. Enforcement of drug war policies has historically targeted black and Latino communities, and drug-induced homicide prosecutions appear to follow this pattern. While comprehensive data are not available, the district attorney of one predominantly white suburban county in Illinois with a black population of only 1.6 percent has charged four black men from Chicago with drug-induced homicide (making up 35 percent of the total prosecutions), and one prosecutor in Minnesota appears to have charged predominately black people with drug-induced homicide. Though we cannot draw any conclusions from these sparse facts, if law enforcement utilizes drug-induced homicide like it has other tools of the drug war, we can reasonably expect that the result will be future cases like James Linder's, a black man from Chicago who is serving 28 years in federal prison after being sentenced by an all-white jury in rural Illinois. Unfortunately, the harms of a highly punitive response to drug use and sales expand far beyond the effects of the actual punishment. Indeed, criminalizing people who sell and use drugs, through means like drug-induced homicide charges, amplifies the risk of fatal overdoses and diseases by increasing stigma and marginalization and driving people away from needed medical care, treatment, and harm reduction services. On the other hand, proven strategies are available to reduce the harms associated with drug misuse, treat dependence and addiction, improve immediate overdose responses, enhance public safety, and prevent fatalities. These strategies include expanding access to the life-saving medicine naloxone and training in how to administer it; enacting and implementing legal protections that encourage people to call for medical help for overdose victims; training people how to prevent, recognize, and respond to an overdose; increasing access to opioid agonist treatment such as methadone and buprenorphine, and to other effective, non-coercive drug treatments; authorizing drug checking and safe consumption sites; and improving research on promising drug treatments. Each of these strategies has evidence to support its effectiveness. Drug-induced homicide laws have none. They have not proven successful at either reducing overdose deaths or curtailing the use or sale of illegal drugs. And yet, ironically, prosecutors and legislators wield this punitive sword with impunity. They are not required to show results in support of their faulty rationale, and they are not held accountable for utterly wasted resources. We simply cannot let our elected officials off the hook that easily anymore. Not when it could be your child, friend or, simply, fellow human being, who dies from a drug overdose or is locked up for murder due to our elected officials' failures to embrace proven, life-saving public health interventions in favor of wasteful, destructive punishments. Details: Washington, DC: Drug Policy Alliance, 2017. 80p. Source: Internet Resource: Accessed January 11, 2019 at: https://www.drugpolicy.org/sites/default/files/dpa_drug_induced_homicide_report_0.pdf Year: 2017 Country: United States URL: http://www.drugpolicy.org/resource/DIH Shelf Number: 154109 Keywords: 911 Good Samaritan LawsDrug DealersDrug Overdose DeathDrug War PoliciesDrug-Induced Homicide Evidence-Based SolutionsOpioidsProsecutorial DiscretionPublic Health Approach |
Author: British Columbia Centre on Substance Use Title: Heroin Compassion Clubs: A cooperative model to reduce opioid overdose deaths & disrupt organized crime's role in fentanyl, money laundering & housing unaffordability Summary: In British Columbia, the fabric of society is fraying. The morgues are full of community members who have died of opioid overdoses as a result of fentanyl poisoning of the illicit drug supply. For the first time in recent history, the life expectancy in British Columbia is decreasing due to extreme rates of overdose deaths. Behind this public health crisis are powerful organized crime groups reaping billions from the illegal fentanyl trade and targeting the local real estate market to launder drug profits, contributing to the housing affordability crisis. The causal relationship between drug prohibition and transnational organized crime's growth is well known and has been clearly articulated, while all available evidence indicates that efforts to curtail the fentanyl supply through drug law enforcement have failed. Instead, prohibition has enriched organized crime groups to the point where recent reports suggest as much as $5 billion annually in drug and organized crime profits is laundered through Vancouver-area real estate in recent years. In the face of this reality, this report describes a model that has the immediate potential to address the underlying structural basis that has led to unprecedented levels of organized crime profits, unaffordable housing and opioid poisonings. This model is inspired by cannabis compassion clubs and buyers clubs, both of which emerged in the 1980s and 1990s in response to the AIDS epidemic-the last public health emergency our province faced. Then as now, compassion clubs functioned to provide a safe place for people to access medical cannabis and connect with a range of health services, while buyers clubs procured lifesaving treatment for patients living with HIV and AIDS when government inaction limited access to these medicines. Similar small user-driven underground initiatives to ensure access to heroin exist today, but they are risky, illegal and without a secure supply of fentanyl-unadulterated heroin. This severely limits access and sustainability. This report proposes evaluating an updated model to these patient-led responses: a cooperative approach through which heroin could be restricted to members and legally obtained from a pharmaceutical manufacturer and securely stored in much the same way as it is already obtained and stored for heroin prescription programs, while also undertaking scientific evaluation to assess impacts. A cooperative could undermine the illegal market wherever it is set up. It could be initiated at little to no operating cost to the public, with the potential to reduce fentanyl-related opioid poisonings and decrease the spread of opioid addiction in the province. Details: Vancouver, BC: The Centre, 2019. 36p. Source: Internet Resource: Accessed March 5, 2019 at: http://www.bccsu.ca/wp-content/uploads/2019/02/Report-Heroin-Compassion-Clubs.pdf Year: 2019 Country: Canada URL: http://www.bccsu.ca/wp-content/uploads/2019/02/Report-Heroin-Compassion-Clubs.pdf Shelf Number: 154809 Keywords: Drug Legalization Drug Overdose Drug Policy Fentanyl Heroin Opioid Epidemic Opioids Organized Crime Public Health Approach |
Author: McVeigh, Clare Title: Violent Britain: People, Prevention and Public Health Summary: The report brings together UK information on youth violence, intimate partner violence, child maltreatment, elder abuse and sexual violence. Key statistics from the report's executive summary include: There are 2.7 million incidents of violence every year in England and Wales. Assault is the second leading cause of hospital admissions in England for young males aged 15-24; Overall costs of intimate partner violence estimated to be L23 billion per year; Almost half of 10-14 year olds have suffered bullying at school; A quarter of women and 5% of men have experienced some form of sexual assault in their lifetime. Both the conference and report aim to promote a public health approach to violence by focusing the attention of health, education, judicial and other public sector agencies on violence prevention. To raise awareness about violence and its causes, the conference included presentations on international examples of violence prevention and local examples of violence prevention research, prevention strategies and interventions for victims Professor Mark Bellis, co-author of the report and Director of the Centre for Public Health, said, "Violence is not just a criminal justice issue. The conference and report are intended to expand understanding of violence across all public services, to help them identify those at risk of violence and to increase their role in its prevention. Individuals are often locked into cycles of violence where young victims become perpetrators of violence later in life. Breaking this cycle requires working with parents, schools and health services to ensure violence and its causes are removed at the earliest possible stages." Professor John Ashton, Regional Director of Public Health, continued, "We have become so familiar with heart disease and cancer that we have overlooked the importance of violence and its cost to the National Health Service. Alcohol and violence are frequently linked, and together they are blighting our efforts to regenerate our cities. They cost a fortune and are a major cause of death. Urgent action is needed to address them and we need to tackle the underlying causes such as poverty and unemployment. We also need to address precipitating factors such as the ready availability of knives, guns and alcohol and we need to enlist the support of the public. The experience of many countries, not least South American countries and, to a certain extent, Northern Ireland, is that violence is reduced when the public say that enough is enough". Professor Qutub Syed, Director of the Health Protection Agency North West, said, "Violence is often directed at the most vulnerable members of society, including women, young children and older people who are often not in a position to defend themselves. There is an onus on all of us as good neighbours and professionals to make a stand against violence and do all we can to prevent it. The conference will highlight the destructive and costly influence of violence in society, enable us to learn about the experiences of other countries and hopefully to recommend solutions to what has become a pernicious problem." Dominic Harrison, Associate Director for the Health Development Agency, explained, "This is the first conference of its kind in the UK and it could not be more timely. Deaths, injury, decreased community cohesion and well-being are all outcomes of an increasing tide of violence affecting us all. The causes and manifestations of this growing social epidemic are multiple, and prevention will require a detailed evidence-based understanding of what can be done. With speakers from across the world, this conference will review what is known of the causes and what might work to address them." Details: Liverpool: Centre for Public health, Liverpool John Moores University, 2005. 154p. Source: Internet Resource: Accessed march 12, 2019 at: https://www.injuryobservatory.net/wp-content/uploads/2012/09/Violence-Research-2005-Violent-Britain.pdf Year: 2005 Country: United Kingdom URL: https://www.injuryobservatory.net/wp-content/uploads/2012/09/Violence-Research-2005-Violent-Britain.pdf Shelf Number: 154901 Keywords: Child Abuse and Neglect Child Maltreatment Elder Abuse Intimate Partner Violence Public Health ApproachSexual Violence Violence Violent Crime Youth Violence |
Author: National Academies of Sciences, Engineering, and Medicine Title: Health Systems Intervention to Prevent Firearm Injuries and Death: Proceedings of a Workshop Summary: Firearm injuries and death are a serious public health concern in the United States that place a burden on individuals, communities, and health care systems. At the suggestion of Kaiser Permanente, and with the support of both Kaiser Permanente and the American Hospital Association, the Board on Population Health and Public Health Practice of the National Academies of Sciences, Engineering, and Medicine convened a workshop that examined the roles that health systems can play in addressing the epidemic of firearm violence in the United States. This workshop proceedings highlights the presentations on firearm violence prevention research and programs as well as discussion of what health systems can do to address firearm violence in the United States. Details: Washington, DC: National Academy of Sciences, 2019. 126p. Source: Internet Resource: Accessed May 2, 2019 at: http://www.nationalacademies.org/hmd/Reports/2019/health-systems-interventions-prevent-firearm-injuries-death.aspx Year: 2019 Country: United States URL: http://www.nationalacademies.org/hmd/Reports/2019/health-systems-interventions-prevent-firearm-injuries-death.aspx Shelf Number: 155610 Keywords: Firearm Violence Gun Violence Gun-Related Violence Guns Homicides Injuries Public Health ApproachViolent Crime |