Association of Neighborhood Violent Crime With Hypertension-Related Emergency Department Visits in Chicago.

The Impact of Heat Waves on Emergency Department Visits in Roanoke, Virginia

While recent studies have demonstrated an overall increase in psychiatric visits in the emergency department (ED), none have focused on a nationally representative pediatric population. Understanding trends in pediatric psychiatric ED visits is important because of limited outpatient availability of pediatric specialists, as well as long wait times for psychiatric appointments. The study aim was to evaluate the trends in ED psychiatric visits for children between 2001 and 2010 with comparison by sociodemographic characteristics. This was a retrospective, cross-sectional analysis of ED psychiatric visits for children<18years of age using the National Hospital Ambulatory Medical Care Survey (NHAMCS). Visits were identified by International Classification of Diseases, Ninth Revision (ICD-9), codes. Outcome measures included frequency of visits for children with psychiatric diagnosis codes and odds and adjusted odds of psychiatric visits controlling for temporal, demographic, and geographic factors. From 2001 to 2010, an average of 28.3 million pediatric visits to EDs occurred annually. Among those, an approximately 560,000 (2% of ED visits) were psychiatric visits each year. Pediatric psychiatric ED visits increased from an estimated 491,000 in 2001 to 619,000 in 2010 (p=0.01). Teenagers (adjusted odds ratio [AOR]= 3.92, 95% confidence interval [CI]=3.37 to 4.57) and publicly insured patient visits (AOR= 1.47, 95% CI=1.25 to 1.74) had increased odds of psychiatric ED visits. Pediatric ED psychiatric visits are increasing. Teenagers and children with public insurance appear to be at increased risk. Further investigation is needed to determine what the causative factors are.

BACKGROUNDSeveral studies have demonstrated that the coronavirus disease 2019 (COVID-19) has affected daily living and the healthcare system. No previous study has described the consequences of COVID-19 on emergency department (ED) visits and hospital admission among kidney transplant (KT) recipients.AIMTo investigate the impact of the COVID-19 pandemic on ED visits and hospital admissions within 1 year in patients who underwent KT in Thailand.METHODSWe conducted a retrospective study at a university hospital in Thailand. We reviewed the hospital records of KT patients who visited the ED during the outbreak of COVID-19 (from January 2020 to December 2021). We used the previous 2 years as the control period in the analysis. We obtained baseline demographics and ED visit characteristics for each KT patient. The outcomes of interest were ED visits and ED visits leading to hospital admission within the 1st year following a KT. The rate of ED visits and ED visits leading to hospital admissions between the two periods were compared using the stratified Cox proportional hazards model.RESULTSA total of 263 patients were included in this study: 112 during the COVID-19 period and 151 during the control period. There were 34 and 41 ED visits after KT in the COVID-19 and control periods, respectively. The rate of first ED visit at 1 year was not significantly different in the COVID-19 period, compared with the control period [hazard ratio (HR) = 1.02, 95% confidence interval (CI): 0.54-1.92; P = 0.96]. The hospital admission rate was similar between periods (HR = 0.92, 95%CI: 0.50-1.69; P = 0.78).CONCLUSIONED visits and hospital admissions within the 1st year in KT recipients were not affected by the COVID-19 pandemic. Despite these findings, we believe that communication between post-KT patients and healthcare providers is essential to highlight the importance of prompt ED visits for acute health conditions, particularly in post-KT patients.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has impacted various aspects of daily living and has influenced the life of every individual in a unique way. Acute myocardial infarction (AMI) is associated with high morbidity and mortality; thus, timely treatment is crucial to prevent poor prognosis. Therefore, an immediate emergency department (ED) visit is required; however, no domestic studies have reported the effect of COVID-19 on ED visits by patients with AMI. Therefore, this study aimed to assess the changes in the pattern of ED visits by patients with AMI by comparing visits during the COVID-19 outbreak period to those during two control periods.MethodsThis nationwide, retrospective study used registry data of the National Emergency Department Information System. The ‘outbreak period’ was defined as the period between February 21, 2020 and April 1, 2020, while the ‘control period’ was defined as the same time period in the preceding two years (2018 and 2019). The primary outcome of our study was the number of patients admitted to the ED owing to AMI during the outbreak and control periods. Secondary outcomes were time from symptom onset to ED visit, length of ED stay, and 30-day mortality following admission.ResultsDuring the outbreak period, 401,378 patients visited the ED; this number was lower than that during the control periods (2018: 577,548; 2019: 598,514). The number of patients with AMI visiting the ED was lower during the outbreak period (2,221) than during 2018 (2,437) and 2019 (2,591).ConclusionThe COVID-19 pandemic has caused a reduction in ED visits by patients with AMI. We assume that this could likely be caused by misinterpretation of AMI symptoms as symptoms of respiratory infection, fear of contracting severe acute respiratory syndrome coronavirus 2, and restrictions in accessing emergency medical care owing to overburdened healthcare facilities. This study sheds light on the fact that healthcare and emergency medical staff members must work towards eliminating hurdles due to this pandemic for patients to receive timely emergency care, which in turn will help curb the growing burden of mortality.

Punitive criminal justice policies caused incarceration and reentry rates to sharply increase in the era of mass incarceration. Disadvantaged communities of color have been disproportionately affected by those policies through heightened levels of prison cycling, which is the flow of individuals into and out of prison. Community-level prison cycling has harmful neighborhood consequences, including increased violent crime. This Boston-based study investigates how prison cycling influences crime by exploring three potential pathways. First, prison cycling may undermine beneficial social behavior, reduce collective efficacy, and create an environment susceptible to crime; second, prison cycling may stimulate neighborhood social problems that encourage crime; and third, prison cycling may simply have a direct, toxic relationship with neighborhood violent crime. The analysis employs Boston crime and prison cycling data,and neighborhood social environment data from the 2008 Boston Neighborhood Survey. Contrary to existing theoretical and empirical research, results suggest that prison cycling is not associated with collective efficacy. However, results indicate that prison cycling predicts neighborhood social problems and community violent crime, offering support for alternative theories on the prison cycling and crime relationship. The study concludes with recommendations for future research and policy implications.

The influence of neighborhood violent crime on child-rearing: Integrating neighborhood ecologies and stratified reproduction approaches.

The effect modification of extreme temperatures on mental and behavior disorders by environmental factors and individual-level characteristics in Canada

BackgroundNeighborhood racial mix is associated with dialysis facility performance metrics and mortality outcomes in patients on hemodialysis. We explored the association of neighborhood racial mix with emergency department (ED) visits in patients receiving hemodialysis.MethodsUsing Looking Glass (Montefiore’s clinical database) we identified a cohort of patients on hemodialysis with an index ED visit at any of 4 Montefiore Hospital locations, between January 2013 and December 2017 and followed it for number of ED visits through December of 2017 or dropout due to death. The racial mix data for the Bronx block group of each subject’s residence was derived from the Census Bureau. We then used negative binomial regression to test the association of quintile of percent of Black residents per residential block group with ED visits in unadjusted and adjusted models. To adjust further for quality offered by local dialysis facilities, with the facility zip code as the locus, we used data from the “Dialysis Compare” website.ResultsThree thousand nine-hundred and eighteen subjects were identified and the median number of ED visits was 3 (interquartile range (IQR) 1–7) during the study period. Subjects living in the highest quintile of percent Black residents were older, more commonly female and had lower poverty rates and higher rates of high school diplomas. Unadjusted models showed a significant association between the highest quintiles of Black neighborhood residence and count of ED visits. Fully adjusted, stratified models revealed that among males, and Hispanic and White subjects, living in neighborhoods with the highest quintiles of Black residents was associated with significantly more ED visits (p-trend =0.001, 0.02, 0.01 respectively). No association was found between dialysis facility locations’ quintile of Black residents and quality metrics.ConclusionsLiving in a neighborhood with a higher percentage of Black residents is associated with a higher number of ED visits in males and non-Black patients on hemodialysis.

482: Neighborhood violent crime is associated with high perceived stress in pregnancy

BackgroundAlthough adverse events of special interest (AESIs) following COVID-19 vaccination are considered to be rare, emerging reports have suggested that risk of AESIs may be higher in certain subgroups of...

The Florida Department of Health, Environmental Public Health Tracking Program, in collaboration with the Escambia County Health Department and the University of West Florida, used the Health Impact Assessment Framework to examine adverse health outcomes that may be related to an extreme flood event in Pensacola, Florida (Escambia County) during April 29 to May 3, 2014. In this 2014 flood event, portions of Pensacola received more than 15.5 in of rain in a single day. Infrastructure impacts from this extreme event included destroyed bridges and roads and the failure of many sewage lift stations. To determine whether there were associated increases in injury, illness, and death, data on reportable diseases, hospitalizations, emergency department (ED) visits, and deaths that occurred during the impact period in 2014 were compared with a control period in 2008. We used an ecological design to compare impact and control periods and examined the proportion of hospitalizations, ED visits, and deaths potentially attributable to the extreme flood event. The results of this comparison were mixed, with some Escambia County zip codes showing increased hospitalizations and ED visits, and some zip codes showing a decrease. However, countywide, there were increases in the proportion of both injury- and respiratory-related hospitalizations and ED visits during the impact period. It is challenging to characterize human health impacts from natural disasters such as extreme floods. Still, it is believed that specific policy changes could result in fewer health impacts during future flood events. For example, this study recommended raising the electric panels on lift stations above the flood elevation to keep them operational during extreme rainfall events. For more maps and tables, consult the complete project report available online at http://www.floridatracking.com/HealthTrackFL/document/Escambia_HIA_Report.pdf.

BackgroundDuring the fifth wave of COVID‐19, accident and emergency departments in Hong Kong experienced significant overcrowding yet there was limited evidence available regarding emergency services and patients' clinical outcomes. The aim of this study was to compare the 28‐day mortality, emergency department (ED) visits, and length of stay (LOS) between the peak period of COVID‐19 and a control period in 2019.MethodThis was a retrospective case‐control study comparing the peak period of COVID‐19 (7 Feb 2022 to 23 Apr 2022) with a control period (7 Feb 2019 to 23 Apr 2019). Patients' characteristics, ED visits, diagnoses, mortality, and LOS were compared.Results35,429 patients were included. The 28‐day in‐hospital mortality was significantly higher in the peak period of COVID‐19 with a risk ratio of 3.91 (95% CI: 3.38–4.53). There was a 36% reduction in ED visits during the peak period of COVID‐19 while there was a 53.7% increase in critical cases at triage. The average LOS of emergency admissions increased from 3.8 days (Median = 2.0; IQR = 1.0–3.0) in the control period to 5.1 days (Median = 2.0; IQR = 1.0–6.0) in the peak period of COVID‐19 especially in the subgroups of chronic kidney disease, influenza and pneumonia, diabetes, and mental disorders.ConclusionIncreased risk of all‐cause 28‐day in‐hospital deaths was observed during the peak period of COVID‐19 along with a reduction in overall ED visits and lengthened LOS.

Research has shown that neighborhoods play a role in the etiology of violence. However, few adolescent relationship aggression (ARA) studies have objective measures of violent neighborhoods. Drawing on a nationally representative sample of youth, this study examines the association between ARA and local levels of violent crime (measured using geocoded Uniform Crime Report data from each of the youths' residential neighborhoods). Study analyses are based on survey data from 723 youth (ages 10-18) in current or recent dating relationships (351 males and 372 females) in the Survey on Teen Relationships and Intimate Violence (STRiV), a national representative household panel survey exploring interpersonal violence and related aggression among adolescents. About 19% of the sample reported ARA victimization in their most recent dating relationship (ARA perpetration was 17%). Neighborhood violent crime in the study (males living in 86.9 and females 99.8) was slightly lower than the national average of 100. With a broad national sample, 40% non-Whites, hypotheses guided by theories of neighborhood influence were tested. The study did not find an association between neighborhood violent crime and ARA victimization and perpetration, controlling for key demographic factors. The results, for a broad range of high- and low-crime neighborhoods, suggest that neighborhood violence does not seem to affect individual rates of ARA. The results suggest the ARA victimization and perpetration are perhaps ubiquitous and found both in low and high violent crime neighborhoods, suggesting that addressing local violent crime rates alone does not seem to be a path to also reducing ARA.

The response of respiratory infectionsto source-specific particulatematter (PM) is an area of active research. Using source-specific PM2.5 concentrations at six urban sites in New York State, acase-crossover design, and conditional logistic regression, we examinedthe association between source-specific PM and the rate of hospitalizationsand emergency department (ED) visits for influenza or culture-negativepneumonia from 2005 to 2016. There were at most N = 14 764 influenza hospitalizations, N =57 522 influenza ED visits, N = 274 226culture-negative pneumonia hospitalizations, and N = 113 997 culture-negative pneumonia ED visits included inour analyses. We separately estimated the rate of respiratory infectionassociated with increased concentrations of source-specific PM2.5, including secondary sulfate (SS), secondary nitrate (SN),biomass burning (BB), pyrolyzed organic carbon (OP), road dust (RD),residual oil (RO), diesel (DIE), and spark ignition vehicle emissions(GAS). Increased rates of ED visits for influenza were associatedwith interquartile range increases in concentrations of GAS (excessrate [ER] = 9.2%; 95% CI: 4.3%, 14.3%) and DIE (ER = 3.9%; 95% CI:1.1%, 6.8%) for lag days 0–3. There were similar associationsbetween BB, SS, OP, and RO, and ED visits or hospitalizations forinfluenza, but not culture-negative pneumonia hospitalizations orED visits. Short-term increases in PM2.5 from traffic andother combustion sources appear to be a potential risk factor forincreased rates of influenza hospitalizations and ED visits.

Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states