California Counties Research Articles

Fair Chance Act failures? Employers’ hiring of people with criminal records

AbstractResearch summaryWe examine the efficacy of the California Fair Chance Act (CFCA) policy—legislative stipulations regarding employers’ hiring of individuals with criminal records—on practices and outcomes in two Southern California counties during 2021. We rely on survey and experiment data with 542 hiring decision makers to investigate employer and personal compliance with the CFCA, whether applicant appeals affect employers’ willingness to hire them, and heterogeneity in treatment effects across firms and industries. Close to 80% of hiring decision makers violate the CFCA by obtaining background information before they extend an offer, appeals have a minimal impact on hiring outcomes, and firm‐level characteristics continue to shape hiring practices to some extent.Policy implicationsAlthough certain firms comply with the relatively new CFCA, most employers violate it by seeking applicant criminal background information, a practice that has profound consequences for those with criminal records as well as other disadvantaged groups. This finding underscores the discrepancy between de jure and de facto policy practices. Better statewide enforcement of the CFCA coupled with increased employer educational training could help reform it and improve policy adherence. Given it is a young policy, future research should continue to assess the CFCA's efficacy over time.

Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges.

Children and adolescents often do not receive mental healthcare when they need it. By 2021, the complex impact of the COVID-19 pandemic, structural racism, inequality in access to healthcare, and a growing shortage of mental health providers led to a national emergency in child and adolescent mental health in the United States. The need for effective, accessible treatment is more pressing than ever. Interdisciplinary, team-based pediatric integrated mental healthcare has been shown to be efficacious, accessible, and cost-effective. In response to the youth mental health crisis, Rady Children's Hospital-San Diego's Transforming Mental Health Initiative aimed to increase early identification of mental illness and improve access to effective treatment for children and adolescents. A stakeholder engagement process was established with affiliated pediatric clinics, community mental health organizations, and existing pediatric integrated care programs, leading to the development of the Primary Care Mental Health Integration program and drawing from established models of integrated care: Primary Care Behavioral Health and Collaborative Care. As of 2023, the Primary Care Mental Health Integration program established integrated care teams in 10 primary care clinics across San Diego and Riverside counties in California. Measurement-based care has been implemented and preliminary results indicate that patient response to therapy has resulted in a 44% reduction in anxiety symptoms and a 62% decrease in depression symptoms. The program works toward fiscal sustainability via fee-for-service reimbursement and more comprehensive payor contracts. The impact on patients, primary care provider satisfaction, measurement-based care, funding strategies, as well as challenges faced and changes made will be discussed using the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Preliminary results suggest that the Primary Care Mental Health Integration is a highly collaborative integrated care model that identifies the needs of children and adolescents and delivers brief, evidence informed treatment. The successful integration of this model into 10 primary care clinics over 3 years has laid the groundwork for future program expansion. This model of care can play a role addressing youth mental health and increasing access to care. Challenges, successes, and lessons learned will be reviewed.

Social vulnerability and climate risk assessment for agricultural communities in the United States

Floods and droughts significantly affect agricultural activities and pose a threat to food security by subsequently reducing agricultural production. The impact of flood events is distributed disproportionately among agricultural communities based on their socio-economic fabric. Understanding climate-related hazards is critical for planning mitigation measures to secure vulnerable communities. This study introduces a holistic approach for evaluating the combined risks associated with drought and flood hazards for agricultural communities in the United States. It accomplishes this by merging social vulnerability indicators with data on drought and flood exposure, enabling the identification of the most susceptible agricultural communities. The research seeks to offer valuable insights into the vulnerability of agricultural communities across the United States. It fills a vital research gap by conducting a comprehensive nationwide assessment of social vulnerability, considering expected annual losses related to both flood and drought hazards, and amalgamating social vulnerability with these expected annual losses. The analyses were conducted by adapting datasets and methodologies that are developed by federal institutions such as FEMA, USACE, and USDA. The study identified the 30 most socially vulnerable counties and assessed their exposure to drought and flooding, finding that Mendocino, Sonoma, Humboldt, El Dorado, Fresno, and Kern counties in California had the highest drought exposure and expected annual losses, with Humboldt (CA) and Montgomery (TX) having the highest combined risk. The study estimated over $1 billion in crop damage, with California experiencing the greatest losses, primarily affecting a diverse range of crops, while the Midwest was primarily impacted in terms of major crop types. The findings of this study can serve as supportive information for policymakers to better understand climate risks in agricultural communities and identify where risk mitigation activities should be allocated.

C’ing is believing: What types of characteristics are found on bottles of wine? Do more characteristics mean more online presence?

ABSTRACT Wine bottles feature various textual and visual elements. Aside from necessary legal information, wine-branding decision-makers choose what goes on the bottle. They may also choose a bottle shape that is out of the ordinary to draw more attention. Rather than a cork, they may opt for a screwcap so that the opening of the bottle requires no corkscrew. The bottle’s base may be flat, or it may be concave. In sum, decisions are made either to blend in with the other wines on the shelf or to stand out. This research set out to tackle two subjects. Firstly, what are these characteristics and how can they be called? Secondly, are wines with more characteristics also more present online? This article proposes a framework, “The C Matrix”, codifying these characteristics so that they all begin with the letter “C”. Still, white, rose and red wines sold by three different mass retailers in Los Angeles (LA) County in California in the USA priced between US$5 and US$15 were studied. LA is an important market in terms of volume consumed. Furthermore, the presence of both domestic and foreign wines makes it an interesting place for a wine-packaging study. The US is the largest country importer of wine in volume and in value. The goal is to better understand what types of characteristics are featured on a mid-range bottle of wine in this lucrative yet competitive market. Calculations reveal a slightly positive coefficient correlation, namely wines with more bottle characteristics are also more prevalent online. This may mean that, in LA, it is beneficial to provide more information and to stand out from crowd.

“Am I going to have to run to get out of this place?” A qualitative study exploring HIV clinical and service provider experiences from California regions heavily impacted by climate disaster

Maintaining continuity of HIV care and prevention resources is critical to the health, wellbeing, and at times survival of individuals who rely on those services. In California, disaster events and extreme conditions caused by climate change are becoming more frequent and intense, impacting many regions in what have become cycles of destruction and disruption. The HIV workforce, already under strain, must now contend with delivering services to clients during and in the wake of repeated climate-related events. From October 2021 to April 2022, using purposive and snowball sampling, we interviewed 18 HIV, sexual health, and harm reduction clinical and service providers in California counties heavily impacted by climate-related events. Participants were asked about their experiences providing services amid climate disasters, including reflections on client needs and strategies for maintaining continuity of care. Data were analyzed following the tenets of thematic analysis. We found that HIV, STI, and harm reduction service providers and their agencies play an integral role within their communities, both in maintaining continuity of essential services to clients during catastrophic events, as well as in disaster response as trusted community resources. We further found that individuals in these roles drive the innovations and adaptive strategies that allow their agencies to endure the shock and disruption of disaster events. Finally, we highlight the extent to which clinical and service providers experience harms due to cyclical climate disasters. We discuss existing research on health system resilience in the face of climate change, and identify a critical research gap: consideration of workforce needs is often limited to professional skills and capacity specific to caring for climate disaster survivors, rather than as support needed by workforce personnel who are survivors of disasters themselves. We propose recommendations for next steps and encourage further research on HIV workforce resilience in a new climate era.

Effects of Wildfire Events on California Radiation Oncology Clinics and Patients

PurposeThe impact of climate-driven events, such as wildfires, on healthcare delivery and cancer care is a growing concern. Patients with cancer undergoing radiotherapy are particularly vulnerable to treatment interruptions, which have a direct impact on survival. We report the results of a study characterizing the impact of wildfires on radiation oncology clinics and their patients. Methods and MaterialsA survey of California radiation oncologists was used to evaluate emergency preparedness and the impact of wildfires on the delivery of radiotherapy services between 2017-2022. Descriptive statistics and Pearson's chi-squared tests were performed to investigate potential relationships between provider characteristics, practice settings, and perceptions of the impact of wildfire events. California Department of Forestry and Fire Protection (CAL FIRE) data were employed to map the geographic distribution of wildfires to clinic locations. ResultsResponse rate was 12.3% (51/415 radiation oncologists), representing 25% of clinics (43/176) in 41% (24/58) of California counties. 61% (31/51) of respondents reported being impacted by a wildfire, two of which are rural clinics (100%, 2/2) and 29 are (59%, 29/49) metropolitan practices. Of these, 18% (9/51) reported a clinic closure, and 29% (15/51) reported staffing shortages. Respondents reported impacts on patients, including having to evacuate (55%, 28/51), cancel/reschedule treatments (53%, 27/51), and experiencing physical, mental, or financial hardship due to wildfires (45%, 23/51). Respondents described impacts on clinical operations, including being forced to transfer patients (24%, 12/51), transportation interruptions (37%, 19/51), regional/community evacuations (35%, 18/51), and physical/mental health impacts (27%, 14/51) on clinic personnel. Less than half of the respondents (47%, 24/51) reported their workplace had a wildfire emergency preparedness plan. Additionally, geographic analysis revealed that 100% (176/176) of clinics were located within 25 miles of a wildfire. ConclusionsThis study highlights the impact of wildfires on radiation oncology clinics and patients, and underscores the need for emergency preparedness planning to minimize the consequences of such disasters.

Do social vulnerability indices correlate with extreme heat health outcomes?

Introduction. Several frameworks exist to measure vulnerability to extreme heat events using a health equity approach, but little evidence validates these measures and their applications. We investigated the degree to which social vulnerability measures and their constituent elements correlate with excess emergency room visits as an outcome measure. Methods. The relationship between six commonly used social vulnerability indicators and measured excess emergency room visit rates (processed by including heat-related illnesses and all-internal causes diagnosis, with considerations for age and heat days) was tested through geospatial analytics and statistical regressions, for both California and Los Angeles County. Results. The vulnerability indicators and the outcome measure were significantly positively associated at the census tract-level but weaker (∼0.2 rs) at the scale of California and stronger (∼0.6 rs) at the scale of Los Angeles County. Hazard-specific vulnerability indicators showed stronger relationships with outcome measures regardless of scale. A Poisson regression model showed a significant inter-county variation, indicating the importance of localized assessments for equitable environmental policies. Conclusion. The findings identify communities that are overburdened by heat and pollution and highlight the need for use of both social vulnerability and indicators of adverse outcomes from excessive heat. Patterns are found across all measures that suggest that populations facing accessibility barriers may be less likely to visit emergency rooms. This suggestion needs to be tested in other environmental settings to draw broader conclusions but has direct implications for environmental scientists and mitigation planners who use these methods.

A novel clustering-based resampling with cost-sensitive boosting method to model and map wildfire susceptibility

Wildfires have been one of the most damaging natural disasters in history, severely damaging the global ecological environment, socio-economics, and public safety. To predict and generate wildfire susceptibility maps to visualize the probability of wildfire occurrence intuitively, we propose a Clustering-based Resampling with the Cost-sensitive Boosting (CRCBoost) method. Emphasizing the highly cluster-able feature vectors in wildfire imbalance data overlooked by previous studies, CRCBoost adopts a clustering-based resampling strategy in each iteration of boosting and sets various misclassification costs for positive and negative samples to be more sensitive for identifying the fire points. Due to the frequent wildfires in two contract counties (Los Angeles and Ventura) in California, USA, they are set as the study area. Data regarding historical wildfires, geographical, meteorological, and vegetation features are collected for the period spanning 2010 to 2020. A recursive feature elimination algorithm is used for filtering out irrelevant features. CRCBoost is more suitable for short-term wildfire occurrence prediction and its performance is demonstrated to be better than other popular machine learning methods. Generating wildfire susceptibility maps and calculating feature importance are helpful to identify areas of high wildfire susceptibility and main drivers. Moreover, the findings can further assist in wildfire prevention, mitigation, and response.

California Certified Registered Nurse Anesthetist Workforce Study

BackgroundNurse anesthesia in California has been instrumental in shaping Certified Registered Nurse Anesthetist (CRNA) practice nationally, but to date, no workforce data has been published on this group of Advanced Practice Registered Nurses. PurposeThe purpose of this workforce study was to explore the demographic information, education, and practice patterns of CRNAs working in California. MethodsSurvey methodology was conducted to gather workforce data from a sample of licensed CRNAs working in California. DiscussionCalifornia CRNAs provide anesthesia services in very diverse settings among different anesthesia delivery models, including independent practice. CRNAs practice in a majority of California counties and are the sole anesthesia providers for four underserved counties. ConclusionThe CRNA workforce in California is comparatively young, highly educated, and desires more education. CRNAs improve access to care for California patients; however, more ethnically diverse CRNAs and CRNAs with Non-Surgical Pain Management Certification are needed.

Variation in rates of sexual assault crisis counsellor usage during forensic examination in California: an observational study

ObjectivesA critical asset to post-assault care of survivors is support from sexual assault crisis counsellors (SACCs). We sought to elucidate variation in implementation between California counties in SACC accompaniment during...

Breastfeeding and Incarceration: An Analysis of California County Jails' Written Breast Milk Feeding Policies.

Between 1980 and 2019, the number of incarcerated women rose by more than 700%. Rising imprisonment of women corresponds with an increase in incarcerated lactating people. In 2018, California signed Assembly Bill (AB) 2507, requiring county jails to develop and implement a breast milk feeding policy for incarcerated women who wish to express their breast milk. We conducted a cross-sectional, descriptive study to determine if California's 58 counties created policies compliant with AB2507. Additionally, policies were analyzed for inclusion of evidence-based breastfeeding and lactation management practices and given a letter grade for their performance. Public records act requests were sent to all California counties, requesting their breast milk feeding policies. Of the 55 counties that responded, 51 had policies. Twenty-eight (51%) counties were in full compliance and 27 (49%) counties lacked compliance. No counties received letter grade A and 48 (87%) counties received letter grade C or below. Results reveal a discrepancy between legally compliant policies and evidence-based practices. The California county jail management needs increased surveillance to ensure policies are in full compliance and reflect best practices. Further research is required to investigate the actual implementation of compliant written breastfeeding policies.

Impacts of Wildfire Events on California Radiation Oncology Clinics and Patients

The impact of climate-related disasters such as wildfires on healthcare delivery and cancer care is a growing concern. Patients undergoing radiotherapy are particularly vulnerable to treatment interruptions which are known to have a direct impact on survival outcomes. We report results of the first pilot study characterizing the impact of wildfires on radiation oncology clinics and their patients. A survey was sent to 415 California radiation oncologists representing 144 clinics identified using the ASTRO member directory to gather information about clinic and radiation oncologist demographics, wildfires' impacts on the clinic (physical/operational), physicians, staff, and patients between 2017 and 2022, as well as clinics' disaster preparedness efforts. A total of 51 radiation oncologists completed the survey, representing 43 clinics (30% of clinics) in 24 (41%) of California counties. 35 (69%) of respondents self-identified as male, 27 (53%) worked at hospital-affiliated centers, 19 (37%) worked in academic centers, with 49 (96%) practicing in metropolitan areas. A total of 31 clinics were impacted by a wildfire between 2017 and 2020. The two rural clinics (100%) and 29 (59%) of metro practices reported being impacted by wildfires in the last 5 years, with 9 (18%) reporting a clinic closure and 15 (29%) reporting staffing shortages. 28 (55%) of respondents reported impacts on patients including having to evacuate, 27 (53%) having to cancel or reschedule treatments, and 23 (45%) experiencing physical, mental, or financial hardship due to the wildfires. Among the 25 clinics impacted by wildfires, 12 (24%) reported physical/operational impacts including being forced to evacuate patients to another treatment center, transportation interruptions (19, 37%), community and regional evacuations (18, 35%), school closures (18, 35%), and physical/mental health impacts (14, 27%) on staff due to the wildfires. Small clinics (25 staff or less) that experienced a wildfire were twice as likely to experience closures (6 of 16 clinics, 38%) but equally likely to experience staffing shortages (8 of 16, 50 %) as compared to larger practices (7 of 15, 47%). Nearly half of respondents 25 (47%) reported their workplace had a wildfire emergency preparedness plan. The results of this study demonstrate the significant impact wildfires have on patient care in both rural and metropolitan areas. The findings emphasize the importance of emergency preparedness planning to minimize the consequences of such disasters and underscores the need for further research to explore risk factors associated with patient and community vulnerability to climate-related crises. Such research will be essential to informing and developing future emergency preparedness plans.

Young, Black/African American, and Latino communities are left behind despite legislative efforts in California to reduce HIV/STI disparities.

Sexually transmitted infections (STI) have been on the rise in the United States with racial/ethnic minority groups, gay and bisexual men, and youth experiencing the highest STI and HIV infection rates. In 2022, California became the first state in the nation to pass legislation, Senate Bill 306 (SB 306), requiring health care plans to cover the costs of home test kits for STIs, including HIV. This study examines provisions within SB 306 and its potential to reduce STI and HIV disparities among key demographic groups and geographic regions within California. Ecological cross-sectional study involving 58 California counties. Descriptive statistics and choropleth maps compared HIV/STI prevalence rates, uninsured rates, demographic composition, and healthcare provider coverage across California counties. Three geographically weighted Poisson regression analyses were conducted to separately examine the association between proportion of uninsured and HIV, gonorrhea, and chlamydia prevalence rates. HIV/STI rates were significantly and positively associated with the proportion of uninsured residents in Central and Southern California counties. These counties had a higher proportion of demographic groups vulnerable to HIV/STI including a large Latino, Black/African American, and younger (age 15-24) population but had a lower rate of healthcare providers with prescription authority for home testing kits, which is a requirement under SB 306. Cutting-edge solutions are needed to stem the rising tide of new STI and HIV infections. While SB 306 is novel and innovative in intent, its coverage gaps will increase disparities and inequities among historically underserved populations.

Fitting a stochastic model of intensive care occupancy to noisy hospitalization time series during the COVID-19 pandemic.

Intensive care occupancy is an important indicator of health care stress that has been used to guide policy decisions during the COVID-19 pandemic. Toward reliable decision-making as a pandemic progresses, estimating the rates at which patients are admitted to and discharged from hospitals and intensive care units (ICUs) is crucial. Since individual-level hospital data are rarely available to modelers in each geographic locality of interest, it is important to develop tools for inferring these rates from publicly available daily numbers of hospital and ICU beds occupied. We develop such an estimation approach based on an immigration-death process that models fluctuations of ICU occupancy. Our flexible framework allows for immigration and death rates to depend on covariates, such as hospital bed occupancy and daily SARS-CoV-2 test positivity rate, which may drive changes in hospital ICU operations. We demonstrate via simulation studies that the proposed method performs well on noisy time series data and apply our statistical framework to hospitalization data from the University of California, Irvine (UCI) Health and Orange County, California. By introducing a likelihood-based framework where immigration and death rates can vary with covariates, we find, through rigorous model selection, that hospitalization and positivity rates are crucial covariates for modeling ICU stay dynamics and validate our per-patient ICU stay estimates using anonymized patient-level UCI hospital data.

Caught Between a Well-Intentioned State and a Hostile Federal System: Local Implementation of Inclusive Immigrant Policies.

In the United States, inclusive state-level policies can advance immigrant health and health care access by extending noncitizens' access to public benefits, workplace rights, and protections from immigration enforcement. Although state policies carry promise as structural population health interventions, there has been little examination of their implementation at the local level. Local jurisdictions play multiple roles in state policy implementation and possess distinct immigration climates. Examining the local implementation of state immigrant policy can address challenges and opportunities to ensure the health benefits of inclusive policies are realized equitably across states' regions. To examine the local implementation of state immigrant policies, we selected a purposive sample of California counties with large immigrant populations and distinct social and political dynamics and conducted and analyzed in-depth interviews with 20 community-based organizations that provided health, safety net, and other services. We found that there were tensions between the inclusionary goals of state immigrant policies and local anti-immigrant climates and federal policy changes. First, there were tensions between state policy goals and resistance from local law enforcement agencies and policymakers (e.g., Board of Supervisors). Second, because of the ongoing threats from federal immigration policies, there was a mismatch between the services and resources provided by state policies and local community needs. Finally, organizations that served immigrants were responsible for contributing to policy implementation but lacked resources to meet community needs while countering local resistance and federal policy threats. This study contributes knowledge regarding the challenges that emerge after state immigrant policies are enacted. The tensions among state immigrant policies, local immigration climates, and federal policy changes indicate that state immigrant policies are not implemented equally across state communities, resulting in challenges and limited benefits from policies for many immigrant communities.

Pollution and fatal traffic accidents in California counties

AbstractWe estimate pollution's causal effect on fatal traffic accidents using instrumental variables. Using variation in fine particulate matter of 2.5 micrometers in diameter or less (PM2.5) because of air temperature inversions and eastward wind, we find that of PM2.5 positively affects fatal traffic accidents. Fatalities increase on average by 1.3% when PM2.5 increases by 1 g/m3. This increase corresponds to 67 more yearly fatalities in California on average. The positive effects we estimate are consistent with mechanisms such as cognitive function due to pollution inhalation. Heterogeneity analysis finds that this mechanism is worsened for non‐rural and for lower‐income counties while it is mitigated by driver risk aversion during poor air quality days.

The Long-Run Impacts of Mexican American School Desegregation

We present the first quantitative analysis of the impact of ending de jure segregation of Mexican American schoolchildren in the United States by examining the effects of the 1947 Mendez v. Westminster court decision on long-run educational attainment for Hispanics and non-Hispanic Whites in California. Our identification strategy relies on comparing individuals across California counties that vary in their likelihood of segregating and across birth cohorts that vary in their exposure to the Mendez court ruling based on school start age. Results point to a significant increase in educational attainment for Hispanics who were fully exposed to school desegregation. (JEL H75, I24, J13, J15, K10, N32, R23)

Alignment in local approaches to alcohol and cannabis control policy: A case study of California cities and counties.

Public health experts have urged governments around the world to regulate newly legalized cannabis as they do alcohol to effectively and efficiently protect health. However, research evaluating the alignment of alcohol and cannabis policies is sparse. We assessed similarities and differences in local alcohol and cannabis control policies across California, and characterized localities adopting distinct policy approaches. Using standard legal epidemiologic techniques, we collected and coded local alcohol and cannabis control policies relevant to public health for 12 California counties and all incorporated cities within them (N=241). We assessed whether localities were equally stringent on alcohol and cannabis policies by comparing overall restrictiveness (summed policy scores) and 9 specific provisions that applied to both substances. We captured distinct local alcohol-cannabis policy approaches using latent class analysis, and examined this classification in relation to local demographic, socioeconomic, political, and retail market characteristics. All 241 localities permitted alcohol sales, while 71% banned cannabis sales. Among those that did not ban cannabis sales, more stringent alcohol policy scores were associated with more stringent cannabis policy scores (linear regression coefficient: 0.16 [95% CI: 0.07, 0.25]). Local governments rarely adopted the same provisions for alcohol and cannabis (e.g., limits on hours of sale, advertising restrictions), and only two regulated the co-location of cannabis and alcohol outlets. Localities that were restrictive on alcohol yet permissive on cannabis (12%) were more urban, politically progressive, and had more low-income and racial/ethnic minority residents. Localities that were more permissive on alcohol and restrictive on cannabis (51%) were more socioeconomically advantaged. We found few similarities between local alcohol and cannabis control policies. California's experience suggests that, as governments around the world legalize cannabis, lessons learned from regulating alcohol are not routinely applied to cannabis, particularly in communities distinguished by high social and economic advantages.

A statewide study of disparities in local policies and tobacco, vape, and cannabis retail environments

The current study: (1) assesses sociodemographic disparities in local policies related to tobacco and cannabis retail, and (2) examines the cross-sectional association between policy strength and retailer densities of tobacco, e-cigarette (vape), and cannabis retailers within California cities and county unincorporated areas (N = 539). We combined (a) American Community Survey data (2019 5-year estimates), (b) 2018 tobacco, vape, and cannabis retailer locations from a commercial data provider, (c) 2017 tobacco and vape retail environment policy data from American Lung Association, and (d) 2018 cannabis policy data from California Cannabis Local Laws Database. Conditional autoregressive models examined policy strength associations with sociodemographic composition and retailer density in California jurisdictions. Jurisdictions with larger percentages of Black and foreign-born residents had stronger tobacco and vape policies. For cannabis policy, only income had a small, significant positive association with policy strength. Contrary to hypothesis, tobacco/vape policies were not significantly associated with retailer density, but cannabis policy strength was associated with lower cannabis retailer density (relative rate = 0.58, 95% Uncertainty Interval 0.47–0.70)—this effect was completely driven by storefront bans. Thus, storefront cannabis bans were the only policy studied that was associated with lower cannabis retailer density. Further research is needed to understand policies and disparities in retail environments for tobacco, vape, and cannabis, including data on the prospective association between policy implementation and subsequent retailer density, and the role of enforcement.

U.S. Civil War Redux? A Prevue

The thought that the United States could engage in a second civil war is disturbing, as it represents a significant threat to the stability not only of one nation, but also of the world. Harbouring the idea of such a conflict is not as outlandish as it might seem at first glance: Several movements that have gained attention in recent years seem to be preparing for such a scenario. The two that are most interesting, essentially because they come with territorial claims, are the Greater Idaho Movement, which advocates for the secession of rural counties in eastern Oregon and northern California to join the state of Idaho and create a super-state, and the American Redoubt, which supports the establishment of a territorial entity that would include most of Greater Idaho plus Montana and Wyoming. Significantly, northern Colorado, along with North and South Dakota, while ideologically in tune with American Redoubt political and cultural philosophies, are specifically excluded in the territorial plan for this super state, as they are mainly flat and therefore difficult to defend against a modern mechanised military. It is obvious that the American Redoubt’s hypothetical defensive operations are being calculated to thwart United States Army advances in case of conflict. I will argue here that these movements’ ideology is secessionist, and that they may cause armed conflict in the United States, the likelihood and scale of which is difficult to determine.