City Of Philadelphia Research Articles

The changing epidemiology of interpersonal firearm violence during the COVID-19 pandemic in Philadelphia, PA

Recent increases in firearm violence in U.S. cities are well-documented, however dynamic changes in the people, places and intensity of this public health threat during the COVID-19 pandemic are relatively unexplored. This descriptive epidemiologic study spanning from January 1, 2015 - March 31, 2021 utilizes the Philadelphia Police Department's registry of shooting victims, a database which includes all individuals shot and/or killed due to interpersonal firearm violence in the city of Philadelphia. We compared victim and event characteristics prior to the pandemic with those following implementation of pandemic containment measures. In this study, containment began on March 16, 2020, when non-essential businesses were ordered to close in Philadelphia. There were 331 (SE = 13.9) individuals shot/quarter pre-containment vs. 545 (SE = 66.4) individuals shot/quarter post-containment (p = 0.031). Post-containment, the proportion of women shot increased by 39% (95% CI: 1.21, 1.59), and the proportion of children shot increased by 17% (95% CI: 1.00, 1.35). Black women and children were more likely to be shot post-containment (RR 1.11, 95% CI: 1.02, 1.20 and RR 1.08, 95% CI: 1.03, 1.14, respectively). The proportion of mass shootings (≥4 individuals shot within 100 m within 1 h) increased by 53% post-containment (95% CI: 1.25, 1.88). Geographic analysis revealed relative increases in all shootings and mass shootings in specific city locations post-containment. The observed changes in firearm injury epidemiology following COVID-19 containment in Philadelphia demonstrate an intensification in firearm violence, which is increasingly impacting people who are likely made more vulnerable by existing social and structural disadvantage. These findings support existing knowledge about structural causes of interpersonal firearm violence and suggest structural solutions are required to address this public health threat.

Music for Counting Votes

Music for Counting Votes

Action Beyond Exhibition: Amplifying Photovoice Through Social Action After a Community Health Needs Assessment in Philadelphia.

Photovoice is a participatory action research method that was founded on mobilizing communities toward action. However, there is limited research detailing the action stages of photovoice that are meant to follow the initial research. In this article, we describe the action stage of a youth photovoice project conducted at the planning phase of a Community Health Needs Assessment of the Latino community in North Philadelphia. In collaboration with local leaders, we utilized photovoice to prioritize the health needs identified in the assessment. We announced a request for proposals and launched twelve, 1-year, community catalyst grants in the amount of US$50,000 each. While grants were funded and implemented, the participants continued to exhibit their findings in Philadelphia City Hall and engage with city policymakers. We developed a health policy workshop where Philadelphia youth beyond the original photovoice participants could learn advocacy skills and policy research to develop a proposal addressing a priority health need identified through photovoice. This workshop was expanded into a year-round program where participants can be matched with a career mentor, engage in professional development sessions, and continue to refine and advocate for their policy proposal. We found that successful action planning stemmed from setting goals several steps ahead of the current stage of action while enhancing the ability to center community voice in guiding action forward. Photovoice influenced decision-making throughout each of the steps taken toward action. Future research should recognize and describe action planning as a central tenet of photovoice methodologies.

Disparities of COVID-19 and HIV Occurrence Based on Neighborhood Infection Incidence in Philadelphia, Pennsylvania.

Objectives. To evaluate the occurrence of HIV and COVID-19 infections in Philadelphia, Pennsylvania, through July 2020 and identify ecological correlates driving racial disparities in infection incidence. Methods. For each zip code tabulation area, we created citywide comparison Z-score measures of COVID-19 cases, new cases of HIV, and the difference between the scores. Choropleth maps were used to identify areas that were similar or dissimilar in terms of disease patterning, and weighted linear regression models helped identify independent ecological predictors of these patterns. Results. Relative to COVID-19, HIV represented a greater burden in Center City Philadelphia, whereas COVID-19 was more apparent in Northeast Philadelphia. Areas with a greater proportion of Black or African American residents were overrepresented in terms of both diseases. Conclusions. Although race is a shared nominal upstream factor that conveys increased risk for both infections, an understanding of separate structural, demographic, and economic risk factors that drive the overrepresentation of COVID-19 cases in racial/ethnic communities across Philadelphia is critical. Public Health Implications. Difference-based measures are useful in identifying areas that are underrepresented or overrepresented with respect to disease occurrence and may be able to elucidate effective or ineffective mitigation strategies. (Am J Public Health. 2022;112(3):408-416. https://doi.org/10.2105/AJPH.2021.306538).

Abstract P4-11-32: Change in body mass index in breast cancer survivors

Abstract Background: Obesity is associated with an increased risk of breast cancer recurrence and poor survival. Obesity rate in adults in the city of Philadelphia is high, with non-Hispanic blacks and Hispanics having the highest rates. We sought to evaluate changes in body mass index (BMI) in breast cancer survivors within the first 2 years from initial encounter for a breast cancer (BC) diagnosis (dx), and investigate factors that may correlate with a change in BMI. Methods: We identified 5,423 BC patients (pts) in our electronic medical record, (1/2015-present), using ICD-10 code C50.X. We then selected pts with BMI values at the three-time points: baseline, 1 year and 2 year intervals from baseline. The closest BMI value before the 1st encounter within 6 months prior to BC dx was considered as the baseline BMI. BMI at 1 year +/- 3 months after the BC dx was considered 1-year interval BMI. BMI at 2 years +/- 6 months after the BC dx was considered 2-year interval BMI. Subjects needed baseline BMI and at least 1 year or 2 year follow-up BMI for inclusion. After all BMI exclusions, 630 pts were included in the study cohort. We used a mixed effects model to predict BMI changes as a linear function of association with time, sex, race and ethnicity, age at BC dx, baseline BMI, treatments (i.e., chemotherapy [CT], endocrine therapy [ET], or immunotherapy [IO] and the interaction of race and ethnicity and treatment in estimating mean change of BMI. The significance level of all tests was set a priori to the 0.05 level. Results: The mean age at BC dx was 61 years; pts identified were mostly white, non-Hispanic/Caucasian (55%), or Black/African American (AA) (34%). By BMI category, we did not observe any substantial difference in the mean age at BC dx and gender distribution (p = 0.81 for age and p = 0.86 for gender). However, the distributions of race and ethnicity differed among BMI categories (p < .01) where the percentage of Black/AA pts was high in the BMI ≥ 30 category. Black/AA pts receiving IO were likely to have BMI change (decrease) compare to white non-Hispanic pts with similar conditions. Black/AA pts receiving no treatment or non IO-treatment were more likely to change BMI (increased, 95% CI: 0.22, 1.03) after BC dx compared to white, non-Hispanic pts. Interestingly, Black/AA pts receiving IO tended to change BMI (decreased) compared to Black/AA pts not receiving IO. Conclusion: We observed the interaction effect of race/ethnicity and treatment on BMI change in BC survivors within 2 years after a BC dx, with Black/AA pts more likely to have an increase in BMI. Table 1.Descriptive Statistics Summary, n = 630.VariableALL (n=630)BMI ≤ 24.9 (n=160, 25%)25 ≤ BMI ≤ 29.9 (n=180, 29%)BMI ≥ 30 (n=290, 46%)p-valueAge at 1st Encounter with BC dx, mean (SD)61.8 (11.8)62.1 (12.5)62.1 (12.1)61.5 (11.2)0.808Sex, n (%)Female625 (99.2)159 (99.4)178 (98.9)288 (99.3)0.857Male5 (0.8)1 (0.6)2 (1.1)2 (0.7)Race & Ethnicity, n (%)White/Caucasian348 (55.2)103 (64.4)106 (58.9)139 (47.9)<.001Black/AA215 (34.1)35 (21.9)48 (26.7)132 (45.5)Hispanic/Latino20 (3.2)5 (3.1)5 (2.8)10 (3.4)Asian/Pacific Islander39 (6.2)17 (10.6)18 (10.0)4 (1.4)American Indian/Alaskan Native2 (0.3)0 (0.0)0 (0.0)2 (0.7)Unknown6 (1.0)0 (0.0)3 (1.7)3 (1.0)BMI (baseline), mean (SD)29.9 (7.1)22.2 (2.0)27.1 (1.4)35.9 (5.7)<.001Treatment (Yes) , n (%)HistoricalCT2 (0.3)1 (0.6)1 (0.6)0 (0.0)0.294ET35 (5.6)7 (4.4)12 (6.7)16 (5.5)0.663IO4 (0.6)2 (1.3)1 (0.6)1 (0.3)0.487BaselineCT20 (3.2)4 (2.5)7 (3.9)9 (3.1)0.815ET54 (8.6)16 (10.0)15 (8.3)23 (7.9)0.742IO11 (1.7)5 (3.1)2 (1.1)4 (1.4)0.3111 yearCT154 (24.4)41 (25.6)42 (23.3)71 (24.5)0.886ET309 (49.0)73 (45.6)93 (51.7)143 (49.3)0.535IO29 (4.6)10 (6.3)8 (4.4)11 (3.8)0.4892 yearsCT71 (11.3)20 (12.5)15 (8.3)36 (12.4)0.337ET231 (36.7)50 (31.3)73 (40.6)108 (37.2)0.198IO32 (5.1)7 (4.4)4 (2.2)21 (7.2)0.051 Citation Format: Maysa Abu-Khalaf, Fnu Nikita, Ayako Shimada, Hannah Hackbart, Dina Alnabulsi, Scott Keith, Ana Maria Lopez, Meghan Butryn. Change in body mass index in breast cancer survivors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-32.

Fine and Fee Reform Efforts in the City of Philadelphia

Reform of government systems is not a straight-forward process. Best understanding how to identify the need for change, the options for change, and the individuals needed to implement the change can be determinative of whether your reform efforts will succeed or fail. In this article, the Director of Financial Inclusion for the City of Philadelphia’s Office of Community Empowerment and Opportunity discuss how fine and fee reform in Philadelphia is occurring.

Unbundling Urban Education: Which School Type, Traditional Public School or Charter School Are Most Effectively Educating Urban Students

Public education has been categorized as the perpetrator for everything from high crime rates to teen pregnancies. The American public has been tricked into believing the school system is a failure [1]. In fact, urban public-school systems have a dismal reputation in many cities across the United States because of lowered standardized test performance and increased school violence. Noted it was not schools that were the culprit for underachieving urban students, but poverty and segregation [2]. As explained by despite continually increasing graduation rates, over one million high school students dropped out of school each year. Stakeholders deliberate about how to improve education for urban students, and the introduction of charter schools came about as a solution to the many issues facing urban public education [3]. Implementation of charter schools could cause traditional public schools to become more effective. Junge concluded, “If a school is not working, let’s end it [4]. That’s how we’ll improve public education for all”. “End it”, is precisely what the city of Philadelphia did, in 2013, 30 schools in Philadelphia were closed, displacing over 15,000 students. The state and mayoral - appointed School Reform Commission engendered substantial political pushback. Philadelphia’s city council voted 14 to two passing a resolution calling for a halt of additional school closures [5]. Additionally, community groups filed civil rights complaints with the US Department of Education [6]. City wide planning meetings attracted upwards of 1000 students and parents [7]. Protests leading up to the decision drew thousands, leading to 19 arrests, including the head of the national teacher’s union.

Religious Freedom and Legal Education

For what was obvious yesterday is not necessarily obvious today, i.e., to the present generation of young citizens. In the past, freedom of religion for all has always been an important element of constitutional guarantees, but one wonders whether religious freedom would be defended by the present younger generation. In particular, would the young of Europe defend it? The answer, unfortunately, is most probably in the negative. But maybe the United States is different - is indeed our Euro-Atlantic world divided on the issue of religion and its role in modern societies? Legal history, in giving the opportunity to take advantage of the experience of past generations and their systems, can prove itself to be quite practical when applied in the field of legal studies, i.e., for legal research or analyses. Legal history teaches that constitutional orders have been formed for centuries and it seems likely that all were established with the intent of enduring forever; nevertheless, we know that in practice they are always in a continuous process of refinement and development and will change during the life of any particular society or state. Inevitably, then, some systems and epochs will be richer than others in their understanding of ways to put in normative order what is needed for a society in those situations that require regulation. Legal history teaches that freedom of religion always comes at a price. The crucial point is who has to pay the price. Freedom cannot defend itself. It needs its own witnesses, martyrs and, above all, guardians and protectors. Recently, that is during the last two terms, the Supreme Court of the United States has sent out a series of instructive and influential signals that protection of religion should be strengthened. The relevant cases are American Legion v. American Humanist Association (2019), Espinoza v. Montana Department of Revenue (2020), Little Sisters for the Poor Saints Peter and Paul Home v. Pennsylvania (2020), Our Lady of Guadalupe v. Morrissey-Berru (2020) and Fulton v. City of Philadelphia (2021).

Predicting citywide distribution of air pollution using mobile monitoring and three-dimensional urban structure

Understanding relationships between urban structure patterns and air pollutants is key to sustainable urban planning. In this study, we employ a mobile monitoring method to collect PM2.5 and BC data in the city of Philadelphia, PA during the summer of 2019 and apply the Structure of Urban Landscapes (STURLA) methodology to examine relationships between urban structure and atmospheric pollution. We find that PM2.5 and BC vary by STURLA class, and some classes exhibit significant difference in pollution concentrations. We also find that the proportions in which STURLA components are present throughout the urban landscape can be used to predict the spatial distribution of urban air pollution. Among frequently sampled STURLA classes, gpl (grass, pavement, and low-rise buildings) hosted the highest PM2.5 concentrations on average (16.60 ± 4.29 µg/m3), while tgbwp (trees, grass, bare soil, water, pavement) hosted the highest BC concentrations (2.31 ± 1.94 µg/m3). Furthermore, STURLA combined with machine learning modeling was able to correlate PM2.5 (R2= 0.68, RMSE 2.82 µg/m3) and BC (R2 = 0.64, RMSE 0.75 µg/m3) concentrations with urban landscape composition and interpolate concentrations throughout the city. These results demonstrate the efficacy of the STURLA methodology in modeling relationships between air pollution and urban structure patterns.

The False Promise of Expanded Religious Liberty Rights after the Covid-19 Cases and Fulton V. City of Philadelphia

The False Promise of Expanded Religious Liberty Rights after the Covid-19 Cases and Fulton V. City of Philadelphia

Monument Lab: Creative Speculations for Philadelphia

Monument Lab: Creative Speculations for Philadelphia

The Worlds of William Penn

The Worlds of William Penn

Community vibrancy and its relationship with safety in Philadelphia.

To what extent can the strength of a local urban community impact neighborhood safety? We construct measures of community vibrancy based on a unique dataset of block party permit approvals from the City of Philadelphia. Our first measure captures the overall volume of block party events in a neighborhood whereas our second measure captures differences in the type (regular versus spontaneous) of block party activities. We use both regression modeling and propensity score matching to control for the economic, demographic and land use characteristics of the surrounding neighborhood when examining the relationship between crime and our two measures of community vibrancy. We conduct our analysis on aggregate levels of crime and community vibrancy from 2006 to 2015 as well as the trends in community vibrancy and crime over this time period. We find that neighborhoods with a higher number of block parties have a significantly higher crime rate, while those holding a greater proportion of spontaneous block party events have a significantly lower crime rate. We also find that neighborhoods which have an increase in the proportion of spontaneous block parties over time are significantly more likely to have a decreasing trend in total crime incidence over that same time period.

Estimating the alignment of tree species composition with foraging practice in Philadelphia's urban forest: Toward a rapid assessment of provisioning services

Urban greenspaces (UGS) are increasingly recognized for their potential to provide provisioning services to residents foraging for food and other plant materials. The alignment of tree species composition with foraging practices in cities, and the provisioning services harvesters derive, in UGS remains less well studied. To address this gap, we draw on existing tree species data and forager practices in the City of Philadelphia to estimate the alignment between tree species composition and foraging in the city. Our approach uses an existing forest inventory, an international online database of useful species, online information for residents about useful species found in the city, and novel data about forager practices. By considering these datasets in tandem, we are able to identify useful tree species, species likely of interest to foragers, and species actively foraged, and estimate the relative abundance of species in each category. Our results suggest that managers may be able to analyze proxy data, through use of online quality ratings, to rapidly identify and assess forager interest in species found in their urban forests.

Fulton v. City of Philadelphia: How no one paid any attention to children's rights

AbstractAs part of the special issue on foster care and Fulton v. City of Philadelphia (2021), this essay provides a brief history of the role of race and religion in the foster care system. It critiques the case for failing to address the foster care system itself, and argues that Fulton essentially endorses a system that may make it impossible for state officials to ensure that the children will thrive in the homes they are obligated to find for them.

Obergefell, Masterpiece Cakeshop, Fulton, and public–private partnerships: Unleashing v. harnessing “Armies of Compassion” 2.0?

AbstractFulton v. City of Philadelphia presented a by‐now familiar constitutional claim: recognizing civil marriage equality—the right of persons to marry regardless of gender—inevitably and sharply conflicts with the religious liberty of persons and religious institutions who sincerely believe that marriage is the union of one man and one woman. While the Supreme Court's 9‐0 unanimous judgment in favor of Catholic Social Services (CSS) surprised Court‐watchers, Chief Justice Roberts's opinion did not signal consensus on the Court over how best to resolve the evident conflicts raised by the contract between CSS and the City of Philadelphia. This article argues that it is productive and illuminating to compare such conflicts over public–private partnerships and the best understanding of pluralism in a constitutional democracy with controversies arising 20 years ago over the faith‐based initiative launched by President George W. Bush with the blueprint, Rallying the Armies of Compassion. That initiative also rested on premises about the place of religion in the public square and the role of civil society in carrying out governmental purposes. In both contexts, concerns over “discrimination” took two forms: first, that religious entities who contract with government might be subject to governmental discrimination in not receiving funding and, second, that religious entities who contract with government might themselves engage in discrimination. This article evaluates how the parties and their amici in Fulton argued over these forms of discrimination. It highlights how, in doing so, they enlisted or rejected analogies between race and sexual orientation discrimination—and between objections to interracial marriage and same‐sex marriage—that were powerful, pervasive, and contested in Obergefell v. Hodges and Masterpiece Cakeshop v. Colorado Civil Rights Commission but scarcely featured in Roberts' Fulton opinion.

Sexual orientation, gender identity, and foster care: What can social science offer in a case like Fulton v. City of Philadelphia?

AbstractAre empirical data and results of research by social scientists relevant to court decisions in foster care cases, and if so, how? How should they be brought to the court's attention? These questions arose in the context of Fulton v. City of Philadelphia (2021), a recent U.S. Supreme Court case that posed the question of whether a religiously based foster care agency could refuse to provide service to LGBTQ+ prospective foster parents on the grounds of religious beliefs, and still accept public funds. Empirical evidence is relevant to the evaluation of at least three propositions related to foster care that were raised in Fulton: (1) There is a need for qualified prospective foster parents; (2) LGBTQ+ adults are at least as likely as others to be interested in becoming foster parents and they are likely to become competent foster parents; and (3) If sufficient numbers of qualified prospective foster parents cannot be found, children are likely to suffer. Consideration of the evidence reveals that each of these three propositions is supported by factual evidence. In the United States today, there is a definite need for competent foster parents, and competence as a foster or adoptive parent is not associated with parental sexual orientation. Moreover, LGBTQ+ adults may be more likely to show interest in becoming foster parents, on average, than their heterosexual peers. If LGBTQ+ adults are not permitted to become foster parents, some children are very likely to remain without homes, and in this way, will suffer. If the best interests of children are to prevail, then child welfare agencies should search out, welcome, and support LGBTQ+ prospective foster parents, rather than turning them away. Ways of bringing the findings from research to the attention of the court are also discussed.

Acute pain and self-directed discharge among hospitalized patients with opioid-related diagnoses: a cohort study

BackgroundPatients with substance use disorders are more likely than those without to have a self-directed hospital discharge, putting them at risk for poor health outcomes including progressing illness, readmissions, and death. Inadequate pain management has been identified as a potential motivator of self-directed discharge in this patient population. The objective of this study was to describe the association between acute pain and self-directed discharges among persons with opioid-related conditions; the presence of chronic pain in self-directed discharges was likewise considered.MethodsWe employed a large database of all hospitalizations at acute care hospitals during 2017 in the city of Philadelphia to identify adults with opioid-related conditions and compare the characteristics of admissions ending with routine discharge versus those ending in self-directed discharge. We examined all adult discharges with an ICD-10 diagnoses related to opioid use or poisoning and inspected the diagnostic data to systematically identify acute pain for the listed primary diagnosis and explore patterning in chronic pain diagnoses with respect to discharge outcomes.ResultsSixteen percent of the 7972 admissions involving opioid-related conditions culminated in self-directed discharge, which was more than five times higher than in the general population. Self-directed discharge rates were positively associated with polysubstance use, nicotine dependence, depression, and homelessness. Among the 955 patients with at least one self-directed discharge, 15.4% had up to 16 additional self-directed discharges during the 12-month observation period. Those admitted with an acutely painful diagnosis were almost twice as likely to complete a self-directed discharge, and for patients with multiple admissions, rates of acutely painful diagnoses increased with each admission coinciding with a cascading pattern of worsening infectious morbidity over time. Chronic pain diagnoses were inconsistent for those patients with multiple admissions, appearing, for the same patient, in one admission but not others; those with inconsistent documentation of chronic pain were substantially more likely to self-discharge.ConclusionsThese findings underscore the importance of pain care in disrupting a process of self-directed discharge, intensifying harm, and preventable financial cost and suffering. Each admission represents a potential opportunity to provide harm reduction and treatment interventions addressing both substance use and pain.

Assessing the risk of acute gastrointestinal illness (AGI) acquired through recreational exposure to combined sewer overflow-impacted waters in Philadelphia: A quantitative microbial risk assessment

Combined sewer overflows (CSOs) are known contributors of human fecal pollution in urban waterways. Exposure to these waterways occurs during recreational activities, including swimming, wading, and fishing. This study used quantitative microbial risk assessment (QMRA) to estimate the risk of acute gastrointestinal illness (AGI) due to recreation during CSO-impacted (< 24 h after a CSO) and non-impacted (> 24 h after a CSO) conditions. Water samples (n = 69) were collected from two creeks and one river in Philadelphia from June–August 2017–2019. HF183 concentrations were measured to estimate concentrations of five reference pathogens: Cryptosporidium, Giardia, norovirus, E. coli O157:H7, and Salmonella. Observational data on the types and frequency of recreational exposures were also collected. Results found that recreating < 24 h after a CSO increased AGI risk by 39–75%, compared to recreating > 24 h after a CSO. However, estimated health risks were still high for some exposure scenarios that occurred > 24 h after a CSO. Crudes estimates determined that recreational activities along known CSO-impacted sites may account for 1–8% of all cases of salmonellosis, cryptosporidiosis, and giardiasis in the city of Philadelphia. Findings support risk reduction strategies that aim to reduce the frequency of CSOs in urban settings and may help target risk mitigation strategies.

Analysis of Public Testimony About Philadelphia's Sweetened Beverage Tax

Although interest in beverage taxes has increased in recent years, industry opposition and other challenges have limited their spread in the U.S. Because beverage tax proposals are often unsuccessful, there is limited empirical evidence to inform advocacy efforts. Philadelphia's 1.5 cent-per-ounce tax on sweetened beverages provides an opportunity to understand how public testimony for and against the tax was framed in a city that ultimately passed the policy. A content analysis of all public testimony about the beverage tax presented to the Philadelphia City Council in 2016 was conducted. Testimonies were coded for policy stance (protax or antitax), speaker type, and specific protax or antitax arguments. Quantitative data were analyzed in 2018-2019 using chi-square tests. A total of 177 unique testimonies were identified, which included 40 protax arguments (grouped into 11 themes) and 31 antitax arguments (grouped into 10 themes). Most testimonies were delivered orally, and most speakers argued in favor of the tax (58%). Among tax supporters, funding early childhood education was the most common argument (71%), whereas tax opponents most frequently argued that sugar-sweetened beverages were the wrong target for the tax (50%). This analysis of public testimony revealed that protax advocacy efforts highlighted the revenue benefits for early childhood education and community infrastructure rather than the tax's potential to reduce sweetened beverage consumption and improve health. By contrast, antitax arguments centered on the unfairness of targeting a single industry, potential negative economic impacts, and the perceived lack of evidence that the tax would influence consumer behavior.