Search Results (7)

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with his legal colleagues and public opinion, he was known as the Big Minority Man. He argued that the assumption of free will—humans as free moral agents—justifies systems of inequity, retributive punishment, and “unadulterated brutality.” Here, the authors revisit Darrow’s views and expand upon them via contemporary research. We examine increasingly louder argumentation—from scholars across multiple disciplines—contending that prescientific notions of willpower, free will, blameworthiness, and moral responsibility, are contributing to social harms. We draw from biopsychosocial perspectives and recent scientific consensus papers calling for the dismantling of folk psychology ideas of willpower and blameworthiness in obesity. We scrutinize how the status quo of the legal system is justified and argue that outdated notions of ‘moral fiber’ need to be addressed at the root. The authors examine recent arguments for one of Darrow’s ideas—a public health quarantine model of public safety and carceral care that considers the ‘causes of the causes’ and risk assessments through a public health lens. In our view, public health needs to vigorously scrutinize the prescientific “normative” underpinnings of the criminal justice system. Full article

HIV rates among young adults remain high, and those impacted by the justice system are at particular risk. Understanding the factors associated with HIV testing, as well as determining changes in risk behavior after an HIV test, may inform interventions to reduce HIV prevalence among this population. As such, this study sought to determine the individual, contextual, and demographic factors associated with HIV testing among legal-system-impacted young adults and to explore whether a first HIV test is associated with changes in future risk behavior when compared to Never Tested individuals. Significant predictors of HIV testing included the absence of a biological father (OR = 0.68, p = 0.049), a higher variety of lifetime offending (OR = 4.74, p = 0.015), and living in Philadelphia vs. Phoenix (OR = 3.07, p < 0.001). Compared to those never tested for HIV, those newly tested significantly increased in their number of unprotected sexual partners (b = 0.52, p < 0.001) and in the number of times they had unprotected sex (b = 0.47, p < 0.001) one year later. This study is one of the first to assess predictors of HIV testing among legal-system-impacted young adults living across both community and carceral settings and to assess changes in risk behavior before and after a first HIV test. Future studies should investigate changes in risk behavior among those newly tested to inform HIV testing and care improvement interventions for this population. Full article

Hepatitis C virus (HCV) disproportionately affects certain sub-populations, including people with experience of incarceration (PWEI). Little is known about how perceptions of HCV and treatment have changed despite simplifications in testing and treatment in carceral settings. Nineteen semi-structured interviews were conducted with people living with or having a history of HCV infection released from Quebec provincial prison. Interviews were guided by the Common Sense Self-Regulation Model (CS-SRM) and aimed to explore cognitive and emotional representations of HCV and coping strategies. Among the 19 participants, seven (37%) were diagnosed with HCV in prison and 14 (74%) had previously received HCV treatment. Participants’ HCV illness perceptions were influenced by fear (of HCV transmission, death, and the well-being of family) and stigma (related to HCV, injection drug use, and incarceration). While some sought education and social and professional support, others self-isolated or engaged in high-risk behaviors to cope. Despite advances in HCV treatment, PWEI continue to experience various forms of stigma and fear surrounding their HCV diagnosis, resulting in delayed HCV care. These findings provide insights into how prison-based healthcare providers can better utilize HCV illness perceptions to evaluate willingness to engage in HCV care among PWEI. Full article

This study characterizes cancer and non-cancer risks due to inhalation exposure to volatile organic compounds (VOCs) in a border city of Windsor in southern Ontario, Canada, using hourly ambient concentrations collected from 17 November 2021 to 17 March 2023. The total incremental lifetime cancer risk (CR) due to benzene and ethylbenzene is 4.33 × 10⁻⁶, which is in the acceptable risk range of 1 × 10⁻⁶ to 1 × 10⁻⁴ used by the USEPA. The CR was higher in winter (5.20 × 10⁻⁶), followed by fall (4.32 × 10⁻⁶), spring (3.86 × 10⁻⁶), and summer (2.96 × 10⁻⁶), all in the acceptable range. The total chronic non-cancer risk (Hazard Quotient, HQ) of inhalation exposure to 16 VOCs was 0.0488, with a higher value in fall (0.0571), followed by winter (0.0464), and lower in spring (0.0454) and summer (0.0451), all in the safe level of below HQ = 1 used by the USEPA. The hazard index (HI) by organs was higher for the nervous system (0.0213), followed by the hematologic system and immune system (0.0165 each), but much lower for the other five target organs, i.e., the liver/kidney (1.52 × 10⁻⁴), developmental system (3.38 × 10⁻⁴), endocrine system and urinary system (2.82 × 10⁻⁴ each), and respiratory system (9.70 × 10⁻⁵). Similar hour-of-day trends were observed in the total CR, total HQ, and HI by organs with higher values in the early morning hours of 5:00–8:00 and lower values during 12:00 to 15:00. Benzene was the major contributor to both total CR (89%) and total HQ (34%) due to its high toxicity and high concentrations. Benzene, toluene, ethylbenzene, and xylenes (BTEX) contributed 100% of the total CR and 51% of the total HQ. Further, BTEX is the sole contributor to the HI for the hematologic system and immune system and the major contributor to the HI for the nervous system (39%) and developmental system (55%). Higher cancer and non-cancer risks were associated with the airmass from the east, southeast, and southwest of Windsor. Full article

Background: Anticancer treatments are improving the prognosis of patients fighting cancer. However, anticancer treatments may also increase the cardiovascular (CV) risk by increasing metabolic disorders. Atherosclerosis and atherothrombosis related to anticancer treatments may lead to ischemic heart disease (IHD), while direct cardiac toxicity may induce non-ischemic heart disease. Moreover, valvular heart disease (VHD), aortic syndromes (AoS), and advanced heart failure (HF) associated with CV risk factors and preclinical CV disease as well as with chronic inflammation and endothelial dysfunction may also occur in survivors of anti-carcer treatments. Methods: Public electronic libraries have been searched systematically looking at cardiotoxicity, cardioprotection, CV risk and disease, and prognosis after cardiac surgery in survivors of anticancer treatments. Results: CV risk factors and disease may not be infrequent among survivors of anticancer treatments. As cardiotoxicity of established anticancer treatments has been investigated and is frequently irreversible, cardiotoxicity associated with novel treatments appears to be more frequently reversible, but also potentially synergic. Small reports suggest that drugs preventing HF in the general population may be effective also among survivors of anticancer treatments, so that CV risk factors and disease, and chronic inflammation, may lead to indication to cardiac surgery in survivors of anticancer treatments. There is a lack of substantial data on whether current risk scores are efficient to predict prognosis after cardiac surgery in survivors of anticancer treatments, and to guide tailored decision-making. IHD is the most common condition requiring cardiac surgery among survivors of anticancer treatments. Primary VHD is mostly related to a history of radiation therapy. No specific reports exist on AoS in survivors of anticancer treatments. Conclusions: It is unclear whether interventions to dominate cancer- and anticancer treatment-related metabolic syndromes, chronic inflammation, and endothelial dysfunction, leading to IHD, nonIHD, VHD, HF, and AoS, are as effective in survivors of anticancer treatments as in the general population. When CV diseases require cardiac surgery, survivors of anticancer treatments may be a population at specifically elevated risk, rather than affected by a specific risk factor. Full article

Risk assessments in carceral settings have proliferated in recent decades and are now prominent in numerous states and regions. A ubiquitous variety is actuarial risk assessment instruments that are used on children and adults to predict their future chance for misconduct (e.g., recidivism) in several vital decision points in carceral processing (e.g., pretrial confinement). These instruments rely on information about past behavior (e.g., criminal history) and an understanding of offending (e.g., antisocial personality) that is thought to be neutral, reliable, and enjoys predictive validity. However, it will be argued that when justice system personnel assess the chance of unwanted behavior in the future, several risk domains are differentially prevalent and more frequently experienced by some groups. Much of this disparity is caused by, or due to, forces external to those being assessed, for instance, inequitable social and economic conditions and inequitable decisions by justice personnel to arrest, charge, or sentence people of color. As such, risk assessment instruments inevitably and disproportionately mark some groups of people as a higher risk to violate rules, conditions, orders, or laws. Consequently, risk assessment instruments systematically disfavor disadvantage, and by inference, favor advantage, leading to the need for a radical shift in the taxonomy of classifying risk for future misconduct. Full article

Environmental injustice occurs when marginalized groups face disproportionate environmental impacts from a range of threats. Environmental racism is a particular form of environmental injustice and frequently includes the implementation of policies, regulations, or institutional practices that target communities of color for undesirable waste sites, zoning, and industry. One example of how the United States federal and state governments are currently practicing environmental racism is in the form of building and maintaining toxic prisons and immigrant detention prisons, where people of color and undocumented persons are the majority of inmates and detainees who suffer disproportionate health risk and harms. This article discusses the historical and contemporary conditions that have shaped the present political landscape of racial and immigration conflicts and considers those dynamics in the context of the literature on environmental justice. Case studies are then presented to highlight specific locations and instances that exemplify environmental injustice and racism in the carceral sector. The article concludes with an analysis of the current political drivers and motivations contributing to these risks and injustices, and ends with a discussion of the scale and depth of analysis required to alleviate these impacts in the future, which might contribute to greater sustainability among the communities affected. Full article