There is much variety in statistics obtained from the different sources that have collected mass shooting information, with little overlap among databases. Researchers should advocate for a standard definition that considers both fatalities and nonfatalities to most appropriately convey the burden of mass shootings on gun violence.
Stephen Holden of The New York Times wrote "Were it not for John Travolta's big-hearted portrayal of an unemployed white factory worker driven to commit a desperate act, the movie would be an emotionally frozen exercise in cautious high-mindedness".[11]
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The COVID-19 pandemic has disproportionately impacted the well-being of vulnerable populations in the US, including Black people. The impact on pregnant women is of special concern for the intrauterine and post-natal development of their offspring. We evaluated in an online survey a sample of 913 pregnant women, 216 Black, 571 White, 126 Other, during a 2-week stay-at-home mandate in the Philadelphia region. We applied logistic regression models and analysis of covariance to examine general and pregnancy-specific worries and negative consequences arising from the COVID-19 pandemic, symptoms of anxiety and depression, and resilience. Black pregnant women reported greater likelihood of having their employment negatively impacted, more concerns about a lasting economic burden, and more worries about their prenatal care, birth experience, and post-natal needs. In the full sample, 11.1% of women met screening criteria for anxiety and 9.9% met criteria for depression. Black women were more likely to meet criteria for depression than White women, but this difference was not significant accounting for covariates. Resilience factors including self-reliance and emotion regulation were higher in Black women. Racial disparities related to COVID-19 in pregnant women can advance the understanding of pregnancy related stressors and improve early identification of mental health needs.
Chemical exposures in the womb or during infancy can be dramatically more harmful than exposures later in life. Substantial scientific evidence demonstrates that children face amplified risks from their body burden of pollution; the findings are particularly strong for many of the chemicals found in this study, including mercury, PCBs and dioxins. Children's vulnerability derives from both rapid development and incomplete defense systems:
In a study spearheaded by the Environmental Working Group (EWG), researchers at two major laboratories found an average of 200 industrial compounds, pollutants, and other chemicals in 10 newborn babies, with a total of 287 chemicals found in the group. To our knowledge this work represents the first reported cord blood tests for 261 of the targeted chemicals, and the first reported detections of at least 209 chemicals. Scientists refer to this contamination as a person's body burden.
Brominated dioxins and furans have dioxin-like activity, meaning that they cause birth defects in animals and otherwise disrupt the reproductive development, immune and hormone systems. They add to the total dioxin body burden, which are near levels where effects may be occurring in the general population (Birnbaum 2003, EPA 2000a, WHO 1998).
Scientists and regulators use body burden data (biomonitoring studies) to estimate human health risks from exposures to industrial chemicals, to set public health policies that protect against these risks, and to track the success of these policies in reducing exposures. The applications of biomonitoring are rapidly expanding beyond its traditional use in occupational medicine and poisoning cases to new applications in measuring exposures and estimating health risks among the general population (Thornton et al. 2002, EWG 2003, Sexton et al. 2004, CDC 2003). Public health officials have recently used body burden data in assessing health risks for chemicals described below, all of which found in this study in newborn umbilical cord blood:
In addition to the clear benefits of its use in exposure and risk assessments that shape public health policy, body burden studies are also a powerful tool for tracking the success of programs that aim to mitigate exposures. Body burden studies show, for example, that blood lead levels in children have dropped steadily since the mandatory reduction of lead in gasoline and house paint of the 1970s; the median concentration fell 85 percent between 1976 and 2000 (EPA 2003a, Pirkle et al. 1994).
More than 75,000 commercial chemicals are currently approved for use in the U.S. (EPA 2005c), a number that grows by 2,500 new chemicals yearly (EPA 1997). U.S. industries produce or import 3,000 of these in quantities of greater than one million pounds per year (EPA 2005c). Many pesticides banned in the U.S. for decades (PCBs and DDT, for example) persist in the environment, build up in the food chain, and continue to contribute to daily exposures. Government sources detail more than 3,000 chemicals used as food additives (FDA 2005), an estimated 10,500 ingredients in personal care products (FDA 2000), and more than 500 chemicals approved as active ingredients in pesticides (EPA 2002a,2005b). Many of these chemicals, whether used purposefully or found as unwanted impurities, can contribute to a person's body burden through exposures from food, air, water, dust and soil, and consumer products. And for many chemicals in our bodies, the health consequences are unknown. The studies aren't required under federal law, and in most cases simply haven't been done.
Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results.
These health projections have been widely used by WHO and governments to help them plan their health policies. However, because they are based on the 1990 estimates of the global burden of disease, the projections now need updating, particularly since they underestimate the spread of HIV/AIDS and the associated increase in death from tuberculosis. In this study, the researchers used similar methods to those used in the 1990 Global Burden of Disease study to prepare new projections of mortality and burden of disease up to 2030 starting from the 2002 WHO global estimates of mortality and burden of disease.
The models used by the researchers provide a wealth of information about possible patterns of global death and illness between 2002 and 2030, but because they include many assumptions, like all models, they can provide only indications of future trends, not absolute figures. For example, based on global mortality data from 2002, the researchers estimate that global deaths in 2030 will be 64.9 million under the optimistic scenario. However, the actual figure may be quite a bit bigger or smaller because accurate baseline counts of deaths were not available for every country in the world. Another limitation of the study is that the models used assume that future increases in prosperity in developing countries will affect their population's health in the same way as similar increases affected health in the past in countries with death registration data (these are mostly developed countries). However, even given these and other limitations, the projections reported in this study provide useful insights into the future health of the world. These can now be used by public-health officials to plan future policy and to monitor the effect of new public-health initiatives on the global burden of disease and death.
As part of the groundbreaking Global Burden of Disease (GBD) study for 1990, Murray and Lopez [1,2] prepared projections of mortality and burden of disease by cause to 2000, 2010, and 2020 under three alternative scenarios. These projections have been widely used and continue to be widely quoted to provide information on likely future trends in global health, for example in the Atlas of Heart Disease and Stroke [3]. However, these projections were based on the GBD 1990 estimates and on projections of HIV/AIDS, smoking, income, and human capital from 1990 to 2020, and are now outdated. The HIV/AIDS projections in particular substantially underestimate the spread of the HIV epidemic and the level of HIV/AIDS mortality around 2000.
The detailed application of such methods may result in substantially improved forecasts of global mortality and burden of disease trends in the next few years. In the meantime, these updated projections provide a comprehensive update of the original GBD projections, with some methodological improvements and extensions.
Whereas the original GBD study carried out projections for eight regions of the world, we carried out these projections at country level, but aggregated the results into regional or income groups for presentation of results. Four income groups were defined based on World Bank estimates of GDP per capita in 2001 (see Table S1 for definitions of the regional and income groups). Baseline estimates at country level for 2002 were derived from the GBD analyses for 2002 as published in the World Health Report 2004 [14]. Data sources and methods for the 2002 estimates were comprehensively documented by Mathers et al. [15], together with an analysis of uncertainty levels of the results [16]. Mortality and burden of disease trends from 1990 to 2001 were recently analyzed by Lopez et al. [17]. 2ff7e9595c
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