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Aims: Alcohol-related harm places a significant strain on victims, perpetrators and society. The present research reports on how licensed alcohol outlet business hours may influence the reported incidence of interpersonal violence and the associated burden of disease. Methods: We examined the relationship between alcohol outlet business hours and violent crime in 2009 in New York State (excluding New York City). Regression analyses modeled the burden of disease for the violence associated with outlet business hours. Results: Every 1 h increase in weekly outlet business hours was associated with a greater reported incidence of violent crimes generally, more reported aggravated assaults and more reported non-gun violence. The estimated cost from having licensed premises open after 1 a.m. was $194 million in 2009. Conclusion: The findings suggest that alcohol outlet business hours affect the incidence of reported violence even in regions that would not be considered to have severe problems with alcohol-fueled violence. [ABSTRACT FROM AUTHOR]

Background:Methamphetamine-related harms have been increasing in Melbourne, Australia, yet little is known of how users interact with the drug market. We describe methamphetamine purchases and use as reported by a Melbourne-based cohort of people who inject drugs (PWID). Methods:A total of 2862 interviews from 757 participants of the Melbourne Injecting Drug User Cohort Study between April 2008 and February 2015 were used to generate descriptive statistics for the: size, search time and setting (e.g. house, street) of methamphetamine purchases, and the percentage that were shared; and the time of day, time between purchasing and using and setting of methamphetamine use. Results:No meaningful differences were observed between the powder and crystal methamphetamine markets. The most frequently purchased amount of methamphetamine was $100 with much larger transactions common; however 42% of purchases were shared, most commonly 50/50 with a partner or friend. The median time to obtain methamphetamine was 20 minutes (interquartile range (IQR) 5–30 minutes) and the median time between purchasing and using methamphetamine was 5 minutes (IQR 5–10 minutes). Most purchases were used between 10 am and 2 pm (43% of purchases), but 33% were used outside of business hours. Both purchasing and using methamphetamine occurred more frequently in houses than public settings. Conclusions:It was common for PWID in our sample to obtain >$100 of methamphetamine with a partner or friend, with relatively little search time. Support services for methamphetamine users may need to increase their operating hours to adapt to the large amount of use occurring outside of business hours. [ABSTRACT FROM AUTHOR]

Background: Primary care serves all age groups and individuals with health states ranging from those with no chronic conditions to those who are medically complex, or frail and approaching the end of life. For information to be actionable and guide planning, there must be some population disaggregation based on differences in expected needs for care. Promising approaches to segmentation in primary care reflect both the breadth and severity of health states, the types and amounts of health care utilization that are expected, and the roles of the primary care provider. The purpose of this study was to assess population segmentation as a tool to create distinct patient groups for use in primary care performance reporting. Methods: This cross-sectional study used administrative data (patient characteristics, physician and hospital billings, prescription medicines data, emergency department visits) to classify the population of British Columbia (BC), Canada into one of four population segments: low need, multiple morbidities, medically complex, and frail. Each segment was further classified using socioeconomic status (SES) as a proxy for patient vulnerability. Regression analyses were used to examine predictors of health care use, costs and selected measures of primary care attributes (access, continuity, coordination) by segment. Results: Average annual health care costs increased from the low need ($ 1460) to frail segment ($10,798). Differences in primary care cost by segment only emerged when attributes of primary care were included in regression models: accessing primary care outside business hours and discontinuous primary care (≥5 different GP's in a given year) were associated with higher health care costs across all segments and higher continuity of care was associated with lower costs in the frail segment (cost ratio = 0.61). Additionally, low SES was associated with higher costs across all segments, but the difference was largest in the medically complex group (cost ratio = 1.11). Conclusions: Population segments based on expected need for care can support primary care measurement and reporting by identifying nuances which may be lost when all patients are grouped together. Our findings demonstrate that variables such as SES and use of regression analyses can further enhance the usefulness of segments for performance measurement and reporting. [ABSTRACT FROM AUTHOR]

Background: Washington State (WA) legalized a recreational marijuana market - including growing, processing and retail sales - through voter initiative 502 in November 2012. Legalized recreational marijuana retail sales began in July 2014. In response to state legalization of recreational marijuana, some cities and counties within the state have passed local ordinances that either further regulated marijuana markets, or banned them completely. The purpose of this study is to describe local-level marijuana regulations on recreational retail sales within the context of a state that had legalized a recreational marijuana market.Methods: Marijuana-related ordinances were collected from all 142 cities in the state with more than 3000 residents and from all 39 counties. Policies that were in place as of June 30, 2016 - two years after the state's recreational market opening - to regulate recreational marijuana retail sales within communities were systematically coded.Results: A total of 125 cities and 30 counties had passed local ordinances to address recreational marijuana retail sales. Multiple communities implemented retail market bans, including some temporary bans (moratoria) while studying whether to pursue other policy options. As of June 30, 2016, 30% of the state population lived in places that had temporarily or permanently banned retail sales. Communities most frequently enacted zoning policies explicitly regulating where marijuana businesses could be established. Other policies included in ordinances placed limits on business hours and distance requirements (buffers) between marijuana businesses and youth-related land use types or other sensitive areas.Conclusions: State legalization does not necessarily result in uniform community environments that regulate recreational marijuana markets. Local ordinances vary among communities within Washington following statewide legalization. Further study is needed to describe how such local policies affect variation in public health and social outcomes. [ABSTRACT FROM AUTHOR]