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Competing Interests: All authors have disclosed no conflicts of interest.

Importance: Although abortion is common in the United States, patients face substantial barriers to obtaining an abortion. Recently enacted abortion restrictions pose such barriers., Objectives: To assess the association between a state legislative climate that is highly restrictive toward abortion provision and the abortion rate and to evaluate whether distance to a facility providing abortion care mediates the association between legislative climate and the abortion rate., Design, Setting, and Participants: This cohort study examined county-of-residence abortion rates from all states that publicly provided them and used data on abortion restrictions, facility locations, and county demographic characteristics for the years 2000 to 2014. The association between legislative climate and abortion rates was evaluated using propensity score-weighted, linear regression difference-in-difference analysis. All models included state and year fixed effects and standard errors adjusted for state-level clustering., Exposures: Highly restrictive legislative climate, defined as having at least 3 of 4 types of abortion restrictions; distance to a high-volume facility providing abortion care (ie, performing ≥395 abortions per year) in miles., Main Outcomes and Measures: County-level abortion rate, defined as abortions per 1000 women per year., Results: Abortion rate data were obtained from 1178 counties in 18 states for a median of 12.5 years (range, 5-14). The median abortion rate was 2.89 per 1000 women (interquartile range, 1.71-4.46 per 1000 women). A highly restrictive legislative climate, when compared with a less restrictive one, was associated with 0.48 fewer abortions per 1000 women (95% CI, -0.92 to -0.04 abortions per 1000 women; P = .03). Adjusted for distance to a facility providing abortion care, a highly restrictive legislative climate was associated with 0.44 fewer abortions per 1000 women (95% CI, -0.85 to -0.03; P = .04). Each mile to a facility was associated with 0.02 fewer abortions per 1000 women (95% CI, -0.03 to -0.01 abortions per 1000 women; P = .003). Legislative climate was not significantly associated with distance to a facility providing abortion care (change in distance associated with highly restrictive climate, -2.73 [95% CI, -6.02 to 0.57] miles; P = .10)., Conclusions and Relevance: This study provides evidence that a state legislative climate that is highly restrictive toward abortion provision is associated with a lower abortion rate. The cumulative effect of restrictive policies may pose a barrier to abortion access.

While there are different approaches to dealing with offenders sentenced to community corrections, the three major ones are law enforcement (surveillance), therapeutic (rehabilitation), and crime opportunity prevention. Using the study of U.S. community corrections staff by Miller as a guide, the current study examined the supervision strategy used by Chinese community corrections staff in the Hubei province of China. Chinese community corrections staff were more likely to use the therapeutic and crime opportunity prevention approaches than the law enforcement model. Predictors of each of the three offender supervision approaches differed. The results from Chinese staff were similar in many ways to that found among U.S. staff reported by Miller but differed in some areas.

This commentary discusses law reform on diminished responsibility in the United Kingdom and provides a personal perspective on forensic psychiatric practice relating to diminished responsibility in Hong Kong.

Aims: In comparison with other central European countries, Switzerland has a high prevalence of gun ownership and a high rate of suicide by shooting. After the Army XXI reform in 2003, which reduced personnel from about 400,000 to approximately 200,000, a decline in suicides by firearms and a decline in the total number of suicides was observed in national data spanning the period from 2000 to 2010. It is, however, unclear whether this decline can be linked to the reduced availability of military guns. This study explored whether the decline in suicide by firearms is related to the decline of suicides by army weapons., Methods: In 83.1% (n = 1112) of the 1338 suicides by firearm between 2000 and 2010 in Switzerland, the firearm could be categorised as an army weapon or a non-army weapon. The army weapon was used in 39.1% of these suicides. In comparison with other firearms, those who used army weapons tended to be younger and more likely to have a university degree. A prior suicide attempt was found less often in cases using a military weapon than other firearms. After the Army XXI reform, there was a significant drop in suicides by males aged 18 to 43 years using an army weapon, but no change in male suicide rates in the same age group who used a non-army weapon. The drop was statistically linked to a reduction of suicide by the army gun., Results: The army weapon was used in 39.1% of suicides by firearm between 2000 and 2010 in Switzerland. In comparison with other methods, those who used army weapons tended to be younger and more likely to have a university degree. A prior suicide attempt was found less often in cases using a military weapon than other methods. After the Army XXI reform, there was a significant drop in suicides by males aged 18 to 43 years using an army weapon, but no change in males' suicide rates in the same age group who used a non-army weapon. The drop was statistically linked to a reduction of suicide by the army gun., Conclusions: Males who use army weapons differ from those who use other types of weapons. The significant drop in suicides was found in males aged 18 to 43 but there was no change in males of the same age group who used a non-army weapon. These results support the hypotheses that the observed drop in suicides is linked to the Army XXI reform and that restriction of access to guns is essential for reducing suicides by firearm.

Introduction: Women have lower rates of drunken driving than men, but their share of arrests has been climbing since 1985. These trends may stem from changes in women's lives that lead to more drinking and driving, or to greater reductions in male drinking and driving. Alternatively, changes in policy and enforcement that focus on less intoxicated offenders may inadvertently target female-typical offending patterns. This paper tracked male and female drunken driving rates and the DUI sex ratio in the United States from 1985 to 2015 across three data sources., Methods: The sex ratio and prevalence estimates were derived from official arrest statistics from Uniform Crime Reports, self-reports from the Centers for Disease Control and Prevention, and traffic fatality data from the National Highway and Transportation Safety Administration. Rates were assessed for four age groups (18-20, 21-34, 35-49, and 50-64), and drunken driving trends tested using Augmented Dickey-Fuller time-series methods., Results: Decreases in DUI rates stagnated over the first decade of 2000, but have again begun to decline, according to self-reports and traffic fatality data, for all sex-by-age groups. Still, the gender gap in DUI arrests continues to narrow. From 1990 to the early 2000s, changes in social control that made female DUI more visible narrowed the gender gap in arrests. In more recent years, narrowing of the gap is due primarily to male rates declining more steeply than female rates., Conclusion: Results indicate that we need more research to understand why female declines have not kept pace with male declines and perhaps more targeted prevention efforts aimed at women., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The article presents the sociological research results of paternalistic attitudes that determine relationships between the state and the elderly in the context of new socio-economic conditions. It was revealed that the previous paternalistic expectations of the elderly are stable and manifested more in the older age group (71-90 years old). The younger age group of the elderly (55-70 years old) begins to distance themselves from the guardianship of the state and relies more on their own resources under new circumstances. Four types of elderly persons were revealed that are differentiated by the degree of social situation reflection adequacy, the state resources reliance, and their own activity. Paternalism takes on new forms, reflected in older generation citizens' mentality.

This article serves as one of the supplementary pieces of this special issue on "Mapping Queer Bioethics," in which we take a solipsistic turn to "map" the Journal of Homosexuality itself. Here, the author examines one of the most controversial moments in the history of the journal, whereby a contributor was subject to governmental and popular rebuke for his scholarship on pederasty, pedophilia, and underage queer sexuality. In a chronological and intellectual appraisal of this pedophilia-themed text, the author asks us to recalibrate the disquietude we posit when same-sex affection, youthful sexuality, and sexual abuse are in close proximity.

A new body of work has emerged under the category of creating age-friendly communities. This article briefly reviews the current state of the work and discusses a potential framework for moving to scale. Based on an understanding that the majority of the local challenges to aging in community stem from state and national policies and practices, the article calls for a measure of "creative destruction" in local efforts. That is, dysfunctional state and national systems should be boldly marked for demolition. Local age-friendly community work must be conceived of and positioned to engage larger policy issues, identify problems, and be part of a process of reinventing larger federal, state, and local policies and practices.

Objective: Firearms are the most common method of suicide among young men in Switzerland. From March 2003 through February 2004, the number of Swiss soldiers was halved as a result of an army reform (Army XXI), leading to a decrease in the availability of guns nationwide. The authors investigated the patterns of the overall suicide rate and the firearm suicide rate before and after the reform., Method: Using a naturalistic study design, the authors compared suicide rates before (1995–2003) and after the intervention (2004–2008) in the affected population (men ages 18–43) and in two comparison groups (women ages 18–44 and men ages 44–53). Data were received from the Swiss Federal Statistical Office. Interrupted time series analysis was used to control for preexisting temporal trends. Alternative methods (Poisson regression, autocorrelation analysis, and surrogate data tests) were used to check validity., Results: The authors found a reduction in both the overall suicide rate and the firearm suicide rate after the Army XXI reform. No significant increases were found for other suicide methods overall. An increase in railway suicides was observed. It was estimated that 22% of the reduction in firearm suicides was substituted by other suicide methods. The attenuation of the suicide rate was not compensated for during the follow-up years. Neither of the comparison groups showed statistically significant changes in firearm suicide rate and overall suicide rate., Conclusions: The restriction of firearm availability in Switzerland resulting from the Army XXI reform was followed by an enduring decrease in the general suicide rate.

Background: Contemporary legislative and constitutional developments in the United Kingdom for public health. This article explores these implications., Key Findings: Examination of the development of parliamentary sovereignty in the United Kingdom shows that, although there is no formal separation of powers, there is a long established convention that legislation should be subject to detailed parliamentary scrutiny, should respect common law, and should be subject to judicial review. This convention has been overturned. Consequently, many recent laws conflict with long-established human rights. Some are unworkable or damaging or both. Public health professionals are being asked to implement poorly thought out laws, against a background of loss of trust. History warns of the danger that public health could be sucked into participation in repressive policies that override the rights of the individual in the apparent interests of the public good., Conclusions: There is a need for a rebalancing of power in the United Kingdom, both among the three branches of government (executive, legislature, and judiciary) and its constituent parts (England, Scotland, Wales, and Northern Ireland). Constitutional reform is a long-term aim but for now much can be done to hold the executive to account and to be aware of the dangers faced by public health.

Aim: To assess alcohol-related harms and offences in New Zealand from 1990 to 2003, a period of alcohol policy liberalization, that included the lowering of the purchase age from 20 to 18 years in 1999., Design, Setting and Participants: Time trend analyses were carried out on routinely collected data for prosecutions for driving with excess alcohol; alcohol-involved vehicle crashes (all and fatal) and prosecutions for disorder offences. These were carried out separately for those aged 14-15, 16-17, 18-19, 20-24 and 25 years and over., Measurements: Rates of: prosecutions for driving with excess alcohol (1990-2003); rates of alcohol- involved vehicle crashes (all and fatal) (1990-2003); and rates of prosecutions for disorder offences (1994-2003)., Findings: Effects of alcohol policy liberalization: positive trends were found in the rates of prosecutions for disorder in the 16-17, 18-19, 20-24 and 25 + age groups; with 18-19-year-olds and 16-17-year-olds having the largest rates and largest positive trend in rates. For 16-17-year-olds, there was a positive trend in the rates of prosecutions for excess breath alcohol. Negative trends in rates were found for alcohol-related crashes (all and fatal) among all age groups. Negative trends for those over 16-17 years were found for prosecutions for driving with excess breath alcohol (this was prior to the lowering of the purchase age). Effects of lowering the minimum purchase age: the lowering of minimum purchase age coincided with an increase in the trend of alcohol-related crashes for 18-19-year-olds; the next largest increase was among the 20-24-year-olds (all other age groups also increased but at a much lower rate). A similar result was found for driving with excess alcohol for those aged 18-19 (and those aged 20-24 years). An increase in the rates of prosecutions for disorder offences occurred for the 14-15-year-old group following the lowering of the purchase age., Conclusion: The liberalization of alcohol throughout the 1990s may have influenced younger people more, as reflected in increases in their disorder offences and drink driving. The lowering of the minimum purchase age may have led to an increase in drink-driving among the 18-19-year-olds (those directly affected by the change in purchase age).

Several thousand young Americans visit the bars in Tijuana, Mexico, each weekend night, raising concerns on both sides of the border. Measures implemented in San Diego, California, and Tijuana have successfully reduced the number of American visitors to Mexican bars. Although San Diego policies have been well-documented, this is the first article on investigation of measures enacted south of the border. Information on Tijuana alcohol policies was obtained from a survey of 29-36 bars from 1997 to 1999. The Tijuana police provided data on Americans arrested in Tijuana from 1998 to 1999. Our study found alcohol regulations are poorly enforced in Tijuana, suggesting that regulatory agencies are captured by bar owners. However, such a capture may be weakening. The importance of identifying and supporting Mexican interest groups, as opposed to the bar owners, as a mechanism to impede the capture of Tijuana's regulatory agencies is discussed. The number of Americans involved in alcohol-related crimes in Tijuana sharply decreased over time. However, such a success is largely related to the success of the San Diego efforts in reducing the number of American visitors to Tijuana. Also, by demonstrating the racial/ethnic heterogeneity of American visitors to Tijuana bars, our study points out the need for prevention policies designed north of the border to take such heterogeneity into account.

This report summarises the controversy of genetic tests and insurance, with a focus on the UK situation during the past decade. UK experience provides insight for future strategies to help people with genetic disadvantages make insurance provision for themselves and their families. Non-disclosure of genetic test results (already carried out for clinical purposes) may not benefit people at risk of genetic disorders or with positive genetic tests. The pressure of geneticists over a decade to prevent disclosure to insurers may have masked opportunities to use insurance to provide help for people with genetic disadvantages. To seize the opportunities now, there must be collaboration, not conflict. Politicians, geneticists, social scientists and all elements of the insurance industry can contribute to wise solutions.

This is a report of a pre- and post-intervention telephone survey to track changes in workplace tobacco policy in Pima County, Arizona, from 1997 to 1999. During this period, an extensive effort was made to assist workplaces to establish and enforce formal tobacco use policies. A random sample of 1134 workplaces, stratified by workforce size, was surveyed in 1997. Complete interviews were conducted with 934 (82.4%) workplaces. All 934 workplaces were contacted for the follow-up survey that was conducted in 1999. Of these, 824 (88.2%) completed follow-up surveys. The analyses presented were conducted on businesses that were included in both the baseline and follow-up surveys, and that reported having at least one employee on-site (n = 813). Tobacco policies and smoke-free policies were more likely to be found in larger businesses and businesses with a predominantly female workforce. There was no clear policy progression from having no policy, to having a policy, to becoming smoke-free. There was a small but significant overall decrease (4.8%) in the proportion of businesses having policies in the last two years. We found that 10.3% (75) of businesses that had policies in 1997 had dropped their policies by 1999, and that 13.4% (73) of worksites that were smoke-free in 1997 retained tobacco policies but were not smoke-free in 1999. However, formalization of policy in writing and the number of enforcement strategies utilized increased. These findings suggest that efforts to encourage businesses to establish workplace tobacco policies must be sustained even after policies have been established.

This paper employs an Eliasian perspective to provide an historical overview to the contemporary crisis in British prisons. It argues that some of the roots of this crisis lie within the very attempts to bring prison development in line with the cultural values of modern society.

Until recently sex and gender issues were thought to be biological or natural rather than political. The feminist movement largely changed perceptions of gender, and the gay and lesbian movements significantly altered conceptions of sex, so that what were once seen as permanent moral standards are now viewed as historical and political constructions. As views of these groups have moved towards social constructionism, perceptions of child sexuality have become more absolutist. Current attitudes towards child sexuality and representations of it resemble historical attitudes towards women and homosexuals. This article argues that there is a two-phase pattern of sexual politics. The first is a battle to prevent the battle, to keep the issue from being seen as political and negotiable. Psychological and moral categories are used to justify ridicule and preclude any discussions of the issue, and standard Constitutional guarantees are seen as irrelevant. The second phase more closely resembles traditional politics as different groups argue over rights and privileges. Feminist and gay/lesbian politics have recently entered the second phase, while pedophilia is in the first.