by tyler | Apr 3, 2023 | CNN, health
A new study found a moderately higher risk of autism spectrum disorder in children born to pregnant people exposed to tap water with higher levels of lithium, but experts caution that this association does not show a direct link between the two.
About 1 in 36 children in the US is diagnosed with autism spectrum disorder (ASD) each year, according to data from the US Centers for Disease Control and Prevention.
Scientists still don’t know the exact cause of autism, a developmental disorder. Genetics may be a factor, but some have been looking at potential environmental causes, too.
Cases may be on the rise, but that is also unclear. One study published this year on cases in the New York-New Jersey area found that autism diagnosis rates tripled among certain age groups between 2000 and 2016. A 2021 report found similar increases in cases, but the CDC says the increased number of cases is most likely linked to more doctors screening for the condition.
Lithium is a rare earth element that can be found naturally in some food and ground water. It’s used in batteries, grease and air conditioners, as well as in the treatment of bipolar disorder and some blood disorders. Its levels in US drinking water are not regulated, according to the US Geological Survey.
A new study, published Monday in the journal JAMA Pediatrics, found a small association between lithium and autism diagnosis in Denmark, where the researchers say the level of lithium in drinking water is similar to that in American water systems.
The researchers checked a database of people with psychiatric disorders for children born between 2000 and 2013 to find information on 8,842 cases of ASD and 43,864 participants who did not have ASD. They then measured the concentration of lithium in 151 public waterworks that served more than half of the Danish population and mapped out where pregnant people lived in relation.
As lithium levels in water increased, there was a modest increased risk of an ASD diagnosis. Specifically, compared with people at the lowest exposure level, those who had the second and third highest exposure during pregnancy had a 24% to 26% higher risk of ASD diagnosed in children. The group with the highest exposure had a 46% higher risk than those at the lowest level of exposure.
The researchers could not tell how much water the pregnant people drank, but they picked Denmark in part because residents there consume some of the lowest amounts of bottled water in Europe.
Experts say it’s important to note that the research can’t show that lithium exposure leads directly to an autism diagnosis.
Further study is required, said study co-author Dr. Beate Ritz, a professor of neurology in the David Geffen School of Medicine at UCLA, and a professor of epidemiology and environmental health at the UCLA Fielding School of Public Health.
“Any drinking water contaminants that may affect the developing human brain deserve intense scrutiny,” Ritz said in a news release. She added that the research would need to be replicated in other countries to look for a similar connection.
The implications of the findings are complex as far as public health policy is concerned, according to an editorial published alongside the study. Lithium levels in water, at concentrations that the study associated with a potential ASD risk, have also been linked with health benefits such as lower rates of hospitalization for psychiatric disorders and suicide.
“If all these of associations are valid, the wisdom of Solomon will be required to develop guidelines for lithium in drinking water that are maximally protective of the entire population,” wrote Dr. David C. Bellinger, a professor of neurology and psychology at Harvard Medical School. “Until the basic biology of ASD is better understood, it will be difficult to distinguish causal from spurious associations.”
Dr. Max Wiznitzer, director of the Rainbow Autism Center at University Hospitals Rainbow Babies and Children’s Hospital in Cleveland, points to other research on the effects of lithium on pregnant people who take it for mental health disorders. Those studies – which look at people exposed to much higher levels than are found in drinking water – do not show a connection with autism spectrum disorder.
“It’s an interesting association, but causation is definitely not proven,” said Wiznitzer, who was not involved in the new research. “We have to see if there’s a viable and biologically plausible mechanism by which a small amount of lithium in the water supply can somehow do this, yet pharmacologic dosing of lithium in women with bipolar disorder has not been reported to be causing increased risk of ASD.”
Other studies have also suggested connections between ASD and environmental exposures to things like pesticides, air pollution and phthalates. But none of them points to any of these factors as a direct cause of the disorder.
A link between environmental exposure and ASD is hard to prove, Wiznitzer said. With research showing that increased exposure to air pollution raises the risk of giving birth to a child with ASD, for example, he often wonders whether pollution is the determining factor or if it’s just the populations who live in more polluted areas.
“There’s a lot of speculation about about environmental factors, but how many of them are truly causally associated?” Wiznitzer said. “We are bombarded with a variety of environmental stressors in our everyday lives. We have to figure out how to basically safely navigate them, and this is probably not one that’s high on our list.”
by tyler | Apr 3, 2023 | CNN, health
The manufacturer of eye drops that have been linked to an outbreak of serious bacterial infections in the US, including at least three deaths, did not follow proper protocol to prevent contamination of its products, according to an inspection report published Friday by the US Food and Drug Administration.
The FDA visited a Global Pharma Healthcare facility in India for an inspection that started in mid-February, two and a half weeks after the company had voluntarily recalled the EzriCare Artificial Tears product due to possible contamination. At the time of the recall, there were already 55 reports of adverse events including eye infections, permanent loss of vision and at least one death with a bloodstream infection.
An 11-day inspection resulted in 11 observations by the FDA, including a “manufacturing process that lacked assurance of product sterility,” specifically for batches of product that were manufactured between December 2020 and April 2022 and shipped to the US.
EzriCare Artificial Tears product, which is manufactured by Global Pharma Healthcare, is part of an outbreak of a rare and drug-resistant bacteria called Pseudomonas aeruginosa. The particular strain of the bacteria associated with this outbreak had never before been reported in the US. Patients affected by the outbreak reported using different brands of artificial tears, but EzriCare Artificial Tears was most commonly reported.
The FDA inspection of the Global Pharma Healthcare facility is part of an ongoing compliance matter.
“The FDA’s highest priority is protecting public health – this includes working with manufacturers to quickly remove unsafe drugs from shelves when they are identified,” the agency told CNN in an email on Monday. “The FDA continues to monitor this issue and is working with the Centers for Disease Control and Prevention (CDC) and the companies recalling these affected products. We urge consumers to stop using these products which may be harmful to their health.”
by tyler | Mar 31, 2023 | CNN, health
These days, many people find it hard to unplug. Inflation, global warming and gun violence are on the rise. Bullies proliferate on social media. The 24/7 news cycle constantly blares distressing news, and people often face difficult personal or professional situations.
About half of Americans said they experienced stress within the past day, according to a Gallup Poll survey from last October, a finding that was consistent for most of 2022. Personal finances and current and political events were major sources of stress for one-third or more of adults, a survey from CNN in partnership with the Kaiser Family Foundation found in October.
Stress isn’t inherently bad, said Richard Scrivener, a personal trainer and product development manager at London’s Trainfitness, an education technology company. Stressing your muscles through weight training, for example, leads to beneficial changes. In addition, short-term stress in healthy people typically isn’t a hazard. “But if stress is continuous, especially in older or unhealthy individuals, the long-term effects of the response to stress may lead to significant health issues,” Scrivener said.
Stress occurs when you face a new, unpredictable or threatening situation, and you don’t know whether you can manage it successfully, said clinical psychologist Dr. Karmel Choi, an assistant professor in the Center for Precision Psychiatry at Harvard Medical School and Massachusetts General Hospital in Boston.
When you’re physically or emotionally stressed, your body snaps into fight-or-flight mode. Cortisol rushes through your system, signaling your body to release glucose. Glucose, in turn, provides energy to your muscles so you are better prepared to fight off a threat or run away. During this cortisol rush, your heart rate may rise, your breathing may become rapid, and you may feel dizzy or nauseated.
If you truly needed to fight or flee a predator, your cortisol levels would drop back down once the conflict was over. When you’re chronically stressed, however, those levels stay elevated.
Remaining in that heightened state is no good since high levels of cortisol can exacerbate health conditions such as cardiovascular disease, diabetes and chronic gastrointestinal problems, according to the Cleveland Clinic. Stress can also cause or contribute to anxiety, irritability, poor sleep, substance abuse, chronic distrust or worry, and more.
Luckily, there are many ways to combat stress. Keep a daily routine, get plenty of sleep, eat healthy foods, and limit your time following the news or engaging in social media, recommends the World Health Organization. It also helps to stay connected with others and to employ calming practices such as meditation and deep breathing. One of the most successful tools, though, is physical activity.
“Exercise is remarkably effective for managing psychological stress,” Choi said. “Exercise doesn’t remove what’s causing the stress, but it can boost mood, reduce tension and improve sleep — all of which are impacted by stress — and ultimately this can support people to approach their challenges in a more balanced way.”
Numerous studies back up the positive effect of exercise on stress. Physical activity, and especially exercise, significantly reduced the symptoms of anxiety in a study published in Advances in Experimental Medicine and Biology, for example. Similarly, a Frontiers in Psychology study of university students found that regularly engaging in low- to moderate-intensity aerobic exercises for six weeks helped alleviate their depressive symptoms and perceived stress.
The reason exercise is so effective in squashing stress is fairly simple. Exercise causes your body to produce more endorphins, which are neurotransmitters that boost your mood. Movement also combats elevated levels of the stress hormone cortisol while improving blood flow.
Jessica Honig, a clinical social worker in Phoenixville, Pennsylvania, said exercise empowers her clients because they realize that, through movement, they hold the key to reset and lessen their stress. “It’s also one of the best ways to pause — to break up or revive energy from a spiraling, unproductive mindset,” she said.
What types of exercise are best? While studies show aerobic exercise, such as swimming, running, dancing and boxing, may be the most efficient at getting mood-boosting endorphins rushing through your body, gentler forms of physical activity work, too. Think yoga, strength training and walking. In addition, sometimes less is more.
“What we’re seeing from the data,” Choi said, “is you actually need to move less than the recommended guidelines to see positive effects on mood.”
Since stress loads may change weekly or even daily, Scrivener said it can be helpful to alter your exercise based on your mood. Feeling a cheery 8 on a scale of 1 to 10? Then go for a run. Barely hitting a 3? Opt for something gentle. “This could be a 15-minute stretch followed by a light cycle for 15 minutes, or a 30-minute swim followed by a sauna session,” he said.
Since social engagement is a powerful protective factor for positive mental health, Choi encourages exercising with others. Studies also have shown being out in nature boosts your mood, so exercising outside with friends may provide even more benefits.
Scientists continue to study the link between stress and physical activity. A small study published recently found that combining mindfulness and physical activity can improve sleep and help regulate emotions more than either alone, Choi said. She also warned that people need to be careful not to go overboard on exercise or rely on it exclusively for coping with challenges. Doing so can backfire and create more stress.
It’s also important to remember that humans are geared to release stress physically, no matter their age, said Honig, the social worker. “We see in children the permission to throw their body into pillows to release intense emotions,” she said. “We do not outgrow a need to physically release stress. We merely lose the outlets and social normalization of it.”
by tyler | Mar 31, 2023 | CNN, health
Seven US government investigators briefly fell ill in early March while studying the possible health impacts of a toxic train derailment in East Palestine, Ohio, the US Centers for Disease Control and Prevention confirmed to CNN on Thursday.
The investigators’ symptoms included sore throats, headaches, coughing and nausea – consistent with what some residents experienced after the February 3 train derailment that released a cocktail of hazardous chemicals into the air, water and soil.
The investigators who experienced symptoms were part of a team conducting a house-to-house survey in an area near the derailment, and they immediately reported their symptoms to federal safety officers.
“Symptoms resolved for most team members later the same afternoon, and everyone resumed work on survey data collection within 24 hours. Impacted team members have not reported ongoing health effects,” a CDC spokesperson said in the statement.
The illnesses are coming to light after repeated assurances by government officials and representatives from Norfolk Southern, the company that operated the train, that the air and drinking water in East Palestine is not hazardous to health.
It is not clear what caused the investigators’ symptoms – whether chemical exposure or something else, such as fatigue. But the team, some of whom are officers and physicians in the CDC’s Epidemic Intelligence Service, found it suspicious that they became ill at the same time and with the same symptoms, according to an official familiar with the cases who spoke to CNN.
The official asked to not be identified because they are not authorized to share details of the incident; a CDC spokesperson confirmed information in the official’s account, including the date, the number of people involved and the symptoms they experienced.
Because the investigators’ symptoms improved soon after they left the area, the incident was not reported to the public, the official said, noting that reports of illnesses experienced by CDC personnel on the job wouldn’t ordinarily be disclosed.
Still, experts in chemical exposures say the episode is significant.
“It adds confirmation that the symptoms reported by East Palestine residents are real and are associated with environmental exposures from the derailment and chemical fire,” said David Michaels, an epidemiologist and professor at the George Washington University School of Public Health who ran the Occupational Safety and Health Administration between 2009 and 2017. He has not been involved in the investigation in East Palestine.
In a separate case in February, two contractors who were working for the US Environmental Protection Agency reported symptoms related to strong odors and reported them to the site safety officer. The safety officer advised the contractors to step away from the area where they were working and monitor their symptoms, according to a statement sent to CNN by an EPA spokesperson. Their symptoms eased, and they returned to work at the site the same day. No other incidents have been reported by more than 100 EPA personnel deployed to the site, the statement said.
CNN asked the EPA where the contractors were working and what they were doing when they experienced these symptoms, but the EPA did not respond by deadline.
A spokesperson for the Federal Emergency Management Agency says its safety officer didn’t receive any reports of staff experiencing symptoms while working in the area.
Andrew Whelton, a professor of civil and environmental engineering at Purdue University who has been traveling to East Palestine to conduct independent testing for the town, says he hopes the government agencies will continue to be forthcoming about the experiences of their staff and contractors in the area.
“I think it is important for not only government officials to communicate with each other, but also to communicate their experiences with the public, so that everybody can understand what’s going on, and how help needs to be brought to East Palestine and the surrounding areas,” Whelton told CNN.
The cause of the February 3 crash is still under investigation, but preliminary reports suggest that a wheel bearing on the train overheated, caught fire and failed – sending 11 cars carrying more than a million pounds of hazardous chemicals off the tracks.
Chemicals spilled into the soil and air and into two small creeks that run through the town. A car carrying flammable vinyl chloride became unstable, sparking fears of a massive explosion. Nearby residents were evacuated while small holes were punched in the railcars so the vinyl chloride could be channeled into a trench where it was burned. A black mushroom cloud rose over the town and left ash and soot on cars and buildings for miles around.
Since February 8, when the burning railcars were finally extinguished, state and federal officials have consistently told East Palestine residents that they have not detected any chemicals linked to the derailment in air or drinking water at levels that would threaten human health.
Yet people living in East Palestine and the surrounding area have continued to share stories about unexplained symptoms including headaches, sore throats, nasal congestion, bloody noses, skin rashes, coughs and eye irritation.
The government team that experienced symptoms is from the CDC’s Agency for Toxic Substances and Disease Registry, or ATSDR, a branch that assesses the health impacts of chemical exposures. After the train derailment, ATSDR sent 15 people to East Palestine to conduct an Assessment of Chemical Exposure, known as an ACE investigation.
They often worked 18-hour days, going door-to-door to ask residents a detailed set of questions about where they spent their time in the days after the spill and what symptoms they or their pets may have experienced.
They worked in small groups of two and three to visit houses in the areas that they expected to be the most affected by the chemicals based on their proximity to the spill and two area creeks, Leslie Run and Sulphur Run, which have been heavily contaminated. They also surveyed parts of nearby Beaver County, Pennsylvania, which was downwind of the spill on the night of the derailment and the controlled burn of five tankers of vinyl chloride, a chemical used to make PVC pipe.
It’s not clear what area the team members were in when they began to feel ill. The CDC spokesperson said the other eight members of the team did not experience symptoms.
The official who was familiar with the cases said team members reported their illnesses to the EPA’s on-site safety officer, who advised them to return to their hotel in Cranberry Township, Pennsylvania, about 30 miles from East Palestine, and to the CDC’s Office of Safety, Security and Asset Management, or OSSAM, the agency’s workplace safety office. OSSAM agreed with the EPA assessment that team members should return to their hotel that night, March 6. The team then worked from their hotel on March 7, according to the official.
The CDC acknowledged the incident to CNN after posts began circulating on social media saying the team was sent home because they got sick; the official said that wasn’t the case.
Members of the team began to rotate out of the area as they finished their work. Most of the team members left March 10, and the last member left March 16, according to the official.
Early results of the Ohio ACE survey show that more than half of the 514 residents who have taken it so far have experienced symptoms after the derailment. The top symptoms reported by residents in the area are headaches, reported by 74% of people taking the survey; anxiety (61%); coughing (53%); fatigue (53%); pain, irritation or burning of the skin (50%); and stuffy nose/sinus congestion (50%), according to the Ohio Department of Health. The questions on the survey ask about a “burning nose or throat” but didn’t specifically mention sore throats or nausea.
The surveys can’t prove that residents were exposed to harmful levels of chemicals or that those chemicals caused their symptoms. They are meant to be a snapshot, documenting the health of the community after an event that results in potentially hazardous exposures.
The ATSDR team reports the results of the surveys back to the state departments of health and may make recommendations based on the findings. The team is doing a total of three reports: one for Ohio, one for residents in Pennsylvania and a third on the first responders to the derailment.
Preliminary results are expected to be shared with the states in early April, with final reports released to the public within a few months.
As of March 28, ATSDR had conducted 1,002 ACE surveys: 686 for area residents and 316 for derailment responders, the CDC spokesperson said in an email to CNN.
The EPA continues real-time air monitoring in East Palestine using a specially equipped bus that samples and tests the air. To date, the agency reports that the cleanup has removed an estimated 11,961 tons of contaminated soil and 9.2 million gallons of liquid wastewater.
It has also tested the indoor air of 624 area homes and sampled the soil at 115 properties in the area.
The agency said this week that early results of its dioxin testing have not shown any levels above expected background levels, although it didn’t release any of the test results, which are still going through quality checks.
Testing conducted by the Ohio EPA shows that two creeks that run through East Palestine are still testing positive for chemicals released by the spill. The state is using aerators to increase oxygen in the water to speed the breakdown of those chemicals.
The testing shows that the chemical levels in the streams are dropping over time, but some chemicals spilled from the train are still being detected almost two months after the derailment. On a recent visit to the area, EPA Administrator Michael Regan said children and adults should not go near the creeks.
“As a father, I would not advise anybody – adult or child – play in the creeks or stream. What we’ve said is the drinking water has been tested” and found to be safe, Regan said at a news conference in East Palestine on March 1.
At a hearing this month, Norfolk Southern CEO Alan Shaw was asked whether he would live in East Palestine, given what he knows about the derailment.
“Yes, sir,” Shaw responded in testimony before the Senate’s Environment and Public Works Committee on March 9. “I believe that the air is safe. I believe that the water is safe. There are hundreds of tests, there are millions of data points, and they all point to the same thing.”
To residents, the official assurances that everything is fine sound hollow.
“They’re all scientists. They’re sitting up here telling us nothing’s wrong. I want you to tell me why everybody in my community is getting sick,” resident Jami Cozza told a panel of federal and state experts at a contentious town hall in East Palestine on March 2.
State and federal government officials have also suggested that the physical complaints some continue to experience are being driven by fear and anxiety, rather than some kind of chemical exposure.
“While all the tests of the air and the soil and the water have thus far shown repeatedly that things are safe, fear – fear remains,” Ohio Gov. Mike DeWine said in testimony before the Senate Committee on Commerce, Science and Transportation on March 23.
DeWine also announced this month that the temporary health assessment clinic, which has been operating out of a local church, will expand its services and become permanent through a partnership with East Liverpool City Hospital, a nonprofit health center.
The clinic will offer primary care, including blood and urine testing and physical exams. Krista McFadden, CEO of East Liverpool City Hospital, told CNN that it will treat anyone who needs care, regardless of their ability to pay.
The clinic is scheduled to open April 10.
by tyler | Mar 30, 2023 | CNN, health
Prescriptions for stimulants often used to treat attention-deficit/hyperactivity disorder surged during the pandemic, especially among adults, a new study found.
The finding comes as one common ADHD treatment, Adderall, has been in shortage for months, in part because of high demand.
Diagnoses for ADHD have become more common in recent decades, and prescriptions for stimulant drugs that are most often used to treat the neurodevelopmental disorder have also been on the rise. But the new report from the US Centers for Disease Control and Prevention highlights a recent surge in demand for the drug and others like it.
Between 2016 and 2020, the share of the population that had filled a prescription for a stimulant drug held relatively steady. But there was a large increase in 2021, with prescription fills jumping more than 10% across most age groups.
Overall, the CDC analysis of private insurance records shows that more than 4% of people ages 5 to 64 had filled a prescription for a stimulant in 2021, up from 3.8% in 2020. The vast majority of people who are prescribed stimulant medications have an ADHD diagnosis or are being treated for symptoms of the disorder.
ADHD is typically identified in childhood and has been more prevalent among boys, and the CDC analysis found that stimulant prescriptions were consistently most common among boys ages 5 to 19.
However, the largest annual increases in 2021 were among adults, especially women in their 20s and 30s.
There are well-established clinical guidelines for ADHD care for children and adolescents, with an outline of symptoms that show a persistent pattern of inattention or hyperactivity-impulsivity. While there is growing recognition of ADHD in adults, a comparable playbook for adults does not exist.
The gap in guidance for adults is a public health concern in part because of the “general inadequate access to mental health providers trained to diagnose and manage ADHD,” according to the researchers.
“Development of clinical recommendations for diagnosing and managing adult ADHD could help guide safe and appropriate stimulant prescribing,” they wrote.
While stimulants can offer “substantial benefits” for people with ADHD, there are also potential harms including misuse and overdose. Nearly 33,000 people died from an overdose involving a psychostimulant in 2021, CDC data shows. Methamphetamine is primary drug involved, but deaths have nearly doubled since 2019.
The sharp rise in prescriptions for stimulants during the pandemic also raises questions about the role of telehealth.
Expanded access to telehealth during the pandemic could have removed barriers and encouraged more people to seek care, especially during a time when mental health struggles were exacerbated.
But it also could have introduced greater potential for inadequate evaluations or inappropriate stimulant prescribing, according to the researchers.
“Evaluation of policies enacted during the pandemic could identify benefits and harms of those policies,” they wrote.
Some people who use stimulants for ADHD have struggled for months to fill their prescriptions.
The US Food and Drug Administration announced a shortage of Adderall on October 12, 2022. The agency noted that it was in communication with all manufacturers of amphetamine mixed salts and that one of those companies was “experiencing ongoing intermittent manufacturing delays.” Although other manufacturers continued to produce the drug, the agency said, “there is not sufficient supply to continue to meet U.S. market demand through those producers.”
Jim McKinney, a spokesperson for the agency, told CNN last month that the manufacturing delay has been resolved and that the shortage is now “demand-driven.”
On its website, the FDA lists eight manufacturers that have reported Adderall shortages to the agency. The website lists the shortage reason for some versions of the drug, such as “demand increase” or “shortage of active ingredient,” but for other versions, it just says “other” or lists no reason at all.
by tyler | Mar 30, 2023 | CNN, health
Emergency department visits for firearm injuries in the United States dropped slightly since 2020, but the rate in 2022 was still above pre-pandemic levels.
According to a new study published Thursday by the US Centers for Disease Control and Prevention in the Morbidity and Mortality Weekly Report, the weekly number of emergency department visits related to firearm injuries began to rise in March 2020 before sharply increasing in May 2020 and remaining high.
The sharpest increase in visits happened the week of May 24, 2020, during a “period of increased social unrest over strained law enforcement–community relations and longstanding systemic inequities, structural racism, and trauma experienced by racial and ethnic minority groups in the United States,” the authors wrote in the study.
On May 25, 2020, George Floyd was killed by three former Minneapolis police officers. The video of his death sparked nationwide uproar related to systemic racism and inequality.
In 2021, the rate dropped slightly from 2020. In 2022, the rate fell again, but still sat above the rate of weekly emergency department visits related to firearm injuries in 2019, prior to the pandemic.
Compared to the rate of visits in 2019, 2020 was 37% higher than the previous year, 2021 was 36% higher than 2019, and 2022 was 20% higher than that year.
In 2019, the average weekly number of visits was about 979, according to the study.
In 2022, the average number of weekly visits reached 1,170.
Of those 1,170 visits, roughly 180 of them were for women and about 990 were for men.
In general, most visitors between 2019 and 2022 were 15 to 24 years of age, but there was a sharp increase in infant to 14-year-olds going to the emergency department for firearm injuries.
In 2019, on average, about 29 of the 979 people who visited an emergency department for firearm related injuries were ages 0 to 14.
In 2022, on average, infants to 14-year-olds made up about 40 of the 1,170 weekly visits.
The authors offered some background for why there was an increase in visits among children.
“Challenges faced by children and adolescents during the COVID-19 pandemic might have influenced their risk for firearm injury, including disruptions to daily routines and schooling,” the authors of the study wrote.
Social isolation, physical distancing, increased time at home, changes in healthcare access, and diminished security and safety could have increased access to firearms in the home for children.
During the Covid-19 pandemic, the rate of firearm homicides increased by 35%, and in 2020 the rate was the highest on record since 1993, according to the study.
In 2021, the rate of firearm suicide was the highest on record since 1990.
According to previous CDC data, during the Covid-19 pandemic in 2020, US counties with the highest poverty level had firearm homicide and firearm suicide rates that were 4.5 and 1.3 times as high, respectively, as counties with the lowest poverty level.
That same year 79% of all homicides and 53% of all suicides in the US involved firearms, according to the CDC.
More research is needed to better understand the overall causes for the increase in emergency department visits for firearm injuries, the study said.
The study said this data should be used to create a comprehensive approach to prevent and respond to firearm injuries, and to address the social and economic inequalities that contribute to an increased risk of violence.
These strategies should be community based, according to the study, and might include street outreach programs and conflict de-escalation tools.
The study authors also suggested implementing hospital-based programs that intervene with victims of violence and improving community physical environment through vacant lot remediation.
Outside of community initiatives, the authors say enhanced secure firearm storage could reduce firearm access to people who could hurt themselves or others.
