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Article ; Online: Racist Factors Underlying Prostate Cancer Disparities.

Poulson, Michael

JAMA oncology

2022 Volume 8, Issue 5, Page(s) 696–697

MeSH term(s)	Health Status Disparities ; Healthcare Disparities ; Humans ; Male ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/therapy
Language	English
Publishing date	2022-03-03
Publishing country	United States
Document type	Journal Article ; Comment
ISSN	2374-2445
ISSN (online)	2374-2445
DOI	10.1001/jamaoncol.2021.7271
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Article ; Online: Geospatial Analysis of Social Vulnerability, Race, and Firearm Violence in Chicago.

Dirago, Camille / Poulson, Michael / Hatchimonji, Justin / Byrne, James / Scantling, Dane

The Journal of surgical research

2023 Volume 294, Page(s) 66–72

Abstract: Introduction: Urban firearm violence (UFV) is associated with inequities rooted in structural racism and socioeconomic disparities. Social vulnerability index (SVI) is a composite measure that encompasses both. We sought to understand the relationship ... ...

Abstract	Introduction: Urban firearm violence (UFV) is associated with inequities rooted in structural racism and socioeconomic disparities. Social vulnerability index (SVI) is a composite measure that encompasses both. We sought to understand the relationship between SVI and the incidence of UFV in Chicago using geospatial analysis for the first time. Materials and methods: Firearm assaults in Chicago 2001-2019 were obtained from the Trace. Locations of incidents were geocoded using ArcGIS and overlaid with census tract vector files. These data were linked to 2018 SVI measures obtained from the Center for Disease Control and Prevention. Shooting rates were calculated by tabulating the total number of shootings per capita in each census tract. We used Poisson regression with robust error variance to estimate the incident rate of UFV in different levels of social vulnerability and Local Moran's I to evaluate spatial autocorrelation. Results: In total, 642 census tracts were analyzed. The median shooting rate was 2.6 per 1000 people (interquartile 0.77, 7.0). When compared to those census tracts with very low SVI, census tracts with low SVI had a 1.7-time increased incident rate of shootings (incidence rate ratio [IRR] 1.74, 95% CI 1.08, 2.81), tracts with moderate SVI had a 3.1-time increased incident rate (IRR 3.07, 95% CI 2.31, 4.10), and tracts with high SVI had a 7-time increased incident rate (IRR 7.03, 95% CI 5.45, 9.07). Conclusions: In Chicago, social vulnerability has a significant association with rates of firearm violence, providing a focus point for policy intervention to address high rates of interpersonal violence in similar cities.
MeSH term(s)	Humans ; Chicago/epidemiology ; Social Vulnerability ; Firearms ; Violence ; Cities
Language	English
Publishing date	2023-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2023.08.058
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Article ; Online: Invited response to: Motivations and impact of international rotations in low- and middle-income countries for orthopaedic surgery residents: Are we on the same page?

Poulson, Michael / Dechert, Tracey

American journal of surgery

2020 Volume 221, Issue 2, Page(s) 244

MeSH term(s)	Developing Countries ; Humans ; Internship and Residency ; Motivation ; Orthopedic Procedures ; Orthopedics/education
Language	English
Publishing date	2020-10-28
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2020.10.035
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Article ; Online: The effect of historic redlining on firearm violence.

Poulson, Michael R / Neufeld, Miriam Y / Laraja, Alexander / Allee, Lisa / Kenzik, Kelly M / Dechert, Tracey

Journal of the National Medical Association

2023 Volume 115, Issue 4, Page(s) 421–427

Abstract: Background: Firearm homicides disproportionately affect young Black men, which in turn have lasting impact of communities of color as a whole. Previous cross-sectional studies have highlighted the role of discriminatory housing policies on the incidence ...

Abstract	Background: Firearm homicides disproportionately affect young Black men, which in turn have lasting impact of communities of color as a whole. Previous cross-sectional studies have highlighted the role of discriminatory housing policies on the incidence of urban firearm violence. We sought to estimate the effects of racist housing policies on firearm incidence. Methods: Firearm incident data were obtained from the Boston Police Department and point locations spatially joined with vector files outlining the original 1930 Home Owner Loan Corporation (HOLC) Redlining maps. A regression discontinuity design was used to assess the increased rate of firearm violence crossing from historically "desirable" neighborhoods (Green) to historically "hazardous" neighborhoods (Red and Yellow) based on HOLC definitions. Linear regression models were fit on either side of the geographic boundaries with firearm incidents graphed at varying distances and the regression coefficient calculated at the boundary. Results: Crossing from desirable to Red hazardous designation there was a significant discontinuity with an increase of 4.1 firearm incidents per 1,000 people (95% CI 0.68,7.55). Similarly, when crossing from desirable areas to the Yellow hazardous designation there was a significant discontinuity and increase of 5.9 firearm incidents per 1,000 people (95% CI 1.85,9.86). There was no significant discontinuity between the two hazardous HOLC designations (coefficient -0.93, 95% CI -5.71, 3.85). Conclusions: There is a significant increase in firearm incidents in historically redlined areas of Boston. This suggests that interventions should focus on downstream socioeconomic, demographic, and neighborhood detriments of historically discriminatory housing policies in order to address firearm homicides.
MeSH term(s)	Male ; Humans ; Firearms ; Residence Characteristics ; Violence/prevention & control ; Boston/epidemiology ; Cross-Sectional Studies
Language	English
Publishing date	2023-06-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	419737-9
ISSN	1943-4693 ; 0027-9684
ISSN (online)	1943-4693
ISSN	0027-9684
DOI	10.1016/j.jnma.2023.06.003
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Article ; Online: State firearm laws and nonfatal firearm injury-related inpatient hospitalizations: A nationwide panel study.

Neufeld, Miriam Y / Poulson, Michael / Sanchez, Sabrina E / Siegel, Michael B

The journal of trauma and acute care surgery

2021 Volume 92, Issue 3, Page(s) 581–587

Abstract: Background: Firearm injury remains a major cause of morbidity and mortality in the United States. Because of prior lack of comprehensive data sources, there is a paucity of literature on nonfatal firearm injury. Associations have previously been shown ... ...

Abstract	Background: Firearm injury remains a major cause of morbidity and mortality in the United States. Because of prior lack of comprehensive data sources, there is a paucity of literature on nonfatal firearm injury. Associations have previously been shown between state-level firearm laws and firearm fatalities, but few studies have examined the effects of these laws on nonfatal firearm hospitalization rates. Our objective was to examine the relationship between state firearm laws and firearm injury-related hospitalization rates across all 50 states over a 17-year period. Methods: In this panel study design, we used fixed effects multivariate regression models to analyze the relationship between 12 laws and firearm state-level injury-related hospitalization rates from 2000 to 2016 using the RAND Corporation Inpatient Hospitalizations for Firearm Injury Database. We used difference-in-differences to determine the impact of law passage in a given state compared with those states without the law, controlling for state-level covariates. The main outcome measure was the change in annual firearm injury-related inpatient hospitalization rates after passage or repeal of a state-level firearm law. Results: Examining each law individually, passage of violent misdemeanor, permitting, firearm removal from domestic violence offenders, and 10-round limit laws were associated with significant firearm injury-related hospitalization rate reductions. Examining multiple laws in the same model, passage of violent misdemeanor laws was associated with a 19.9% (confidence interval, 11.6%-27.4%) reduction, and removal of firearms from domestic violence offenders was associated with a 17.0% (confidence interval, 9.9%-23.6%) reduction in hospitalization rates. Conclusion: State laws related to preventing violent offenders from possessing firearms are associated with firearm injury-related hospitalization rate reductions. Given significant physical, mental, and social burdens of nonfatal firearm injury, determining the efficacy of firearm-related policy is critical to violence and injury prevention efforts. Level of evidence: Prognostic and Epidemiologic; Level IV.
MeSH term(s)	Female ; Firearms/legislation & jurisprudence ; Hospitalization/statistics & numerical data ; Humans ; Male ; United States/epidemiology ; Wounds, Gunshot/epidemiology
Language	English
Publishing date	2021-11-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000003445
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Article ; Online: ASO Author Reflections: The Impact of Residential Segregation on Pancreatic Cancer Diagnosis, Treatment, and Mortality.

Poulson, Michael R / Blanco, Barbara Aldana / Sachs, Teviah E

Annals of surgical oncology

2020 Volume 28, Issue 6, Page(s) 3156

MeSH term(s)	Humans ; Pancreas ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/therapy
Language	English
Publishing date	2020-10-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-020-09257-0
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Article ; Online: Challenges in the Methodology for Health Disparities Research in Thoracic Surgery.

Adnan, Sakib M / Poulson, Michael / Litle, Virginia R / Erkmen, Cherie P

Thoracic surgery clinics

2021 Volume 32, Issue 1, Page(s) 67–74

Abstract: Research on health disparities in thoracic surgery is based on large population-based studies, which is associated with certain biases. Several methodological challenges are associated with these biases and warrant review and attention. The lack of ... ...

Abstract	Research on health disparities in thoracic surgery is based on large population-based studies, which is associated with certain biases. Several methodological challenges are associated with these biases and warrant review and attention. The lack of standardized definitions in health disparities research requires clarification for study design strategy. Further inconsistencies remain when considering data sources and collection methods. These inconsistencies pose challenges for accurate and standardized downstream data analysis and interpretation. These sources of bias should be considered when establishing the infrastructure of health disparities research in thoracic surgery, which is in its infancy and requires further development.
MeSH term(s)	Bias ; Humans ; Thoracic Surgery
Language	English
Publishing date	2021-11-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2149218-9
ISSN	1558-5069 ; 1547-4127
ISSN (online)	1558-5069
ISSN	1547-4127
DOI	10.1016/j.thorsurg.2021.09.008
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Article ; Online: Socioeconomic Mediation of Racial Segregation in Pancreatic Cancer Treatment and Outcome Disparities.

Poulson, Michael R / Papageorge, Marianna V / LaRaja, Alexander S / Kenzik, Kelly M / Sachs, Teviah E

Annals of surgery

2022 Volume 278, Issue 2, Page(s) 246–252

Abstract: Objective: To understand the mediating effect of socioeconomic factors on the association between residential segregation and racial disparities in pancreatic cancer (PC).: Background: Black patients with PC present at a later stage and have worse ... ...

Abstract	Objective: To understand the mediating effect of socioeconomic factors on the association between residential segregation and racial disparities in pancreatic cancer (PC). Background: Black patients with PC present at a later stage and have worse mortality than White patients. These disparities have been explained by the level of residential segregation. Methods: Data were obtained from Surveillance, Epidemiology, and End-Results (SEER) and included all Black and White patients who were diagnosed with PC between 2005 and 2015. The primary exposure variable was the Index of Dissimilarity, a validated measure of segregation. County-level socioeconomic variables from the US Census were assessed as mediators. The primary outcomes were advanced stage at diagnosis, surgical resection for localized disease, and overall mortality. Generalized structural equation modeling was used to assess the mediation of each of the socioeconomic variables. Results: Black patients in the highest levels of segregation saw a 12% increased risk [relative risk=1.12; 95% confidence interval (CI): 1.08, 1.15] of presenting at an advanced stage, 11% decreased likelihood of undergoing surgery (relative risk=0.89; 95% CI: 0.83, 0.94), and 8% increased hazards of death (hazard ratio=1.08; 95% CI: 1.03, 1.14) compared with White patients in the lowest levels. The Black share of the population, insurance status, and income inequality mediated 58% of the total effect on the advanced stage. Poverty and Black income immobility mediated 51% of the total effect on surgical resection. Poverty and Black income immobility mediated 50% of the total effect on overall survival. Conclusions: These socioeconomic factors serve as intervention points for legislators to address the social determinants inherent to the structural racism that mediate poor outcomes for Black patients.
MeSH term(s)	Humans ; Black or African American ; Health Status Disparities ; Pancreatic Neoplasms/ethnology ; Pancreatic Neoplasms/surgery ; Residence Characteristics ; Social Segregation ; Socioeconomic Factors ; Treatment Outcome ; White ; Pancreatic Neoplasms
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005543
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Article ; Online: Gun Laws, Stay-at-Home Orders, and Poverty: Surges in Pandemic Firearm Violence in Large US Cities.

Duraiswamy, Swetha / Dirago, Camille / Poulson, Michael / Torres, Crisanto / Sanchez, Sabrina / Kenzik, Kelly / Dechert, Tracey / Scantling, Dane

The Journal of surgical research

2023 Volume 293, Page(s) 204–216

Abstract: Introduction: The COVID-19 pandemic heralded a surge in firearm homicides (FH) in many, but not all, urban centers. We aimed to determine the relationship of firearm restrictive legislation, stay-at-home orders (SaHOs), and FH during the height of the ... ...

Abstract	Introduction: The COVID-19 pandemic heralded a surge in firearm homicides (FH) in many, but not all, urban centers. We aimed to determine the relationship of firearm restrictive legislation, stay-at-home orders (SaHOs), and FH during the height of the COVID-19 pandemic in US cities. Methods: Demographics and socioeconomic data were captured from the 2020 US Census for large (population ≥250,000) cities. FH data were captured from the Gun Violence Archive. We retrieved firearm recovery estimates from the Bureau of Alcohol, Tobacco, and Firearms Firearms Trace Database. Firearm restrictive legislation was gathered from the State Firearm Laws Database. SaHO durations were found from press releases and government sources. Variables with P ≤ 0.200 in univariate linear regression were entered into a final multivariable model. Results: A median of 7.5 FH per 100,000 people occurred in the 85 included US cities across 32 states in 2020 (range, 0.35-69.80 per 100,000). In multivariable regression, longer SaHOs (β: 0.033, 95% confidence interval [CI]: 0.014-0.053, P = 0.001) and higher poverty (β: 0.471, 95% CI: 0.280-0.670, P < 0.001) were associated with increases in FH. Handgun-specific laws (β: -0.793, 95% CI: -1.430 to -0.160, P = 0.015) were associated with lower FH. Conclusions: We found that poverty and longer SaHOs were associated with increased FH in large US cities during the height of the pandemic, while handgun-specific laws were associated with a decrease. Reducing poverty, mitigating the negative effects of SaHOs, and expanding handgun-specific legislation may protect from surges in FH during future crises.
MeSH term(s)	Humans ; United States/epidemiology ; Pandemics/prevention & control ; Cities/epidemiology ; Firearms ; Violence ; Poverty ; COVID-19/epidemiology ; COVID-19/prevention & control ; Wounds, Gunshot/epidemiology
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2023.08.025
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Article ; Online: Death by the minute: Inequities in trauma care for victims of firearm violence.

Poulson, Michael / Jay, Jonathan / Kenzik, Kelly / Torres, Crisanto / Sanchez, Sabrina E / Saillant, Noelle / Holena, Daniel / Galea, Sandro / Scantling, Dane

The journal of trauma and acute care surgery

2023 Volume 96, Issue 4, Page(s) 589–595

Abstract: Background: Gunshot wounds (GSWs) remain a significant source of mortality in the United States. Timely delivery of trauma care is known to be critical for survival. We sought to understand the relationship of predicted transport time and death after ... ...

Abstract	Background: Gunshot wounds (GSWs) remain a significant source of mortality in the United States. Timely delivery of trauma care is known to be critical for survival. We sought to understand the relationship of predicted transport time and death after GSW. Given large racial disparities in firearm violence, we also sought to understand disparities in transport times and death by victim race, an unstudied phenomenon. Methods: Firearm mortality data were obtained from the Boston Police Department 2005 to 2023. Firearm incidents were mapped using ArcGIS. Predicted transport times for each incident to the closest trauma center were calculated in ArcGIS. Spatial autoregressive models were used to understand the relationship between victim race, transport time to a trauma center, and mortality associated with the shooting incidents. Results: There were 4,545 shooting victims with 758 deaths. Among those who lived, the median transport time was 9.4 minutes (interquartile range, 5.8-13.8) and 10.5 minutes (interquartile range, 6.4-14.6; p = 0.003) for those who died. In the multivariable logistic regression, increased transport time to the nearest trauma center (odds ratio, 1.024; 95% confidence interval, 1.01-1.04) and age (odds ratio, 1.016; 95% confidence interval, 1.01-1.02) were associated with mortality. There was a modest difference in median transport time to the nearest trauma center by race with non-Hispanic Black at 10.1 minutes, Black Hispanic 9.2 minutes, White Hispanic 8.5 minutes, and non-Hispanic White 8.3 minutes ( p < 0.001). Conclusion: Our results highlight the relationship of transport time to a trauma center and death after a GSW. Non-White individuals had significantly longer transport times to a trauma center and predicted mortality would have been lower with White victim transport times. These data underscore the importance of timely trauma care for GSW victims and can be used to direct more equitable trauma systems. Level of evidence: Prognostic/Epidemiological; Level III.
MeSH term(s)	Humans ; United States/epidemiology ; Wounds, Gunshot/therapy ; Firearms ; Violence ; Trauma Centers ; Ethnicity ; Retrospective Studies
Language	English
Publishing date	2023-11-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000004219
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