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      Immediate Impact of Hurricane Sandy on People Who Inject Drugs in New York City

      , , ,
      Substance Use & Misuse
      Informa UK Limited

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          Abstract

          Over the eight months following Hurricane Sandy, of October 2012, we interviewed 300 people who inject drugs in New York City. During the week after the storm, 28% rescued others or volunteered with aid groups; 60% experienced withdrawal; 27% shared drug injection or preparation equipment, or injected with people they normally would not inject with; 70% of those on opioid maintenance therapy could not obtain sufficient doses; and 43% of HIV-positive participants missed HIV medication doses. Although relatively brief, a hurricane can be viewed as a Big Event that can alter drug environments and behaviors, and may have lasting impact. The study's limitations are noted and future needed research is suggested.

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          Most cited references29

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          Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission.

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            The social structural production of HIV risk among injecting drug users.

            There is increasing appreciation of the need to understand how social and structural factors shape HIV risk. Drawing on a review of recently published literature, we seek to describe the social structural production of HIV risk associated with injecting drug use. We adopt an inclusive definition of the HIV 'risk environment' as the space, whether social or physical, in which a variety of factors exogenous to the individual interact to increase vulnerability to HIV. We identify the following factors as critical in the social structural production of HIV risk associated with drug injecting: cross-border trade and transport links; population movement and mixing; urban or neighbourhood deprivation and disadvantage; specific injecting environments (including shooting galleries and prisons); the role of peer groups and social networks; the relevance of 'social capital' at the level of networks, communities and neighbourhoods; the role of macro-social change and political or economic transition; political, social and economic inequities in relation to ethnicity, gender and sexuality; the role of social stigma and discrimination in reproducing inequity and vulnerability; the role of policies, laws and policing; and the role of complex emergencies such as armed conflict and natural disasters. We argue that the HIV risk environment is a product of interplay in which social and structural factors intermingle but where political-economic factors may play a predominant role. We therefore emphasise that much of the most needed 'structural HIV prevention' is unavoidably political in that it calls for community actions and structural changes within a broad framework concerned to alleviate inequity in health, welfare and human rights.
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              Climate change: the public health response.

              There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations.
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                Author and article information

                Journal
                Substance Use & Misuse
                Substance Use & Misuse
                Informa UK Limited
                1082-6084
                1532-2491
                July 09 2015
                June 07 2015
                March 16 2015
                June 07 2015
                : 50
                : 7
                : 878-884
                Article
                10.3109/10826084.2015.978675
                4498981
                25775259
                f0995b27-6674-4091-a805-312b843a4cce
                © 2015
                History

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