Objectives. To determine the impact of city-level cannabis decriminalization and medical marijuana laws (MMLs) on fatal traffic crashes in US cities. Methods. Using a census of fatal traffic crashes from the 2010 to 2017 Fatality Analysis Reporting System, we examined MMLs and cannabis decriminalization on fatal crashes by age and sex of driver. We used a Poisson difference-in-differences approach, exploiting temporal and geographic variation in marijuana decriminalization laws. Results. Cities experienced a 13% increase in fatal crashes involving 15- to 24-year-old male drivers following decriminalization (incidence rate ratio = 1.125; 95% confidence interval = 1.014, 1.249). This effect was immediate and strongest on weekend nights. We found no effect on female drivers or older males. Conversely, we found that MMLs were associated with fewer fatal crashes for both males and females, which was most pronounced in 15- to 24-year-old drivers. Conclusions. Unlike MMLs, which are associated with fewer fatal crashes, cities experienced a relative increase in fatal crashes involving young male drivers following marijuana decriminalization. Public Health Implications. MMLs stipulate consumption occurs at home, whereas decriminalization only lessens the penalty for marijuana possession. Therefore, travel incentives of such laws have heterogeneous effects on traffic safety.
A competency-based approach to health human resources (HHR) planning is one that explicitly considers the spectrum of knowledge, skills and judgement (competencies) required for the health workforce based on the health needs of the relevant population in some specific circumstances. Such an approach is of particular benefit to planners challenged to make optimal use of limited HHR as it allows them to move beyond simply estimating numbers of certain professionals required and plan instead according to the unique mix of competencies available from the existing health workforce. This kind of flexibility is particularly valuable in contexts where healthcare providers are in short supply generally (e.g. in many developing countries) or temporarily due to a surge in need (e.g. a pandemic or other disease outbreak). A pilot application of this approach using the context of an influenza pandemic in one health district of Nova Scotia, Canada, is described, and key competency gaps identified. The approach is also being applied using other conditions in other Canadian jurisdictions and in Zambia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.