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Record W4407595908 · doi:10.1016/j.lana.2025.101022

Investigating the spatial association between supervised consumption services and homicide rates in Toronto, Canada, 2010–2023: an ecological analysis

2025· article· en· W4407595908 on OpenAlexafffundabout
Dan Werb, Hae Seung Sung, Yingbo Na, Indhu Rammohan, Jolene Eeuwes, Ashley Smoke, Akwasi Owusu‐Bempah, Thomas Kerr, Mohammad Karamouzian

Bibliographic record

VenueThe Lancet Regional Health - Americas · 2025
Typearticle
Languageen
FieldMedicine
TopicHIV, Drug Use, Sexual Risk
Canadian institutionsBritish Columbia Centre on Substance UseUniversity of British ColumbiaUniversity of TorontoCentre for Addiction and Mental HealthInstitute for Work & HealthOntario Stroke NetworkInstitute of Health Services and Policy ResearchSt. Michael's Hospital
FundersCanadian Institutes of Health ResearchSt. Michael's Hospital FoundationSt. Michael’s Hospital Foundation
KeywordsHomicideAssociation (psychology)Ecological studyGeographyConsumption (sociology)EcologyEnvironmental healthPsychologyPoison controlInjury preventionMedicineSociologyBiologySocial science

Abstract

fetched live from OpenAlex

Background: Supervised consumption services (SCS) are effective at preventing overdose mortality. However, their effect on public safety remains contested. We investigated homicide rates in areas near SCS in Toronto. Methods: We classified coroner-reported fatal shootings and stabbings (January 1st, 2010 to September 30th 2023) by geographic zone: within 500 m ('near'), between 500 m and 3 km ('far'), and beyond 3 km of an SCS ('out'). We then used Poisson regression to calculate the rate ratio (RR) across zones 18, 36, 48, and 60 months pre vs. post SCS implementation. Finally, we compared spatial homicide incidence prior to and after the date of the implementation of each SCS using interrupted time series (ITS). Findings: Overall, 956 homicides occurred, and 590 (62%) were fatal shootings and stabbings. There was no meaningful change in the rate of fatal shootings and stabbings within 3 kms of SCS (near and far zones) after their implementation. However, between 48 and 60 months pos-implementation, we detected an increase in out zones. In an ITS analysis, we observed a reduction in the monthly incidence in near zones and an increase in out zones. Interpretation: SCS implementation was not associated with increased homicide rates; instead, we observed a reduction in monthly incidence near SCS. These results may inform drug market activity responses that optimize community health and safety. Funding: Canadian Institutes of Health Research, the New Frontiers in Research Fund, St. Michael's Hospital Foundation.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.022
Threshold uncertainty score0.158

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0020.004
Science and technology studies0.0010.001
Scholarly communication0.0010.000
Open science0.0010.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.098
GPT teacher head0.406
Teacher spread0.308 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2025
Admission routes3
Has abstractyes

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