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Jailed drug users far more likely to share needles later

Most media and our mayor may have ignored it, but as I’ve tried to show in my previous three posts to the Hook, last week’s 7th International Conference on Urban Health bristled with fresh evidence about successful interventions in addressing issues of relevance to urbanites in Canada and worldwide.

In my final several blog posts, I’d like to touch on three other talks that I heard. For abstracts and further information, check out the conference program.

The event opened with a call to action by Dr. Jacob Kumaresan, Director of the World Health Organization’s Centre for Health Development, in Kobe, Japan.

He noted that last year, for the first time, cities were home to more than half the world’s population, and by 2030, six out of ten Earthlings will live in urban areas.

He showed a bar graph indicating that, while the population of London, England, took 130 years to grow from one million to 8 million, Seoul, Korea, made that leap recently in just 25 years.

Such explosive growth in many cities has seen the burgeoning of slums and degradation of air and water quality and left many cities burdened with infectious and chronic disease -- particularly among the poor.

The solution? Better governance and this:

"People need to be empowered," Kumaresan said. "Health inequities are the embodiment of social inequities -- not the result of individual failure.

"Our goal then should be to advocate for an end to social inequities."

Many speakers gave evidence of the link between social status and health. At a session on Drug Use, Mental Health and the Urban Environment, on Friday (Oct.31), for example, M-J Milloy, a researcher from the B.C. Centre for Excellence in HIV/AIDS, presented the results of a study of syringe-sharing after incarceration among active injection drug users in Vancouver.

Previous research indicates that one in five cases of HIV infection among residents of the Downtown Eastside is related to prison-time and, in particular, the practice among inmates of sharing rigs. Using data from the Vancouver Injection Drug Users Survey (VIDUS), Milloy and his team were able to show that injecting drug users who go to jail are twice as likely to share syringes after they get out than are those who do not go to jail.

Prime Minister Stephen Harper might want to consider these findings before going ahead with controversial to use jail sentences more liberally, even among 14 year olds.

Jim Boothroyd was spokesperson for the NAOMI project conducting prescribed heroin trials in Vancouver, and researches and writes for the World Health Organization and others. The views expressed here are his own.

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