Race and selective enforcement in public housing

Drugs, crime and public housing are closely linked in policy and politics, and their nexus has animated several intensive drug enforcement programs targeted at public housing residents. In New York City, police systematically conduct "vertical" patrols in public, making tens of thousands of "Terry" stops to detect drugs or weapons each year under the Trespass Abatement Program, or TAP. Both uniformed and undercover officers move systemically within the halls and stairwells of buildings, temporarily detaining and questioning residents and visitors, often at a low threshold of suspicion, and usually alleging trespass to justify the stop. This pattern of selective enforcement through elevated rates of high discretion stops in public housing under TAP raises constitutional concerns at the intersection of the Fourteenth Amendment prohibitions on racial discrimination -- residents of public housing are overwhelming nonwhite -- and Fourth Amendment prohibitions on suspicionless stops. We use a case-control design to identify the effects of living in a public housing development on the probability of stop, frisk and arrest for trespass or other crimes in New York City's 330 public housing developments from 2005-8. We find that the incidence rate ratio for trespass stops and arrests is 1.5 times greater in public housing than in the immediate surrounding neighborhoods. We decompose these effects using first differences models and find that the difference in percent Black population in public housing compared to the surrounding area predicts the disparity in trespass enforcement. Four-wave cross-lag regressions show that trespass enforcement in public housing is independent from enforcement in the surrounding area, suggesting that public housing is specifically targeted for intensive enforcement. The results raise constitutional concerns about equal protection. Qualitative evidence suggests that stops have a stigmatizing effect on public housing residents and their families, and that they inhibit basic social interactions such as child care arrangements and family visitation

Curative salvage liver transplantation in patients with cirrhosis and hepatocellular carcinoma:An intention-to-treat analysis

The salvage liver transplantation (SLT) strategy was conceived for initially resectable and transplantable (R&T) hepatocellular carcinoma (HCC) patients, to try to obviate upfront liver transplantation, with the safety net of SLT in case of postresection recurrence. The SLT strategy is successful or curative when patients are recurrence free following primary resection alone, or after SLT for recurrence. The aim of the current study was to determine the SLT strategy's potential for cure in R&T HCC patients, and to identify predictors for its success. From 1994 to 2012, all R&T HCC patients with cirrhosis were enrolled in the SLT strategy. An intention-to-treat (ITT) analysis was used to determine this strategy's outcomes and predictors of success according to the above definition. In total, 110 patients were enrolled in the SLT strategy. Sixty-three patients (57%) had tumor recurrence after initial resection, and in 30 patients SLT could be performed (recurrence transplantability rate = 48%). From the time of initial resection, ITT 5-year overall and disease-free survival rates were 69% and 60%, respectively. The SLT strategy was successful in 60 patients (56%), either by resection alone (36%), or by SLT for recurrence (19%). Preresection predictors of successful SLT strategy at multivariate analysis included Model for End-Stage Liver Disease (MELD) score >10, and absence of neoadjuvant transarterial chemoembolization (TACE). Additional postresection predictive factors were absence of postresection morbidity, and T-stage 1-2 at the resection specimen. Conclusion: The SLT strategy is curative in only 56% of cases. Higher MELD score at inception of the strategy and no pre-resection TACE are predictors of successful SLT strategy

Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)

BACKGROUND AND AIMS: Liver transplantation (LT) has been proposed to be an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to address the current clinical practice and outcomes of ACLF patients wait listed (WL) for LT in Europe. METHODS: Retrospective study including 308 consecutive ACLF patients, listed in 20 centres across 8 European countries, from January 2018 to June 2019. RESULTS: 2677 patients received a LT, 1216 (45.4%) for decompensated cirrhosis (DC). Of these, 234 (19.2%) had ACLF at LT: ACLF-1, 58 (4.8%); ACLF-2, 78 (6.4%); and ACLF-3, 98 (8.1%). Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and Netherlands had medium rates (9-15%); and United Kingdom and Spain had low rates (3-5%) (p 4 mmol/L (HR 3.14, 95% CI 1.37-7.19), recent infection from multi-drug resistant organisms (HR 3.67, 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74, 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the WL. In an intention-to-treat analysis, one-year survival of ACLF patients on the LT WL was 73% for ACLF-1 or -2 and 50% for ACLF-3. CONCLUSION: The results reveal wide variations in listing patients with ACLF in Europe despite favorable post-LT survival. Risk factors for mortality were identified, allowing a more precise prognostic assessment of ACLF patients for potential LT. LAY SUMMARY: Acute on chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonized to avoid inequities. Post-LT survival for patients with ACLF was >80% after 1 year and some factors have been identified for selecting patients with favorable outcomes

NEWS AND NOTES 1988, VOL.19, NO.3

https://digitalcommons.rockefeller.edu/news_and_notes_1988/1001/thumbnail.jp

Race and Selective Enforcement in Public Housing

Drugs, crime and public housing are closely linked in policy and politics, and their nexus has animated several intensive drug enforcement programs targeted at public housing residents. In New York City, police systematically conduct “vertical patrols” in public housing buildings, making tens of thousands of Terry stops each year. During these patrols, both uniformed and undercover officers systematically move through the buildings, temporarily detaining and questioning residents and visitors, often at a low threshold of suspicion, and usually alleging trespass to justify the stop. We use a case-control design to identify the effects of living in one of New York City’s 330 public housing developments on the probability of stop, frisk and arrest from 2004-11. We find that the incidence rate ratio for trespass stops and arrests is more than two times greater in public housing than in the immediate surrounding neighborhoods. We decompose these effects using first differences models and find that the difference in percent Black and Hispanic populations in public housing compared to the surrounding area predicts the disparity in trespass enforcement and enforcement of other criminal law violations. The pattern of racially selective enforcement suggests the potential for systemic violations of the Fourteenth Amendment’s prohibition on racial discrimination

Race and Selective Enforcement in Public Housing

Drugs, crime and public housing are closely linked in policy and politics, and their nexus has animated several intensive drug enforcement programs targeted at public housing residents. In New York City, police systematically conduct “vertical patrols” in public housing buildings, making tens of thousands of Terry stops each year. During these patrols, both uniformed and undercover officers systematically move through the buildings, temporarily detaining and questioning residents and visitors, often at a low threshold of suspicion, and usually alleging trespass to justify the stop. We use a case-control design to identify the effects of living in one of New York City’s 330 public housing developments on the probability of stop, frisk and arrest from 2004-11. We find that the incidence rate ratio for trespass stops and arrests is more than two times greater in public housing than in the immediate surrounding neighborhoods. We decompose these effects using first differences models and find that the difference in percent Black and Hispanic populations in public housing compared to the surrounding area predicts the disparity in trespass enforcement and enforcement of other criminal law violations. The pattern of racially selective enforcement suggests the potential for systemic violations of the Fourteenth Amendment’s prohibition on racial discrimination