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Article

Alcohol Abuse and Drug Use in Sport and Performance  

Matthew P. Martens

Issues associated with athletics, alcohol abuse, and drug use continue to be salient aspects of popular culture. These issues include high-profile athletes experiencing public incidents as a direct or indirect result of alcohol and/or drug use, the role that performance-enhancing drugs play in impacting outcomes across a variety of professional and amateur contests, and the public-health effects alcohol abuse and drug use can have among athletes at all competitive levels. For some substances, like alcohol abuse, certain groups of athletes may be particularly at-risk relative to peers who are not athletes. For other substances, participating in athletics may serve as a protective factor. Unique considerations are associated with understanding alcohol abuse and drug use in sport. These include performance considerations (e.g., choosing to use or not use a certain substance due to concerns about its impact on athletic ability), the cultural context of different types of sporting environments that might facilitate or inhibit alcohol and/or drug use, and various internal personality characteristics and traits that may draw one toward both athletic activity and substance use. Fortunately, there are several effective strategies for preventing and reducing alcohol abuse and drug use, some of which have been tested specifically among athlete populations. If such strategies were widely disseminated, they would have the potential to make a significant impact on problems associated with alcohol abuse and drug use in sport and athletics.

Article

Preterm Birth: Epidemiology, Risk Factors, Pathogenesis, and Prevention  

Xiaojing Zeng, Wen Jiang, Xiaoqing He, and Jun Zhang

Preterm birth is a significant global public health issue. It is defined by the World Health Organization as infants born alive before 37 completed weeks of gestation. The preterm birth rate varies significantly across countries and regions. Globally, an estimated 13.4 million babies were born preterm in 2020 (i.e., 1 in 10 babies worldwide was preterm birth). It is the leading cause of under-5 child mortality worldwide, and preterm infants are particularly vulnerable to respiratory complications, feeding difficulty, poor body temperature regulation, and high risk of infection. Both genetic and nongenetic factors (exposome factors) contribute to the risk of preterm birth. Social and behavioral factors, medical and pregnancy conditions, and environmental exposures are common nongenetic risk factors for preterm birth. Individuals from certain ethnic and racial groups, in low- and middle-income countries, or with a low socioeconomic status are at an increased risk of having preterm birth, and social determinants of health are the root causes of these factors. Existing pregnancy complications, history of preterm birth, and other medical conditions are also common risk factors. Environmental exposures such as air pollution, climate change, and endocrine-disrupting chemicals have been increasingly realized as potential risk factors for preterm birth. Various pathological events in different feto-maternal systems have been reported to be involved in the development of preterm birth. Immunopathogenesis plays a pivotal role, and both pathogenic and nonpathogenic inflammation can induce preterm birth. Oxidative stress, decidual hemorrhage and vascular lesions, uterine overdistension, and cervical insufficiency have all been proposed to contribute to the pathophysiology of preterm birth. Prevention strategies for preterm birth include primary prevention aimed at the modifiable risk factors at the individual and societal levels and therapeutic approaches using pharmaceuticals and mechanical interventions, such as progesterone and cervical cerclage. A comprehensive approach is still needed to reduce the global disease burden of preterm birth.

Article

Firearm Injuries and Public Health  

Linda Dahlberg, Alexander Butchart, James Mercy, and Thomas Simon

An important function of public health is to prevent injuries or to lessen their impact when they occur. An estimated 251,000 people worldwide die each year from a firearm-related death and many more suffer nonfatal injuries with consequences that can last a lifetime. Firearm injuries, which include those that are intentionally self-inflicted, unintentional, or from an act of interpersonal violence, are heavily concentrated in the Americas, driven largely by firearm homicides. Firearm-related deaths and injuries disproportionately impact males and younger populations and are associated with factors such as access, substance use, adverse childhood experiences, involvement in high-risk social networks, drug trafficking, density of alcohol outlets, and neighborhood and social disadvantage. While progress is being made to understand firearm injuries and how to effectively prevent them, much more needs to be done to improve the availability and timeliness of data; apply the knowledge that is generated to effectively reduce firearm-related injuries, deaths, and costs; strengthen the scientific infrastructure; and move countries closer to achieving the violence-related targets in the 2030 Sustainable Development Goals.

Article

Enemy Penology  

Susanne Krasmann

When Guenther Jakobs introduced the concept of “enemy criminal law” (Feindstrafrecht), or enemy penology, into the legal debate, this was due to a concern with the increasingly anticipatory nature of criminalization in German legislation in the last decades of the 20th century. Against the backdrop of a series of terror attacks in the West and the ensuing debates on how to deal with the dangers and threats of the new millennium, Jakobs’s theory gained new momentum in Germany’s public discourse and beyond. As it seems, the author himself turned the concept into a device for political intervention, declaring the notion of the enemy as indispensable for dealing with certain extreme crimes and notorious offenders, not only to prevent future crime and avert harm from society but also, and most notably, to preserve the established “citizen criminal law” (Bürgerstrafrecht): the enemy is the one to be isolated and excluded from the system. Enemy criminal law may be a peculiar legal concept. The logic of enemy penology, however, leads us to some more fundamental insights into the conundrums of liberal political thinking and attendant legal conceptions. It requires us to think about the enemy as a liminal figure that points to the preconditions and the paradoxes of our legal system. The history of criminology attests to the discipline’s struggle with penal law’s inherent limitations. And if we live today in times where exception and rule, internal security and external security, and military and police concerns increasingly overlap and intermingle in the face of ever new threats, the notion of enemy penology helps us to critically reflect on the mechanisms that drive these transformations.

Article

Violence  

Sheara A. Williams

Violence is a serious social issue that affects millions of individuals, families, and communities every year. It transcends across racial, age, gender, and socioeconomic groups, and is considered a significant public health burden in the United States. The purpose of this entry is to provide an overview of violence as a broad yet complicated concept. Definitional issues are discussed. Additional prevalence rates of select types of violence are presented in addition to risk and protective factors associated with violent behavior. The entry concludes with a summary of approaches to address violence in the context of prevention and intervention strategies.

Article

Teen Pregnancy Prevention  

Carol M. Lewis and Shanti Kulkarni

Despite downward trends in the U.S. teen birth rate overall, the associated social and economic costs are still significant. Historically, teen pregnancy prevention policy and program adoption have been influenced by the sociopolitical environment at national, state, and local levels. Recent federal efforts have begun to re-emphasize the importance of developing and supporting evidence-based prevention efforts. Current teen pregnancy prevention approaches are reviewed with attention to the range of program philosophies, components, settings, populations served, and documented effectiveness. Promising directions in pregnancy prevention program development for adolescents are also highlighted.

Article

School Crisis Prevention and Intervention  

Mary Margaret Kerr

A school crisis unexpectedly disrupts the school, causes emotional and physical distress, and requires extraordinary decisions and resources to restore stability. During a crisis, teachers and administrators are the first decision-makers. Yet, their training may not prepare them for this responsibility. The first school crisis framework published in educational psychology appeared in 1994, following a U.S. symposium of school psychologists to discuss a recent school massacre. In addition, cross-country communications forums and seminars recognized cultural considerations while fostering the exchange of school crisis research findings and their implications for practice. These efforts have led educational psychologists worldwide to adopt a temporal framework of recommended practices to guide educators’ decisions before, during, and after crises. Pre-crisis work includes assessment, prevention, planning, and training. Pre-crisis planning calls on expertise in multidisciplinary collaboration with other emergency responders and risk assessments that require one to choose measures and interpret data. Once a school staff identifies impending risks, educational psychologists collaborate with responder agencies to communicate some of this information. Planning for a crisis includes procedures for young children, as well as those with special needs, which calls on the psychologist to consider how best to assess their needs and accommodate these groups. Practices and drills call for behavioral observation skills and an understanding of stress reactions that impede compliance with directives. Here, the educational psychologist contributes technical expertise in behavioral observations and performance assessment. The crisis response phase thrusts educators into rapid collaborations with emergency responders to prevent casualties and reduce exposure to trauma. During a crisis, psychologists work alongside others to safeguard, reassure, and empower those affected, taking into account the assistance that older students may offer. Post-crisis efforts seek to restore psychological safety through the restoration of social supports, then address acute mental health needs. Educational psychologists impart clinical expertise to restore social supports, arrange for psychological first aid, minimize continued exposure, and triage mental health needs. Academic recovery requires decisions about how and when to resume instruction. A return to schooling, ongoing supports for victims and responders, and evaluations to improve school crisis responses comprise the final goals. Some view this post-crisis mental health work as the psychologist’s primary contribution; however, the aforementioned examples reveal a greater agenda of opportunities during all school crisis phases.

Article

Situational Crime Prevention  

Joshua D. Freilich and Graeme R. Newman

Situational crime prevention (SCP) is a criminological perspective that calls for expanding the crime-reduction role well beyond the justice system. SCP sees criminal law in a more restrictive sense, as only part of the anticrime effort in governance. It calls for minutely analyzing specific crime types (or problems) to uncover the situational factors that facilitate their commission. Intervention techniques are then devised to manipulate the related situational factors. In theory, this approach reduces crime by making it impossible for it to be committed no matter what the offender’s motivation or intent, deterring the offender from committing the offense, or by reducing cues that increase a person’s motivation to commit a crime during specific types of events. SCP has given rise to a retinue of methods that have been found to reduce crime at local and sometimes national or international levels. SCP’s focus is thus different than that of other criminological theories because it seeks to reduce crime opportunities rather than punish or rehabilitate offenders. SCP emerged more than 40 years ago, and its major concepts include rational choice, specificity, opportunity structure, and its 25 prevention techniques. Contrary to the common critique that SCP is atheoretical, it is actually based upon a well-developed interdisciplinary model drawing from criminology, economics, psychology, and sociology. Importantly, a growing number of empirical studies and scientific evaluations have demonstrated SCP’s effectiveness in reducing crime. Finally, the SCP approach inevitably leads to a shifting of responsibility for crime control away from police and on to those entities, public and private, most competent to reduce it.

Article

Crime Prevention Through Environmental Design  

Rachel Armitage

Crime Prevention Through Environmental Design (CPTED) is an approach to crime reduction that seeks to reduce perceived opportunities for crime through the design and management of the built or, less often, the natural environment. It is based on a set of principles, which can be applied as a guide to the design and construction of buildings, as well as the organization of spaces around them. Because CPTED provides a guide rather than a rigid specification, with a range of possible realizations, design compliance with its principles is often recognized through an award scheme, such as Secured by Design (SBD) in the United Kingdom and the Police Label Secured Housing in the Netherlands. Research has consistently demonstrated that CPTED is an effective crime reduction approach—reducing crime, alleviating the fear of crime, and enhancing feelings of safety. Its increasing recognition within planning policy reflects a growing acknowledgment of efficacy.

Article

Recruiting Opinion Leaders for the United Kingdom ASSIST Programme  

Jo Holliday, Suzanne Audrey, Rona Campbell, and Laurence Moore

Addictive behaviors with detrimental outcomes can quickly become embedded in daily life. It therefore remains a priority to prevent or modify these health behaviors early in the life course. Diffusion theory suggests that community norms are shaped by credible and influential “opinion leaders” who may be characterized by their values and traits, competence or expertise, and social position. With respect to health behaviors, opinion leaders can assume a variety of roles, including changing social norms and facilitating behavioral change. There is considerable variation in the methods used to identify opinion leaders for behavior change interventions, and these may have differential success. However, despite the potential consequences for intervention success, few studies have documented the processes for identifying, recruiting, and training opinion leaders to promote health, or have discussed the characteristics of those identified. One study that has acknowledged this is the effective UK-based ASSIST smoking-prevention program. The ASSIST Programme is an example of a peer-led intervention that has been shown to be successful in utilizing opinion leaders to influence health behaviors in schools. A “whole community” peer nomination process to identify opinion leaders underwent extensive developmental and piloting work prior to being administered in a randomized trial context. Influential students were identified through the use of three simple questions and trained as “peer supporters” to disseminate smoke-free messages through everyday conversations with their peers. In response to a need to understand the contribution of various elements of the intervention, and the degree to which these achieve their aim, a comprehensive assessment of the nomination process was conducted following intervention implementation. The nomination process was successful in identifying a diverse group of young people who represented a variety of social groups, and whom were predominantly considered suitable by their peers. The successful outcome of this approach demonstrates the importance of paying close attention to the design and development of strategies to identify opinion leaders. Importantly, the involvement of young people during the development phase may be key to increasing the effectiveness of peer education that relies on young people taking the lead role.

Article

Anxiety Disorders in Children and Young People  

Cathy Creswell, Sasha Walters, Brynjar Halldorsson, and Peter J. Lawrence

Anxiety disorders are the most common psychiatric disorders among children and young people, affecting an estimated 6.5% of children and young people worldwide. Childhood anxiety disorders often persist into adulthood if left untreated and are associated with a significant emotional and financial cost to individuals, their families, and wider society. Models of the development and maintenance of childhood anxiety disorders have underpinned prevention and treatment approaches, and cognitive behavioral treatments have good evidence for their efficacy. Ongoing challenges for the field include the need to improve outcomes for those that do not benefit from current prevention and treatment, and to increase access to those who could benefit.

Article

Modeling Chronic Diseases in Relation to Risk Factors  

Pieter van Baal and Hendriek Boshuizen

In most countries, non-communicable diseases have taken over infectious diseases as the most important causes of death. Many non-communicable diseases that were previously lethal diseases have become chronic, and this has changed the healthcare landscape in terms of treatment and prevention options. Currently, a large part of healthcare spending is targeted at curing and caring for the elderly, who have multiple chronic diseases. In this context prevention plays an important role, as there are many risk factors amenable to prevention policies that are related to multiple chronic diseases. This article discusses the use of simulation modeling to better understand the relations between chronic diseases and their risk factors with the aim to inform health policy. Simulation modeling sheds light on important policy questions related to population aging and priority setting. The focus is on the modeling of multiple chronic diseases in the general population and how to consistently model the relations between chronic diseases and their risk factors by combining various data sources. Methodological issues in chronic disease modeling and how these relate to the availability of data are discussed. Here, a distinction is made between (a) issues related to the construction of the epidemiological simulation model and (b) issues related to linking outcomes of the epidemiological simulation model to economic relevant outcomes such as quality of life, healthcare spending and labor market participation. Based on this distinction, several simulation models are discussed that link risk factors to multiple chronic diseases in order to explore how these issues are handled in practice. Recommendations for future research are provided.

Article

Police Officer Suicide  

John M. Violanti

All too often we emphasize the dangers of police work, but seem to neglect the hidden psychological danger of this profession. Suicide is a consequence of that hidden danger. It is a clear indication of the intolerable strain placed on the police officer’s work and life roles. Policing is an occupation replete with stress and traumatic incidents. For example, witnessing death, encountering abused children, and experiencing violent street combat weigh heavily as precipitants to depression, alcohol use, and suicide among police. Ideas as far back as Freud’s aggression theory relate to the police because officers cannot legally express anger and aggression outwardly and turn it within. Following Freud, other studies examined the frustration of police work and how it was turned inward. Other theoretical ideas concerning police suicide that have emerged over the years are included in this article—police cultural socialization, strain theory, and interpersonal suicide theory. Scientific research on police suicide has helped to focus on this topic. Much research is on suicide rates in an effort to determine the scope of this problem. Several recent studies are discussed in this article, including a national study. Such studies, however, are not without controversy and more work is necessary to clarify the validity of findings. There is lack of data available on police suicide, which adds to the problem of research. Many believe that causes of police suicide are really no different than those in other groups in society, such as relationship problems, financial difficulties, or significant loss. While scholars cannot yet be certain that police work is an etiological suicide risk factor, we can with some assurance state that it serves as a fertile arena for suicide precipitants. Culturally approved alcohol use and maladaptive coping, firearms availability, and exposure to psychologically adverse incidents all add to the suicide nexus. Last, and most important, the issue of police suicide prevention is discussed. Likely the biggest challenge in prevention is convincing officers to go for help. The police and societal culture at large attach a stigma to suicide which is difficult to deal with. Additionally, the police culture does not allow for weakness of any kind, either physical or psychological. Several promising prevention approaches are discussed. Given the reluctance to report the deaths of police officers as suicides unfortunately leaves us in a position of “best guess” based on what evidence we can collect. Looking to the future, the development of a national database focused on police suicide would help to establish the actual scope of this tragic loss of life. Interventions need to more efficaciously target at-risk police officers. More research, using longitudinal study designs, is needed to inform interventions and, in particular, to determine how suicide prevention efforts can be modified to meet the unique needs of law enforcement officers.

Article

Sex Workers and HIV/AIDS in India  

Sunny Sinha

The risk of HIV infection looms large among male, female, and transgender sex workers in India. Several individual, sociocultural, and structural-environmental factors enhance the risk of HIV infection among sex workers by restricting their ability to engage in safer sexual practices with clients and/or intimate partners. While most HIV prevention programs and research focus on visible groups of women sex workers operating from brothels (Pardasani, 2005) and traditional sex workers, for example, Devadasis (Orchard, 2007); there is a whole subgroup of the sex worker population that remains invisible within HIV prevention programs, such as the male, female, and transgender sex workers operating from non-brothel-based settings. This paper provides an overview of the different types and contexts of sex work prevalent in Indian society, discusses the factors that increase a sex worker’s risk of HIV infection, describes the varied approaches to HIV prevention adopted by the existing HIV prevention programs for sex workers, discusses the limitations of the HIV prevention programs, and concludes with implications for social work practice and education.

Article

Fall Prevention and Interventions for Older People  

Claudia Meyer and Lindy Clemson

Across the globe, falls among older people can have grave consequences for individuals and for the healthcare and aged-care systems more broadly. The synergy between intrinsic and situational risk factors adds complexity to the identification and management of falls, as does the public health response at primary, secondary, and tertiary levels of prevention. Falls among people age 65 years and over are recognized as a geriatric syndrome and as a marker of frailty, with increasing rates among those experiencing other chronic conditions, such as Parkinson’s disease, stroke, and dementia. Prevention or management of falls requires a combination of strategies as single or multicomponent interventions. Multimodal exercise, combining balance and functional exercise, environmental adaptation, medication reduction and withdrawal, cataract surgery, single-lens glasses, vitamin D supplementation, management of foot problems and footwear, and cardiac pacing have a degree of evidence to support their implementation. Multicomponent programs, such as i-FOCIS and PDSAFE, have important benefits for specific population groups. Importantly, over the past few decades, falls prevention has shifted from a biomedical approach to a holistic biopsychosocial model. This model aids promotion of a whole-of-community approach through building healthy public policy, creating supportive environments, and strengthening personal skills and community action. The biopsychosocial approach also focuses attention on understanding local contexts, ensuring that falls prevention interventional research can be adapted and fit-for-purpose for low-, middle- and high-income countries. The uptake of falls prevention evidence into practice and policy still faces challenges and new frontiers. Supporting the adoption, implementation, and sustainability of interventions is complex at the individual level, the service provider level, and the healthcare system level. Practice-change frameworks and models are useful, such as those utilized in the Stopping Elderly Accidents, Deaths and Injuries (USA), iSOLVE (Australia), and STRIDE (USA) trials. Falls prevention is complex, yet solutions can be relatively simple. Working together with older people, health professionals and community health leaders can champion ways of bringing falls prevention activities to scale. Research collaboration between stakeholders is a crucial mechanism for drawing together unique perspectives to address ongoing gaps and concerns.

Article

Injury Prevention Methods  

Samuel Forjuoh and Guohua Li

Injury prevention encompasses all the processes, strategies, and approaches designed to mitigate any unintentional or intentional bodily damage from external causes, such as motor vehicle crashes, falls from height, or incidents resulting in deprivation of the two essential elements needed for the proper functioning of the body, oxygen and heat. The methods for developing injury prevention strategies have undergone a steady upward developmental trajectory since Hippocratic times. In particular, the past few decades have witnessed transformative innovations from a myriad of studies that focused on the best strategies to prevent injury from occurring and/or to mitigate the severity of injury when primary prevention fails. These methods, techniques, and processes for developing injury prevention strategies and interventions are generally classified as falling under the “6 Es” of injury prevention: education, engineering modifications, enforcement/enactment, economic incentive (equity), empowerment, and evaluation. The Haddon matrix is the primary conceptual framework for developing injury prevention strategies. Other issues that are germane to effective injury prevention include synergism of interventions and appropriate transfer of interventions across settings.

Article

Behavioral Interventions to Reduce and Prevent Racial Bias  

Nicole Farmer, Alyssa Baginski, and Talya Gordon

Unlike other public health crises, attention to the role of prevention in racial bias has not predominated. Most human actions, including racism, are informed by unconscious thoughts. Behavior-change interventions seek to understand facilitators and barriers to human action and antecedent unconscious thoughts, which are guided not only within an individual but also in interpersonal and societal environments. Current behavioral interventions on implicit and explicit racial bias can identify gaps and opportunities in the literature to evaluate operational definitions of behavior and bias, discuss psychological and neurobiological processes involved in racial bias, that may provide insight into prevention. Furthermore, a focus on public health–based interventions which integrate behavioral science foundations may assist to develop adaptable, accurate, and effective interventions across global communities. Based on the literature results discussed, the benefit for the field of public health may be to inform future studies and create a multilevel, behavioral-based framework to prevent or mitigate racial bias behaviors..

Article

Infectious Diseases Among Migrant Populations  

Silvia Declich, Maria Grazia Dente, Christina Greenaway, and Francesco Castelli

Increasing human mobility, of which migration is a component, is a key driver of microorganism circulation. Migration is a minor component of all human mobility, with most movement due to international tourism, travel for work, business, or study, and military operations abroad. Migration flows from southern low-income countries to the industrialized north have steadily increased as a consequences of a complex array of distal and proximal factors such as economic inequality, climate change, political turbulence, war and persecution, and family reunification. This has raised concerns about the potential transmission and reintroduction of microorganisms and infectious diseases into high-income host countries from migrants with asymptomatic infections such as tuberculosis, HIV, viral hepatitis, malaria, Chagas disease, and arboviral infections. These factors contribute to the mounting hostile attitude sometimes observed in receiving countries and deserve careful scientific assessment to inform policies and interventions. The available evidence does not support the hypothesis that migrants constitute a relevant infectious public health risk for the local population, although careful epidemiological surveillance is mandatory, especially where competent vectors for specific infection are present in the destination area, where certain diseases may potentially be introduced or reintroduced. The greatest risk of infectious diseases is to the migrants themselves due to increased risk of exposure within their own communities and from the burden of undetected and untreated infections caused by marginalization and poor living conditions. The health conditions vary at the different stages of settlement and interventions need to be tailored accordingly. In the early arrival phase the main health concerns are psychological, traumatic, and chronic conditions. Crowded unhygienic living conditions often experienced by migrants in reception camps coupled with low vaccination rate may facilitate the transmission of respiratory or gastrointestinal infections or vaccine-preventable diseases. After resettlement, undetected infections and the lack of access to health care due to social marginalization may lead to the reactivation or progression of infections such as tuberculosis, viral hepatitis, HIV, and chronic helminthiasis. These outcomes could be prevented through screening and treatment and would benefit both migrants and the host populations. Pretravel interventions that increase the awareness of the possible infectious risks in their countries of origin are critical to decrease travel-related infection among visiting friends and relatives, especially those traveling with children. Migrant-friendly health systems that ensure prompt access to diagnosis and treatment, regardless of legal status, are the best interventions to limit the burden and transmission of infections in this population.

Article

Vehicle-Related Causes of Flood Fatalities  

Andrew Gissing, Kyra Hamilton, Grantley Smith, and Amy E. Peden

Vehicle-related flood incidents represent a leading cause of flood fatalities, as well as resulting in an additional health system and emergency services burden. A large proportion of these deaths are preventable and represent an area of collaboration across a range of fields, including emergency services, disaster preparedness, floodplain management, public health, and road safety. The nature of the risk is exacerbated by increases in the frequency and severity of flood events in a warming climate and further urbanization. The nature of vehicle-related flood incidents is multidimensional, consisting of flood hazard, behavioral, vehicle, and road-related factors. Equally, strategies required to reduce the incidence of vehicles entering floodwater must be multidimensional, giving consideration to behavioral, regulatory, structural, and emergency response measures. Such an approach requires the involvement of a diverse range of stakeholders.

Article

Race, Ethnicity, and Street Gang Involvement in an American Context  

Adrienne Freng

Race and ethnicity represent a pivotal issue in almost any conversation regarding gang members. These two concepts have been invariably linked in both research and the larger social world. Images of this connection invade our social milieu and appear frequently in movies, television, news, and music. However, academic research also contributes to this perception. Much of the early work, as well as a significant portion of the qualitative work on gangs, perpetuates the continued examination of racial and ethnic homogeneous gangs, with a focus on African American and Hispanic groups. This work ignores increasing problems among other racial and ethnic groups, such as Asians and Native Americans, within the literature. More recently, however, the intricacies of this relationship are becoming clearer, including the growing involvement of White individuals and the fact that gangs are increasingly multiracial. Furthermore, with the development of the Eurogang project in the late 1990s, research regarding these groups in Europe, as well as in other countries across the world, has become more plentiful, further expanding our knowledge regarding gangs and the role of race and ethnicity, as well as immigration and migration. As the relationship between race and ethnicity and gang membership takes on more meaning, numerous explanations have been developed to account for this connection. Much of the research, both past and present, centers on the association between race and ethnicity and the impacts of social disorganization, discrimination, immigration, and cumulative disadvantage. Community and environmental factors play a crucial role in explaining why gangs thrive in communities often occupied by racial and ethnic minorities. Relatedly, external threats, specifically violence from other groups, can provide the impetus for gang development in neighborhoods marked by disorder; thus, other explanations center on violence and the role that gangs play in mitigating this threat while serving as a protective factor for the youth in the community. The risk factor approach, gaining more prominence in gang literature, investigates individual risk for gang membership, as well as the cumulative effects of risk factors. These various frameworks assist in beginning to understand the underlying factors contributing to gang membership. With regard to policy recommendations, investigating “race and ethnicity specific” risk factors as well how these risk factors might impact programming remain key. In order to fully comprehend the development of gangs, a number of gang researchers have called for the need to understand the different historical experiences of racial and ethnic groups within the United States. For example, the histories of Hispanic and African American groups impact their experiences and thus may result in different pathways to gang membership. And yet, in many respects, these groups are still treated as single entities, ignoring their distinct histories. In fact, there remains a paucity of information regarding cross-group comparisons that examine actual differences between racial and ethnic groups. Without a closer examination of the relationship between race, ethnicity, and gang membership, effective gang policies and practices will remain out of reach.