Ten‐Year Secular Trends in Youth Violence: Results From the Philadelphia Youth Risk Behavior Survey 2003‐2013

BACKGROUNDYouth violence reduction is a public health priority, yet few studies have examined secular trends in violence among urban youth, who may be particularly vulnerable to numerous forms of violence. This study examines 10‐year secular trends in the prevalence of violence‐related behaviors among Philadelphia high school students.METHODSRepeated cross‐sectional data were analyzed from 5 waves of the Philadelphia Youth Risk Behavior Survey (YRBS) from 2003 to 2013. Sex‐specific multivariate regression models were used to examine secular trends in multiple types of violence, accounting for age, race/ethnicity, and sampling strategy.RESULTSIn 2013, the most prevalent violent behavior was physical fighting among boys (38.4%) and girls (32.7%). Among girls, the prevalence of sexual assault and suicide attempts declined between 2003 and 2013 (β = −0.13, p = .04 and β = −0.14, p = .007, respectively). Among boys, significant declines in carrying a weapon (β = −0.31, p < .001), carrying a gun (β = −0.16, p = .01), and physical fighting (β = −0.35, p = .001) were observed.CONCLUSIONSWhereas the prevalence of some forms of violence stabilized or declined among Philadelphia youth during 2003‐2013 time span, involvement in violence‐related behaviors remains common among this population. Continued surveillance and evidence‐based violence reduction strategies are needed to address violence among urban youth.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136403/1/josh12491_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136403/2/josh12491.pd

Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear

Vacant and blighted urban land is a widespread and potentially risky environmental condition encountered by millions of people on a daily basis. About 15% of the land in US cities is deemed vacant or abandoned, an area roughly the size of Switzerland. In a citywide cluster randomized controlled trial, we investigated the effects of standardized, reproducible interventions that restore vacant land on the commission of violence, crime, and the perceptions of fear and safety. Quantitative and ethnographic analyses were included in a mixed-methods approach to more fully test and explicate our findings. A total of 541 randomly sampled vacant lots were randomly assigned into treatment and control study arms; outcomes from police and 445 randomly sampled participants were analyzed over a 38-month study period. Participants living near treated vacant lots reported significantly reduced perceptions of crime (−36.8%, P < 0.05), vandalism (−39.3%, P < 0.05), and safety concerns when going outside their homes (−57.8%, P < 0.05), as well as significantly increased use of outside spaces for relaxing and socializing (75.7%, P < 0.01). Significant reductions in crime overall (−13.3%, P < 0.01), gun violence (−29.1%, P < 0.001), burglary (−21.9%, P < 0.001), and nuisances (−30.3%, P < 0.05) were also found after the treatment of vacant lots in neighborhoods below the poverty line. Blighted and vacant urban land affects people’s perceptions of safety, and their actual, physical safety. Restoration of this land can be an effective and scalable infrastructure intervention for gun violence, crime, and fear in urban neighborhoods

A Difference-In-Differences Study of the Effects of a New Abandoned Building Remediation Strategy on Safety.

Vacant and abandoned buildings pose significant challenges to the health and safety of communities. In 2011 the City of Philadelphia began enforcing a Doors and Windows Ordinance that required property owners of abandoned buildings to install working doors and windows in all structural openings or face significant fines. We tested the effects of the new ordinance on the occurrence of crime surrounding abandoned buildings from January 2011 to April 2013 using a difference-in-differences approach. We used Poisson regression models to compare differences in pre- and post-treatment measures of crime for buildings that were remediated as a result of the ordinance (n = 676) or permitted for renovation (n = 241), and randomly-matched control buildings that were not remediated (n = 676) or permitted for renovation (n = 964), while also controlling for sociodemographic and other confounders measured around each building. Building remediations were significantly associated with citywide reductions in overall crimes, total assaults, gun assaults and nuisance crimes (p < 0.001). Building remediations were also significantly associated with reductions in violent gun crimes in one city section (p < 0.01). At the same time, some significant increases were seen in narcotics sales and possession and property crimes around remediated buildings (p < 0.001). Building renovation permits were significantly associated with reductions in all crime classifications across multiple city sections (p < 0.001). We found no significant spatial displacement effects. Doors and windows remediation offers a relatively low-cost method of reducing certain crimes in and around abandoned buildings. Cities with an abundance of decaying and abandoned housing stock might consider some form of this structural change to their built environments as one strategy to enhance public safety

Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults.

BACKGROUND:Social isolation is an important determinant of all-cause mortality, with evidence suggesting an association with cancer-specific mortality as well. In this study, we examined the associations between social isolation and neighborhood poverty (independently and jointly) on cancer mortality in a population-based sample of US adults. METHODS:Using data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994), NHANES III Linked Mortality File (through 2011) and 1990 Census, we estimated the relationship between social isolation and high neighborhood poverty and time-to-cancer death using multivariable-adjusted Cox proportional hazards models. We examined the associations of each factor independently and explored the multiplicative and additive interaction effects on cancer mortality risk and also analyzed these associations by sex. RESULTS:Among 16 044 US adults with 17-23 years of follow-up, there were 1133 cancer deaths. Social isolation (HR 1.25, 95% CI: 1.01-1.54) and high neighborhood poverty (HR 1.31, 95% CI: 1.08-1.60) were associated with increased risk of cancer mortality adjusting for age, sex, and race/ethnicity; in sex-specific estimates this increase in risk was evident among females only (HR 1.39, 95% CI: 1.04-1.86). These associations were attenuated upon further adjustment for socioeconomic status. There was no evidence of joint effects of social isolation and high neighborhood poverty on cancer mortality overall or in the sex-stratified models. CONCLUSIONS:These findings suggest that social isolation and higher neighborhood poverty are independently associated with increased risk of cancer mortality, although there is no evidence to support our a priori hypothesis of a joint effect

Map of Doors and Windows Ordinance violations, and treatment and control locations for violation compliance and renovation permits in Philadelphia, PA.

<p>Data source: Philadelphia Department of Licensing and Inspection (2013) North (N), Northwest (NW), South (S) and West (W) sections are indicated.</p

Monthly Frequencies of Violation Citations (A), Violation Compliances (B) and Renovation Permits (C) between January 2011 and May 2013.

<p>Monthly Frequencies of Violation Citations (A), Violation Compliances (B) and Renovation Permits (C) between January 2011 and May 2013.</p

Adjusted Difference-in-Differences Estimates of Renovation Permit on Census-Tract Level Crime Outcomes, by City Section, Philadelphia, PA, January 2010 –April 2013¹.

<p>* p<0.05</p><p>**p<0.01</p><p>***p<0.001</p><p>1.All estimates include controls for median age, median household income, percent of the population with less than a high school-level education, and percent of households earning less than the federal poverty standard. 2. IRR: Incidence Rate Ratio; ratio of incidence rate of crimes per square mile at the treatment site to incidence rate of crimes per square mile at the control site 3. SE: Standard Error</p><p>4. “-”indicates that numbers are too small to report.</p><p>Adjusted Difference-in-Differences Estimates of Renovation Permit on Census-Tract Level Crime Outcomes, by City Section, Philadelphia, PA, January 2010 –April 2013¹.</p

Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults - Fig 1

<p>Sex-stratified hazard ratios (HR) of the effects of Social Network Index (A) and Neighborhood Poverty (B) on cancer mortality. In model 1, the HRs are unadjusted, in model 2 they are adjusted for race/ethnicity and age, and in model 3 they are adjusted for race/ethnicity, age, education, and poverty income ratio. The error bars represent the 95% confidence intervals around each HR.</p