Community Safety

What Is It?

The health impacts of community safety are far-reaching, from the obvious impact of violence on the victim to the symptoms of post-traumatic stress disorder (PTSD) and psychological distress felt by those who are routinely exposed to violence. Community safety impacts various other health factors and outcomes as well, including birth weight, diet and exercise, and family and social support. In an effort to understand community safety, the County Health Rankings measures violent crime per 100,000 residents or homicide death rate per 100,000 residents in select states.

Why Do We Measure It?

Violence against others is a major public health problem in the U.S., accounting for the loss of 18,000 lives each year.[1] Among Americans between the ages of 15 and 24, homicide was the second leading cause of death in 2005. Many violent crimes, however, do not result in death. In the U.S., approximately 268,000 cases of hospitalized violence-related injury occurred in 2004.[2]

A systematic review considering the significance of neighborhood context to child and adolescent health found that neighborhood characteristics seem to have an effect that is independent of the individual family situation and that neighborhood effects have a multiplicative effect on the individual family’s risk.[3] The review goes on to report that in neighborhoods characterized by high crime, the risk that women will give birth to low birth weight infants increases.[3]

A meta-analysis conducted by Fowler et al. finds that exposure to community violence is an important predictor of psychological distress.[4] The meta-analysis found that youth who live in violent neighborhoods may constantly fear for their own safety as well as the safety of others, causing them to be chronically emotionally and physiologically hyperaroused.[4]

Exposure to crime and violence has been shown to increase stress, which may exacerbate hypertension and other stress-related disorders.[5] It also may lead people to engage in smoking in an effort to reduce or cope with stress.[5-6] Exposure to violent neighborhoods has been associated with increased substance abuse and sexual risk-taking behaviors as well as risky driving practices.[6]

Neighborhoods with high violence are thought to encourage isolation and therefore inhibit the social support needed to cope with stressful events.[6] Additionally, exposure to chronic stress contributes to the increased prevalence of certain illnesses, such as upper respiratory illness and asthma, in neighborhoods with high levels of violence.[6]

Measurement Strategies

Studies exploring the impact of neighborhood violence on health traditionally measure violence in one of three ways: perception of neighborhood safety, exposure to neighborhood violence, or actual measures of crime or disorder.[6] Johnson et al. notes that studies that explore general health or physical activity tend to focus on perceptions of neighborhood safety, studies that investigate mental health tend to measure exposure to violence, and multi-community studies use actual measures of crimes or disorder.[6]

There is no gold standard for assessing crime rates at the neighborhood level, but some researchers have successfully used the Federal Bureau of Investigation’s Uniform Crime Reports because they are used consistently across government reporting agencies and are considered a valid and reliable index of the types of crime residents view as serious events.[7] Others have turned to local police data as an objective measure of both violent crime and homicide rates.[8-10]

In examining the effectiveness of community policing strategies in reducing crime, MacDonald linked the FBI’s Uniform Crime Reports to U.S. Census and police administrative data to compute city-level measures of violent crime.[11] The study used robbery and homicide rates per 100,000 residents, noting that research indicates that they are the most serious and reliable measures of violent crime.[11] Because of potential year-to-year variations in recording practices and other potential causes of missing data, MacDonald used two-year average rates in an effort to stabilize the variations and increase the efficiency of the estimates.[11]

What Is the County Health Rankings Measurement Strategy?

The County Health Rankings uses the FBI’s Uniform Crime Reports (UCR) data from 2005-2007 for violent crime rates and, for states with insufficient violent crime-reporting coverage, the CDC’s National Center for Health Statistics National Vital Statistics System data from 2000-2006 for the homicide death rate. The exception is Illinois, for which state data for violent crimes were used. In the FBI’s Uniform Crime Report, violent crime is composed of four offenses: murder and non-negligent manslaughter, forcible rape, robbery, and aggravated assault.[12] Violent crimes are defined as those offenses which involve force or threat of force.[12] 

Measure Strengths & Limitations

Johnson et al. suggests that for purposes of multi-community study or analysis, actual measures of crime are most often used.[6] UCR data is generally regarded as a valid and reliable index of the types of crime residents view as serious events.[7] The use of multiple year averages stabilizes year-to-year variations.[11]

Shihadeh and Flynn note that UCR data has been criticized on the grounds that it measures the reaction of law enforcement agencies rather than criminal behavior itself, but add that for serious crimes such as homicide and robbery, the data appears to accurately reflect rates.[13] Sampson cautions that UCR data may be contaminated by bias when compared across jurisdictions and explains the methodology by which his study controlled for any such bias.[14]

References

[1] Paulozzi LJ, Mercy J, Frazier L, Annest JL. CDC's national violent death reporting system: Background and methodology. Inj Prev. 2004;10:47-52.
[2] Weiss H, Gutierrez MI, Harrison J, Matzopoulos R. The U.S. national violent death reporting system: Domestic and international lessons for violence injury surveillance. Inj Prev. 2006;12:58-62.
[3] Sellström E, Bremberg S. The significance of neighbourhood context to child and adolescent health and well‐being: A systematic review of multilevel studies. Scand J Public Health. 2006;34:544-554.
[4] Fowler PJ, Tompsett CJ, Braciszewski JM, Jacques-Tiura AJ, Baltes BB. Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Dev Psychopathol. 2009;21:227-259.
[5] Ellen IG, Mijanovich T, Dillman KN. Neighborhood effects on health: Exploring the links and assessing the evidence. Journal of Urban Affairs. 2001;23:391-408.
[6] Johnson SL, Solomon BS, Shields WC, McDonald EM, McKenzie LB, Gielen AC. Neighborhood violence and its association with mothers' health: assessing the relative importance of perceived safety and exposure to violence. J Urban Health. 2009;86:538-550.
[7] Clark C, Kawachi I, Ryan L, Ertel K, Fay M, Berkman L. Perceived neighborhood safety and incident mobility disability among elders: The hazards of poverty. BMC Public Health. 2009;9:162.
[8] Limbos MAP, Casteel C. Schools and neighborhoods: Organizational and environmental factors associated with crime in secondary schools. J Sch Health. 2008;78:539-544.
[9] Curry A, Latkin C, Davey-Rothwell M. Pathways to depression: The impact of neighborhood violent crime on inner-city residents in Baltimore, Maryland, USA. Soc Sci Med. 2008;67:23-30.
[10] Browning CR, Feinberg SL, Dietz RD. The paradox of social organization: Networks, collective efficacy, and violent crime in urban neighborhoods. Soc Forces. 2004;83:503-534.
[11] MacDonald JM. The effectiveness of community policing in reducing urban violence. Crime Delinq. 2002;48:592-618.
[12] U.S. Department of Justice. 2007 Crime in the United States: Violent Crime. U.S. Department of Justice, Federal Bureau of Investigation Web Site. www.fbi.gov/ucr/cius2007/offenses/violent_crime/index.html. Updated September 2008. Accessed January 14, 2010.
[13] Shihadeh ES, Flynn N. Segregation and crime: The effect of black social isolation on the rates of black urban violence. Soc Forces. 1996;74:1325-1352.
[14] Sampson RJ. Urban black violence: The effect of male joblessness and family disruption. AJS. 1987; 93:348-382.