Violent crime exposure classification and adverse birth outcomes: a geographically-defined cohort study.

Full Abstract

BACKGROUND:
Area-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the reproductive and public health literature. When crime has been used in research, it has been variably defined, resulting in non-comparable associations across studies.

METHODS:
Using geocoded linked birth record, crime and census data in multilevel models, this paper explored the relevance of four spatial violent crime exposures:
two proximal violent crime categorizations (count of violent crime within a one-half mile radius of maternal residence and distance from maternal residence to nearest violent crime) and two area-level crime categorizations (count of violent crimes within a block group and block group rate of violent crimes) for adverse birth events among women in living in the city of Raleigh NC crime report area in 1999-2001. Models were adjusted for maternal age and education and area-level deprivation.

RESULTS:
In black and white non-Hispanic race-stratified models, crime characterized as a proximal exposure was not able to distinguish between women experiencing adverse and women experiencing normal birth outcomes. Violent crime characterized as a neighborhood attribute was positively associated with preterm birth and low birth weight among non-Hispanic white and black women. No statistically significant interaction between area-deprivation and violent crime category was observed.

CONCLUSION:
Crime is variably categorized in the literature, with little rationale provided for crime type or categorization employed. This research represents the first time multiple crime categorizations have been directly compared in association with health outcomes. Finding an effect of area-level violent crime suggests crime may best be characterized as a neighborhood attribute with important implication for adverse birth outcomes.

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Author information

Author/s: Messer, Lynne C (LC); Kaufman, Jay S (JS); Dole, Nancy (N); Herring, Amy (A); Laraia, Barbara A (BA);

Affiliation: US Environmental Protection Agency/National Human Environmental Effects Research Laboratory, Human Studies Division, MD 58A, Research Triangle Park, NC 27711, USA. lmesser(-atsign-)email.unc.edu

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.

Journal: International journal of health geographics (Int J Health Geogr), published in England. (Language: eng)

Reference: 2006-; vol 5 (issue ) : pp 22

Dates: Created 2006/07/14; Completed 2006/08/31; Revised 2008/11/20;

PMID: 16707017, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

African Continental Ancestry Group - statistics & numerical data
Analysis of Variance
Cohort Studies
European Continental Ancestry Group - statistics & numerical data
Female
Humans

North Carolina - epidemiology; ethnology
Odds Ratio
Poverty - ethnology; statistics & numerical data
Pregnancy
Pregnancy Outcome - epidemiology; ethnology
Violence - statistics & numerical data

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