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2016 ; 170
(5
): 473-80
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Modifiable Neighborhood Features Associated With Adolescent Homicide
#MMPMID26954939
Culyba AJ
; Jacoby SF
; Richmond TS
; Fein JA
; Hohl BC
; Branas CC
JAMA Pediatr
2016[May]; 170
(5
): 473-80
PMID26954939
show ga
IMPORTANCE: Homicide is a leading cause of adolescent mortality. To our
knowledge, relatively little has been studied in terms of the association between
environmental neighborhood features, such as streets, buildings, and natural
surroundings, and severe violent injury among youth. OBJECTIVE: To assess
associations between environmental neighborhood features and adolescent homicide
in order to identify targets for future place-based interventions. DESIGN,
SETTING, AND PARTICIPANTS: Population-based case-control study conducted in
Philadelphia, Pennsylvania, from April 15, 2008, to March 31, 2014. We identified
adolescents who died by homicide at 13 to 20 years of age from 2010 to 2012 while
residing in Philadelphia. We used incidence-density sampling and random-digit
dialing to recruit control participants ages 13 to 20 years matched on sex and
indoor-outdoor location at the time of each index case participant's homicide.
EXPOSURES: To obtain environmental data about modifiable features that were
present in the immediate surroundings of our case and control participants,
blinded field researchers used standardized techniques to photograph case and
control participant outdoor locations. Photographic data were stitched together
to create 360° panoramic images that were coded for 60 elements of the visible
environment. MAIN OUTCOME AND MEASURE: Adolescent homicide. RESULTS: We enrolled
143 homicide case participants (mean [SD] age, 18.4 [1.5] years) and 155 matched
control participants (mean [SD] age, 17.2 [2.1] years) who were both outdoors at
the time of the homicide. In adjusted analyses, multiple features of Philadelphia
streets, buildings, and natural surroundings were associated with adolescent
homicide. The presence of street lighting (odds ratio [OR], 0.24; 95% CI,
0.09-0.70), illuminated walk/don't walk signs (OR, 0.16; 95% CI, 0.03-0.92),
painted marked crosswalks (OR, 0.17; 95% CI, 0.04-0.63), public transportation
(OR, 0.13; 95% CI, 0.03-0.49), parks (OR, 0.09; 95% CI, 0.01-0.88), and
maintained vacant lots (OR, 0.17; 95% CI, 0.03-0.81) were significantly
associated with decreased odds of homicide. The odds of homicide were
significantly higher in locations with stop signs (OR, 4.34; 95% CI, 1.40-13.45),
security bars/gratings on houses (OR, 9.23; 95% CI, 2.45-34.80), and private
bushes/plantings (OR, 3.44; 95% CI, 1.18-10.01). CONCLUSIONS AND RELEVANCE: Using
a population-based case-control design, we identified multiple modifiable
environmental features that might be targeted in future randomized intervention
trials designed to reduce youth violence by improving neighborhood context.
|Adolescent
[MESH]
|Case-Control Studies
[MESH]
|Environment Design
[MESH]
|Female
[MESH]
|Homicide/*statistics & numerical data
[MESH]
|Humans
[MESH]
|Male
[MESH]
|Philadelphia/epidemiology
[MESH]
|Residence Characteristics/*statistics & numerical data
[MESH]
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