Article Text
Abstract
Objective: To examine whether measures of neighbourhood economic deprivation, social disorganisation, and acculturation explain homicide mortality differentials between Mexican Americans, non-Hispanic black Americans, and non-Hispanic white Americans, net of individual factors.
Design: Prospective study, National Health Interview Survey (1986–1994) linked to subsequent mortality in the National Death Index (1986–1997).
Setting: United States of America.
Participants: A nationally representative sample of non-institutionalised Mexican Americans, non-Hispanic black Amricans, and non-Hispanic white Americans, aged 18–50 at the point of interview.
Analysis: Cox proportional hazard models estimate the risk of death associated with various neighbourhood and individual factors.
Main results: Both individual and neighbourhood risk factors partially account for race/ethnic disparities in homicide. Homicide mortality risks are between 20% and 50% higher for residents of areas that have economic inequality of 0.50 or greater based on the coefficient of variation, or where 4% or more of the residents are Mexican American, 10% or more of the residents are non-Hispanic black, or 20% or more of the households are headed by single parents (p⩽.05). But residents of areas where 10% or more of their neighbours are foreign born have 35% lower mortality risks than people living in areas with fewer foreign born people (p⩽0.05). These differences persist even after controlling for individual level risk factors.
Conclusions: The findings support economic deprivation, social disorganisation, and acculturation theories, and suggest that both neighbourhood and individual risk factors affect race/ethnic differences in homicide mortality. Public health policies must focus on both individual and neighbourhood factors to reduce homicide risks in vulnerable populations.
- homicide mortality
- neighbourhoods
- race
- ethnicity
- NHIS, National Health Interview Survey
- NDI, National Death Index
- VSA, very small area
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Footnotes
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Funding: National Science Foundation (grants SES-0243249, SES-0243189, and SES-0221093) and the Agency for Healthcare Research and Quality (grant 1 R03 HS013996-01),
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Conflicts of interest: none declared.