Bernadette Hohl

Effects of greening and community reuse of vacant lots on crime

The Youngstown Neighborhood Development Corporation initiated a ‘Lots of Green’ programme to reuse vacant land in 2010. We performed a difference-in-differences analysis of the effects of this programme on crime in and around newly treated lots, in comparison to crimes in and around randomly selected and matched, untreated vacant lot controls. The effects of two types of vacant lot treatments on crime were tested: a cleaning and greening ‘stabilisation’ treatment and a ‘community reuse’ treatment mostly involving community gardens. The combined effects of both types of vacant lot treatments were also tested. After adjustment for various sociodemographic factors, linear and Poisson regression models demonstrated statistically significant reductions in all crime classes for at least one lot treatment type. Regression models adjusted for spatial autocorrelation found the most consistent significant reductions in burglaries around stabilisation lots, and in assaults around community reuse lots. Spill-over crime reduction effects were found in contiguous areas around newly treated lots. Significant increases in motor vehicle thefts around both types of lots were also found after they had been greened. Community-initiated vacant lot greening may have a greater impact on reducing more serious, violent crimes.

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.

Developing measures of community-relevant outcomes for violence prevention programs: A community-based participatory research approach to measurement

Community-Based Participatory Research is a research paradigm that encourages community participation in designing and implementing evaluation research, though the actual outcome measures usually reflect the “external” academic researchers’ view of program effect and the policy-makers’ needs for decision-making. This paper describes a replicable process by which existing standardized psychometric scales commonly used in youth-related intervention programs were modified to measure indicators of program success defined by community partners. This study utilizes a secondary analysis of data gathered in the context of a community-based youth violence prevention program. Data were retooled into new measures developed using items from the Alabama Parenting Questionnaire, the Hare Area Specific Self-Esteem Scale, and the Youth Asset Survey. These measures evaluated two community-defined outcome indicators, “More Parental Involvement” and “Showing Kids Love.” Results showed that existing scale items can be re-organized to create measures of community-defined outcomes that are psychometrically reliable and valid. Results also show that the community definitions of parent or parenting caregivers exemplified by the two indicators are similar to how these constructs have been defined in previous research, but they are not synonymous. There are nuanced differences that are important and worthy of better understanding, in part through better measurement.

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.

Association of Drug and Alcohol Use With Adolescent Firearm Homicide at Individual, Family, and Neighborhood Levels

Importance Homicide is the third leading cause of death for adolescents in the United States and the leading cause of death for adolescents who are African American. Large cities have disproportionate homicide rates. Objective To determine the relationships between exposures to drugs and alcohol at the individual, family, and neighborhood levels and adolescent firearm homicide and to inform new approaches to preventing firearm violence. Design, Setting, and Participants Population-based case-control study from January 2010 to December 2012 of all 13- to 20-year-olds who were homicide victims in Philadelphia during the study period matched to randomly selected 13- to 20-year-old controls from the general population. Exposures Individual drug and alcohol use at the time of injury, history of drug and alcohol use, caregiver drug and alcohol use, and neighborhood availability of alcohol and illegal drugs. We also controlled for age, race, school suspensions, arrests, and neighborhood ethnicity. Main Outcomes and Measures Adolescent firearm homicide identified from police and medical examiner’s reports. Results We enrolled 161 adolescent homicide cases, including 157 (97.5%) firearm homicide cases and 172 matched controls, including 166 (96.5%) firearm homicide controls. Adolescents with a history of alcohol use (adjusted odds ratio [AOR], 4.1; 95% CI, 1.2-14.0) or drug use (AOR, 4.4; 95% CI, 1.7-11.6) had increased odds of firearm homicide. Adolescents whose caregiver had a history of drug use had increased odds of firearm homicide (AOR, 11.7; 95% CI, 2.8-48.0). Adolescents in neighborhoods with high densities of alcohol outlets (AOR, 3.2; 95% CI, 1.1-9.1) and moderate or high drug availability had increased odds of firearm homicide (AOR, 3.4; 95% CI, 1.1-10.3 vs AOR, 7.5; 95% CI, 2.2-25.8). Conclusions and Relevance Almost all adolescent homicides in Philadelphia between 2010 and 2012 were committed with a firearm. Substance use at the individual, family, and neighborhood levels was associated with increased odds of adolescent firearm homicide; drug use was associated at all 3 levels and alcohol at the individual and neighborhood levels. Expanding violence prevention efforts to target drug and alcohol use at multiple levels may help to reduce the firearm violence that disproportionately affects adolescents in minority populations in large US cities.

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

Significance Blighted and vacant urban land is a widespread and potentially risky environmental condition encountered by millions of people every day. About 15% of the land in US cities is deemed vacant or abandoned, translating into an area roughly the size of Switzerland: over 3 million hectares of otherwise beneficial spaces remain neglected. Urban residents, especially in low-income neighborhoods, point to these spaces as primary threats to their health and safety. Cities continue to seek meaningful, evidence-based interventions for remediating vacant land. Standardized processes for the restoration of vacant urban land were experimentally tested on a citywide scale and found to significantly reduce gun 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.

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

BACKGROUND Youth 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. METHODS Repeated 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. RESULTS In 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. CONCLUSIONS Whereas 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.

Effect of Greening Vacant Land on Mental Health of Community-Dwelling Adults: A Cluster Randomized Trial

Key Points Question Does the greening of vacant urban land reduce self-reported poor mental health in community-dwelling adults? Findings In this cluster randomized trial of urban greening and mental health, 110 randomly sampled vacant lot clusters were randomly assigned to 3 study groups. Among 342 participants included in the analysis, feeling depressed significantly decreased by 41.5% and self-reported poor mental health showed a reduction of 62.8% for those living near greened vacant lots compared with control participants. Meaning The remediation of vacant and dilapidated physical environments, particularly in resource-limited urban settings, can be an important tool for communities to address mental health problems, alongside other patient-level treatments.

Perceived neighborhood disorder, racial-ethnic discrimination and leading risk factors for chronic disease among women: California Behavioral Risk Factor Surveillance System, 2013

Social environmental factors are theoretically identified as influential drivers of health behaviors – tobacco smoking, alcohol consumption, and physical activity – related to chronic disease disparities. Empirical studies investigating relationships involving social environmental factors have found that either greater interpersonal racial-ethnic discrimination or perceived neighborhood disorder were associated with adverse health behaviors, with potentially larger effects among women. We simultaneously tested whether measures of perceived racial-ethnic discrimination and perceived neighborhood disorder were associated with physical activity, alcohol consumption and tobacco smoking; lifestyle risk factors of major chronic disease among women. Data were from the 2013 California Behavioral Risk Factor Surveillance System. In addition to demographic and socioeconomic factors, women self-reported experiences with racial-ethnic discrimination and perception of neighborhood disorder (i.e., crime safety, traffic safety, and aesthetics/physical disorder). Survey-, and inverse probability of censoring-weighted regression models of each chronic disease risk factor were used to investigate associations involving racial-ethnic discrimination and neighborhood disorder, controlling for potential confounders. Perceiving racial-ethnic discrimination and greater neighborhood disorder were associated with a greater tobacco smoking prevalence. Experiences of racial-ethnic discrimination were associated with greater alcohol consumption among African American and Latino women, but not White women. Similarly, African American women reporting experiences with racial-ethnic discrimination report engaging in physical activity about half as much time as women reporting no racial-ethnic discrimination. Increases in perceived neighborhood disorder were associated with increases in alcohol consumption. All associations with social environmental factors were adjusted for potential confounders and each other. Neighborhood disorder and racial-ethnic discrimination may be important, independent contributors to chronic disease risk through relationships with tobacco smoking, alcohol consumption, and physical activity.

149 Developing strategies to prevent youth from obtaining illegal firearms

Statement of Purpose The greater than 11 000 annual firearm homicides and 60 000 nonfatal firearm assaults are disproportionately borne by young, urban males and their families. Cities across the United States are left to address the epidemic of firearm injuries resulting from this flow of illegally obtained firearms across their borders. With scarce resources, local municipalities have had a difficult time identifying the sources of guns, the patterns of behaviour, and the pathways of transactions for youth who obtain firearms illegally. Understanding these transactions can help cities properly address the issue at local, state and even federal levels. The purpose of this study was to explore youth and young adult perspectives on gun violence and accessibility in their community. Methods We conducted focus groups (n=5, ages 14–17) and semi-structured (n=19, ages 18–24) interviews with a purposive sample of youth who either lived in or spent a significant amount of time in one police district in Philadelphia, PA. Youth were recruited from at-risk, youth serving community organisations. Interviews were recorded, transcribed and coded thematically. Results Participants reported they could quickly and easily access a firearm and believed that to be true of their peers. They discussed people who owned the firearms and places around the community where guns were carried and stored. Participants did not have an accurate understanding of firearm laws and policies and shared some solutions to addressing the problem of violence. Conclusions Youth firearm violence is a result of many factors including easy access to firearms. Enhancing existing community infrastructure and knowledge will address some issues but is not comprehensive enough to address spillover effects of state laws. Significance Curbing firearm access will require a multi-pronged approach of national, state and local efforts. Specifically, city officials need to hold state officials accountable for addressing the needs of urban youth.