Claudia J. Coulton

Neighborhoods and Child Maltreatment: A Multi-Level Study.

OBJECTIVE To better understand how neighborhood and individual factors are related to child maltreatment. METHOD Using an ecological framework, a multi-level model (Hierarchical Linear Modeling) was used to analyze neighborhood structural conditions and individual risk factors for child abuse and neglect. Parents (n = 400) of children under the age of 18 were systematically selected from 20 randomly selected census-defined block groups with different risk profiles for child maltreatment report rates. Parents were administered the Neighborhood Environment for Children Rating Scales, the Child Abuse Potential Inventory, the Zimet measure of social support, and the Conflict Tactics Scales as a measure of childhood experience with violence. RESULTS Neighborhood factors of impoverishment and child care burden significantly affect child abuse potential after controlling for individual risk factors. However, neighborhood effects are weaker than they appear to be in aggregate studies of official child maltreatment reports. Variation in child abuse potential within neighborhoods is greater than between neighborhoods. However, adverse neighborhood conditions weakend the effects of known individual risk and protective factors, such as violence in the family of origin. CONCLUSIONS If individual potential for child maltreatment is more evenly distributed across neighborhoods than reported maltreatment, then neighborhood and community play an important, if as yet unspecified, role in child maltreatment. Multi-level models are a promising research strategy for disentangling the complex interactions of individual and contextual factors in child maltreatment.

Use of social and health services by the elderly.

The differences in physical and social functioning between the elderly and the general population are likely to affect the utilization of social and health services we focus on two areas: (1) determining whether the elderly are affected by factors known to be important to service utilization among the general population; and (2) exploring the relationship between medical, mental health, personal care, and recreational services, and conceptually analogous factors. Results suggest that the elderly and the general population are similarly affected by need, enabling, and predisposing factors. Once need was taken into account, enabling and predisposing factors explained little variance in utilization of any services. With the exception of recreational services, both social and medical care service utilization can be explained by the same factors.

Measuring Neighborhood Context for Young Children in an Urban Area

Awareness of worsening conditions in urban areas has led to a growing interest in how neighborhood context affects children. Although the ecological perspective within child development has acknowledged the relevance of community factors, methods of measuring the neighborhood context for children have been quite limited. An approach to measuring neighborhood environments was tested using the average perceptions of caregivers of young children sampled from high- and low-risk block groups. Individual- and aggregate-level reliabilities and discriminant validity were acceptable for dimensions of neighborhood quality and change, participation in block organizations, disorder and incivilities, service usage and quality, and retaliation against adults. However, for measures of neighborhood interaction and the tendency of adults to intervene with children, there was virtually no agreement among respondents within block groups, resulting in poor aggregate reliability. A model of variability may be a more promising way of characterizing neighborhoods along these dimensions.

Impoverishment and child maltreatment in African American and European American neighborhoods

Although it is well documented that child maltreatment exerts a deleterious impact on child adaptation, much less is known about the precise etiological pathways that eventuate in child abuse and neglect. This paper reports on a multimethod ecological study of the relationship between neighborhood structural factors and child maltreatment reports in African American and European American census tracts. The study had two major components. First, in an aggregate analysis, the effects of four measures of community structure (impoverishment, child care burden, instability, and geographic isolation) on child maltreatment report rates were examined separately for predominantly African American (n = 94) and predominantly European American (n = 189) census tracts. Impoverishment in particular had a significantly weaker effect on maltreatment rates in African American than in European American neighborhoods. Second, focused ethnographies were conducted in four selected census tracts with child maltreatment report rates in the highest and lowest quartiles. Ethnographic data point to the importance of the social fabric in accounting for differences in child maltreatment report rates by predominant neighborhood ethnicity.

Building Community Capacity for Violence Prevention

The capacity of communities to prevent violence is examined fromthree perspectives: youth violence, child maltreatment, and intimate partner violence. The analysis suggests that community social control and collective efficacy are significant protective factors for all three types of violence, but these need to be further distinguished for their relationships to private, parochial, and state controls. It is argued that strong interpersonal ties are not the only contributor to collective efficacy and violence prevention. Weak ties, including those outside the community, and organizational ties are also seen as necessary. Violence prevention programs should be structured in ways that contribute to the communities’ own capacity to prevent violence.

Geographic Concentration of Affluence and Poverty in 100 Metropolitan Areas, 1990

The geographic concentration of poverty and affluence is examined for the 100 largest metropolitan areas. Concentration of poverty and affluence are uncorrelated, but metropolitan areas can be classified into five types based on six indices of concentration and affluence. The types differ significantly in their racial and ethnic segregation, the relative advantage of the central city as compared to the suburbs, and the economic inequality in the population. Cities in which both affluence and poverty are highly concentrated differ along all dimensions from cities of the more egalitarian type.

Utilization and physical activity levels at renovated and unrenovated school playgrounds

OBJECTIVE This study examined utilization and physical activity levels at renovated compared to unrenovated school playgrounds. METHODS Ten unrenovated and ten renovated school playgrounds (renovated at least a year prior) in Cleveland, OH were matched on school and neighborhood characteristics. Using direct observation (SOPLAY), the number of persons attending each playground and their physical activity levels were recorded using separate counts for girls, boys, men and women. Each school was observed ten times for 90 min each time outside of school hours in 2005. Paired t-tests, Wilcoxon Signed Ranks tests, and regression analyses were completed to examine differences across school pairs. RESULTS More persons overall including adults and children utilized the renovated playgrounds compared to the unrenovated playgrounds. The proportion moderately-to-vigorously active was not different between renovated and unrenovated playgrounds although the proportion of children, in particular boys, who were vigorously active was greater at the renovated playgrounds. Although utilization was higher at the renovated playgrounds, absolute utilization was low across all playgrounds. CONCLUSIONS This study suggests that playgrounds renovations may have the potential to increase the number of children utilizing the playground outside of school hours and may increase the proportion of children, especially boys, who are vigorously active.

Finding Place in Community Change Initiatives: Using GIS to Uncover Resident Perceptions of their Neighborhoods

The growing recognition that place matters has led to numerous foundation- and government-sponsored initiatives that attempt to simultaneously strengthen neighborhoods and address the needs of families that live there. Despite the centrality of the concept of neighborhood, these place-based initiatives have few tools to understand how residents identify with the space within their target areas. This article demonstrates how resident-drawn maps gathered in a household survey can be used to uncover individual and collective neighborhood definitions. Using data gathered as part of the Annie E. Casey Foundations Making Connections program in 10 cities, the study finds that there is considerable variation among residents in how they define their neighborhoods, but that there are also commonly held neighborhood identities that need to be taken into account in community practice. Funding for this analysis was provided by the Annie E. Casey Foundation.

Implications of DRG payments for medical intensive care.

Patients in the most prevalent DRGs in a Medical Intensive Care Unit (MICU) were compared with their counterparts who received only routine hospital care on adjusted total hospital costs and length of stay. Costs for both groups were compared with estimated DRG payments under an allpayer system. For patients in three DRGs, measures of severity of illness were examined as predictors of costs. Significant differences between MICU and routine care patients were found in 10 of 13 DRGs studied; intensive care costs were substantially above overall payment rates. The severity of illness measures varied widely in their correlation with costs, depending on DRG and whether the patients were MICU or routine care. These apparent differences in accounting costs may result in hospital decisions to restrict the number of MICU beds. Severity of illness adjustments to DRGs might produce more equitable payments. The most useful measure of severity may differ, however, depending on DRG.

Job Access, Employment and Earnings: Outcomes for Welfare Leavers in a US Urban Labour Market

This article examines the effect of job access on employment outcomes for welfare recipients in Cleveland, Ohio, leaving assistance during 1998—2000. A rich longitudinal dataset is employed, combining administrative and survey data with multiple measures of access to and competition for jobs. The focus is on both a population and a range of measures of employment outcomes not previously studied in this context. Empirical ambiguity in the existing literature has resulted from the difficulty of modelling causality when employment and residential location are jointly determined. In this study, labour market outcomes are related to the residential locations of welfare leavers prior to employment, thus overcoming much potential endogeneity. Virtually no evidence is found that job access influences labour market outcomes for this population.