Elizabeth A. LaScala

Understanding the Ecology of Child Maltreatment: A Review of the Literature and Directions for Future Research

Studies examining neighborhood characteristics in relation to social problems, including child maltreatment, have proliferated in the past 25 years. This article reviews the current state of knowledge of ecological studies of child maltreatment. Taken as a whole, these 18 studies document a stable ecological relationship among neighborhood impoverishment, housing stress, and rates of child maltreatment, as well as some evidence that unemployment, child care burden, and alcohol availability may contribute to child abuse and neglect. The authors include a discussion of methodological difficulties in conducting research at the neighborhood level and present a set of recommendations for future research that emphasizes movement from a simple examination of neighborhood-level characteristics toward a theoretically driven explication of processes and mechanisms supported by appropriate multilevel modeling techniques. The final goal of such efforts would be to enable practitioners to develop evidence-based neighborhood interventions that would prevent and reduce child abuse and neglect.

NEIGHBORHOOD CHARACTERISTICS OF ALCOHOL-RELATED PEDESTRIAN INJURY COLLISIONS: A GEOSTATISTICAL ANALYSIS

This study conducted a geostatistical analysis of ecological data to examine the relationships of neighborhood characteristics, including alcohol availability and alcohol consumption patterns to pedestrian injury collisions. The central research question asked whether it was possible to identify unique neighborhood characteristics related to alcohol- and non–alcohol-involved pedestrian injuries. It was hypothesized that greater numbers of alcohol-involved pedestrian injuries would be observed in areas with greater concentrations of alcohol outlets, even after adjusting for socioeconomic characteristics, environmental factors, and drinking patterns of neighborhood residents. It was also hypothesized that independent of drinking patterns and alcohol availability, greater numbers of pedestrian injuries would be observed in areas with higher unemployment, lesser income, greater population, and a predominance of younger or older age populations. Archival and individual-level data from a general population telephone survey were obtained from four California communities. The survey data included sociodemographic and drinking pattern measures. Archival data included environmental measures relevant to pedestrian travel and measures of alcohol availability. Units of analysis were geographic areas within each community defined by the spatial clustering of telephone survey respondents. The results showed that alcohol-involved pedestrian collisions occurred more often in areas with greater bar densities and greater population, and where the local population reported drinking more alcohol per drinking occasion. Pedestrian collisions not involving alcohol occurred more often in lower income areas with greater population and cross-street densities, and in areas having either younger or older age populations. The identification of neighborhood variables associated with pedestrian collisions has important implications for policy formation and targeted prevention efforts.

An ecological study of the locations of schools and child pedestrian injury collisions

Geographic studies of the incidence and prevalence of child pedestrian injury collisions in different community environments have been primarily descriptive and idiosyncratic, reflecting one or another likely determinant of the places where these injuries occur. The current study maintains that multiple determinants of child pedestrian injury collisions must be considered in evaluating the unique contributions of any one community feature to injury rates. These features include local characteristics of populations, such as rates of unemployment, and places, such as locations of schools. Schools are one stable geographic feature associated with regular, often concentrated periods of complex and congested traffic patterns. The objective of the present study was to examine annual rates of child pedestrian injury in four California communities with a focus on the unique contribution of schools to injury risk. We predicted that annual numbers of child pedestrian injury collisions (both in-school and summer combined) would be greater in communities with higher youth population densities, more unemployment, fewer high-income households, and higher traffic flow. It was hypothesized that youth population density and its interaction with the number of schools in a given area would be related to greater rates of child pedestrian collisions during in-school months. An ecological approach was taken that divided the four communities into 102 geographic units with an average of 6321 people residing in each unit. Archival data on traffic flow, number of child pedestrian injury collisions and locations of schools were obtained from state agencies. Individual-level data were obtained from a general population survey conducted in the communities. The results showed that annual numbers of injuries were greater in areas with higher youth population densities, more unemployment, fewer high-income households, and greater traffic flow. Annual numbers of injuries during in-school months were greater in areas containing middle schools and greater population densities of youth.

An ecological assessment of the population and environmental correlates of childhood accident, assault, and child abuse injuries.

BACKGROUND This study examines the relationships of population and environmental characteristics to hospital discharges for childhood accident, assault, and child abuse injuries among youth from 0 to 17 years of age. METHODS The analysis uses aggregate data on populations and environments in 1,646 California zip code areas that were collected for the year 2000. Zero inflated negative binomial models were used to assess ecological relationships between these characteristics and numbers of hospital discharges for childhood injuries from accidents and assaults; negative binomial models were used to assess these relationships for injuries related to child abuse. RESULTS A number of different characteristics were related to the different injury outcomes. Childhood accident injuries were related to measures female headed households, adult to child ratio, and nonalcohol retail establishments (e.g., numbers of gas stations). Assault injuries were related to measures of poverty and vacant housing. All 3 outcomes were directly related to percent of female-headed households, percent African American residents, and density of off-premise alcohol outlets. CONCLUSIONS The results demonstrate that both population and environmental characteristics are significantly correlated with rates of childhood injuries. These results suggest that some environmental characteristics, in particular the presence of many off-premise alcohol outlets in neighborhoods, may reduce the overall level of guardianship of childrens activities in zip code areas, resulting in harm to their children.

An Exploratory Study Examining the Spatial Dynamics of Illicit Drug Availability and Rates of Drug Use.

This study examines the spatial relationship between drug availability and rates of drug use in neighborhood areas. Responses from 16,083 individuals were analyzed at the zip code level (n = 158) and analyses were conducted separately for youth and adults using spatial regression techniques. The dependent variable is the percentage of respondents using drugs in the past year. Neighborhood drug availability (the major independent variable) was measured by the percentage of non-drug users who had been approached to purchase drugs. Data were obtained as part of the Fighting Back community evaluation. For youth (aged 12 to 18), drug sales in adjacent and surrounding areas were positively associated with self-reported drug use in areas where youth were residents. For adults, drug sales within the neighborhood were negatively associated with drug use, while drug sales in immediately adjacent neighborhoods were positively related to self-reports of drug use. Findings suggest that the areas where rates of drug users are greatest are not necessarily the same area where drugs are sold. Designing strategies to reduce the supply of drugs should receive input from city and regional planners and developers, as well as law enforcement and public health professionals.

Ecological associations of alcohol outlets with underage and young adult injuries.

OBJECTIVE This paper argues that associations between rates of 3 specific problems related to alcohol (i.e., accidents, traffic crashes, and assaults) should be differentially related to densities of alcohol outlets among underage youth and young adults based upon age-related patterns of alcohol outlet use. METHODS Zip code-level population models assessed local and distal effects of alcohol outlets upon rates of hospital discharges for these outcomes. RESULTS Densities of off-premise alcohol outlets were significantly related to injuries from accidents, assaults, and traffic crashes for both underage youth and young adults. Densities of bars were associated with more assaults and densities of restaurants were associated with more traffic crash injuries for young adults. CONCLUSIONS The distribution of alcohol-related injuries relative to alcohol outlets reflect patterns of alcohol outlet use.

Assessing Correlates of the Growth and Extent of Methamphetamine Abuse and Dependence in California

Using aggregate-level data, this study performed cross-sectional analyses on all 1,628 populated California zip code areas and longitudinal analyses on 581 consistently defined zip codes over six years (1995–2000), relating place and population characteristics of these areas to rates of hospital discharges for amphetamine dependence/abuse using linear spatial models. Analyzing the data in two ways, spatial time series cross-sections and spatial difference models, amphetamine dependence/abuse were greatest in rural areas with more young low-income whites, larger numbers of retail and alcohol outlets, and smaller numbers of restaurants. Growth rates of these problems were greater in areas with higher income and larger non-White and Hispanic populations. This suggests that there was some change in the penetration of the methamphetamine epidemic into different population groups during this time. Study implications and limitations are discussed.

Social Disorganization, Alcohol, and Drug Markets and Violence*

The United States remains one of the most violent countries in the developed world. We believe that at least three separate sets of factors have contributed to these high rates: (1) social disorganization and related community structural factors, (2) over-densities in the distribution of alcohol outlets, and (3) illegal drug markets. Data were collected for the city of Sacramento, CA, for the years 1997 through 2001 and geocoded to 304 Census block groups. The outcome measure for the study was numbers of Emergency Medical System (EMS, ambulance, and fire) calls for service related to assault injuries. Data on population and housing characteristics related to social disorganization were obtained from the US Census. California Alcohol Beverage Control data provided the locations of active alcohol outlets in the city separated into bars and taverns and off-premise establishments. Sacramento Police Department incident reports related to drug sales and transport were used to indicate areas of the city where drug market activities were most prevalent. Bayesian disease models were used to assess statistical relationships between EMS assault injuries and these independent measures. The index of drug market activity and numbers of alcohol outlets were positively related to the number of assault injuries. Areas with lesser White and greater African-American populations had more assaults. Lower education, greater amounts of vacant housing, and more unemployment were also related to greater levels of violence. However, contrary to the expectations, more owner-occupied housing and greater household incomes were positively related to the levels of assaults, and greater numbers of households below the poverty line were related to lower levels of assaults. A substantive effect was observed for the interaction of drug arrests and poverty, indicating lower levels of violence in poor areas with high degrees of drug activity (actually increasing the size of the anomalous effect noted in the previous paragraph). Substantive positive interactions were observed with respect to sizes of minority populations, African-Americans, and Hispanics. Drug market activities and alcohol outlets have separable and substantive effects upon observed rates of violence. These environmental conditions serve as catalysts for violence among at-risk populations.