暴力犯罪暴露分类与不良出生结局：一项基于地理区域界定的队列研究。
Violent crime exposure classification and adverse birth outcomes: a geographically-defined cohort study.
作者信息
Messer Lynne C, Kaufman Jay S, Dole Nancy, Herring Amy, Laraia Barbara A
机构信息
US Environmental Protection Agency/National Human Environmental Effects Research Laboratory, Human Studies Division, MD 58A, Research Triangle Park, NC 27711, USA.
出版信息
Int J Health Geogr. 2006 May 17;5:22. doi: 10.1186/1476-072X-5-22.
BACKGROUND
Area-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the reproductive and public health literature. When crime has been used in research, it has been variably defined, resulting in non-comparable associations across studies.
METHODS
Using geocoded linked birth record, crime and census data in multilevel models, this paper explored the relevance of four spatial violent crime exposures: two proximal violent crime categorizations (count of violent crime within a one-half mile radius of maternal residence and distance from maternal residence to nearest violent crime) and two area-level crime categorizations (count of violent crimes within a block group and block group rate of violent crimes) for adverse birth events among women in living in the city of Raleigh NC crime report area in 1999-2001. Models were adjusted for maternal age and education and area-level deprivation.
RESULTS
In black and white non-Hispanic race-stratified models, crime characterized as a proximal exposure was not able to distinguish between women experiencing adverse and women experiencing normal birth outcomes. Violent crime characterized as a neighborhood attribute was positively associated with preterm birth and low birth weight among non-Hispanic white and black women. No statistically significant interaction between area-deprivation and violent crime category was observed.
CONCLUSION
Crime is variably categorized in the literature, with little rationale provided for crime type or categorization employed. This research represents the first time multiple crime categorizations have been directly compared in association with health outcomes. Finding an effect of area-level violent crime suggests crime may best be characterized as a neighborhood attribute with important implication for adverse birth outcomes.
背景
地区层面的社会经济差异长期以来一直与不良妊娠结局相关。犯罪是邻里环境的一个重要因素，但在生殖和公共卫生文献中对此研究不足。当犯罪被用于研究时，其定义各不相同，导致各研究之间的关联无法比较。
方法
本文利用地理编码链接的出生记录、犯罪数据和人口普查数据构建多层次模型，探讨了四种空间暴力犯罪暴露的相关性：两种近距离暴力犯罪分类（产妇居住地半英里半径内的暴力犯罪数量以及产妇居住地到最近暴力犯罪地点的距离）和两种地区层面的犯罪分类（普查区组内的暴力犯罪数量以及普查区组的暴力犯罪率），以研究1999 - 2001年居住在北卡罗来纳州罗利市犯罪报告区的女性发生不良出生事件的情况。模型对产妇年龄、教育程度和地区层面的贫困状况进行了调整。
结果
在按非西班牙裔黑人和白人种族分层的模型中，被视为近距离暴露的犯罪无法区分经历不良出生结局的女性和正常出生结局的女性。被视为邻里属性的暴力犯罪与非西班牙裔白人和黑人女性的早产和低出生体重呈正相关。未观察到地区贫困与暴力犯罪类别之间有统计学意义的相互作用。
结论
文献中对犯罪的分类各不相同，且很少为所采用的犯罪类型或分类提供理论依据。本研究首次直接比较了多种犯罪分类与健康结局之间的关联。发现地区层面暴力犯罪的影响表明，犯罪最好被视为一种邻里属性，对不良出生结局具有重要影响。
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