Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA.
Ann Epidemiol. 2021 Mar;55:27-33. doi: 10.1016/j.annepidem.2020.11.008. Epub 2020 Dec 5.
Research examining the association between crime and health outcomes has been hampered by a lack of reliable small-area (e.g., census tract or census block group) crime data. Our objective is to assess the accuracy of synthetically estimated crime indices for use in health research by using preterm birth as a case study.
We used violent crime data reported by 47 law enforcement agencies in 15 counties in Atlanta, Georgia and compared them with commercially estimated crime rates from the same year to assess (1) how two measures of crime were correlated and (2) if the associations between violent crime rate indices and preterm birth (PTB) varied as a function of the source of crime index. To assess the association between violent crime and PTB, we used multilevel logistic regression and controlled for potential individual- and neighborhood-level confounders.
Violent crime, both estimated and observed, was positively correlated with poverty, neighborhood proportion Black, and neighborhood deprivation index; however, the association was stronger using estimated rates as compared with observed crime rates. The association between living in a high violent crime neighborhood and PTB was only consistent for white women across the two crime indices after covariate adjustment. For Black women, the association between living in a high violent crime neighborhood and PTB is systematically underestimated across all models when the estimated crime rate is used.
There is evidence that model-estimated crime rates are not reliable proxies for crime in an urban area even when appropriate confounders are adjusted for.
由于缺乏可靠的小区域（例如，人口普查区或人口普查街区组）犯罪数据，研究犯罪与健康结果之间的关联受到了阻碍。我们的目的是评估综合估计的犯罪指数在健康研究中的准确性，以早产作为案例研究。
我们使用了佐治亚州亚特兰大市 15 个县的 47 个执法机构报告的暴力犯罪数据，并将其与同年的商业估算犯罪率进行了比较，以评估（1）两种犯罪衡量标准之间的相关性，以及（2）暴力犯罪率指数与早产（PTB）之间的关联是否随犯罪指数来源的变化而变化。为了评估暴力犯罪与 PTB 之间的关联，我们使用了多层次逻辑回归，并控制了潜在的个体和邻里水平混杂因素。
无论是估计的还是观察到的暴力犯罪，都与贫困、邻里黑人比例和邻里剥夺指数呈正相关；然而，与观察到的犯罪率相比，使用估计的比率时，相关性更强。在调整了协变量后，对于白人女性来说，在两个犯罪指数中，居住在高暴力犯罪社区与 PTB 之间的关联在所有模型中都是一致的。对于黑人女性，当使用估计的犯罪率时，居住在高暴力犯罪社区与 PTB 之间的关联在所有模型中都被系统地低估了。
有证据表明，即使调整了适当的混杂因素，模型估计的犯罪率也不是城市地区犯罪的可靠替代指标。
