Urban Health Lab, Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Leonard Davis Institute, University of Pennsylvania, Philadelphia.
JAMA Netw Open. 2021 Jul 1;4(7):e2117067. doi: 10.1001/jamanetworkopen.2021.17067.
The root causes of violent crime in Black urban neighborhoods are structural, including residential racial segregation and concentrated poverty. Previous work suggests that simple and scalable place-based environmental interventions can overcome the legacies of neighborhood disinvestment and have implications for health broadly and crime specifically.
To assess whether structural repairs to the homes of low-income owners are associated with a reduction in nearby crime.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study using difference-in-differences analysis included data from the City of Philadelphia Basic Systems Repair Program (BSRP) from January 1, 2006, through April 30, 2013. The unit of analysis was block faces (single street segments between 2 consecutive intersecting streets) with or without homes that received the BSRP intervention. The blocks of homes that received BSRP services were compared with the blocks of eligible homes that were still on the waiting list. Data were analyzed from December 1, 2019, to February 28, 2021.
The BSRP intervention includes a grant of up to $20 000 provided to low-income owners for structural repairs to electrical, plumbing, heating, and roofing damage. Eligible homeowners must meet income guidelines, which are set by the US Department of Housing and Urban Development and vary yearly.
The main outcome was police-reported crime across 7 major categories of violent and nonviolent crimes (homicide, assault, burglary, theft, robbery, disorderly conduct, and public drunkenness).
A total of 13 632 houses on 6732 block faces received the BSRP intervention. Owners of these homes had a mean (range) age of 56.5 (18-98) years, were predominantly Black (10 952 [78.6%]) or Latino (1658 [11.9%]) individuals, and had a mean monthly income of $993. These census tracts compared with those without BSRP intervention had a substantially larger Black population (49.5% vs 12.2%; |D| = 0.406) and higher unemployment rate (17.3% vs 9.3%; |D| = 0.357). The main regression analysis demonstrated that the addition to a block face of a property that received a BSRP intervention was associated with a 21.9% decrease in the expected count of total crime (incidence rate ratio [IRR], 0.78; 95% CI, 0.76-0.80; P < .001), 19.0% decrease in assault (IRR, 0.81; 95% CI, 0.79-0.84; P < .001), 22.6% decrease in robbery (IRR, 0.77; 95% CI, 0.75-0.80; P < .001), and 21.9% decrease in homicide (IRR, 0.78; 95% CI, 0.71-0.86; P < .001). When restricting the analysis to blocks with properties that had ever received a BSRP intervention, a total crime reduction of 25.4% was observed for each additional property (IRR, 0.75; 95% CI, 0.73-0.77; P < .001). A significant dose-dependent decrease in total crime was found such that the magnitude of association increased with higher numbers of homes participating in the BSRP on a block.
This study found that the BSRP intervention was associated with a modest but significant reduction in crime. These findings suggest that intentional and targeted financial investment in structural, scalable, and sustainable place-based interventions in neighborhoods that are still experiencing the lasting consequences of structural racism and segregation is a vital step toward achieving health equity.
黑人城市社区暴力犯罪的根本原因是结构性的,包括居住种族隔离和贫困集中。先前的研究表明,简单且可扩展的基于场所的环境干预措施可以克服社区投资不足的遗留问题,并对广泛的健康和具体的犯罪产生影响。
评估对低收入所有者房屋进行结构性修复是否与附近犯罪的减少有关。
设计、设置和参与者:这项使用差异中的差异分析的横断面研究包括 2006 年 1 月 1 日至 2013 年 4 月 30 日期间费城基本系统修复计划(BSRP)的数据。分析单位是有或没有接受 BSRP 干预的房屋的街区面(两条连续相交街道之间的单个街道段)。接受 BSRP 服务的房屋街区与仍在候补名单上的符合条件的房屋街区进行了比较。数据分析于 2019 年 12 月 1 日至 2021 年 2 月 28 日进行。
BSRP 干预措施包括向符合条件的低收入所有者提供高达 20000 美元的赠款,用于修复电气、管道、供暖和屋顶损坏。符合条件的房主必须符合美国住房和城市发展部制定的收入标准,这些标准每年都在变化。
主要结果是警方报告的 7 大类暴力和非暴力犯罪(凶杀、攻击、盗窃、抢劫、抢劫、行为不检和公共醉酒)的犯罪情况。
共有 13632 所房屋在 6732 个街区面上接受了 BSRP 干预。这些房屋的所有者平均(范围)年龄为 56.5(18-98)岁,主要是黑人(10952 [78.6%])或拉丁裔(1658 [11.9%])个体,平均月收入为 993 美元。与没有 BSRP 干预的那些人相比,这些普查区的黑人人口比例要大得多(49.5%对 12.2%;|D|=0.406),失业率也更高(17.3%对 9.3%;|D|=0.357)。主要回归分析表明,在街区面上增加一个接受 BSRP 干预的房产与总犯罪预期数量的减少有关,减少了 21.9%(发病率比 [IRR],0.78;95%CI,0.76-0.80;P<.001),攻击减少 19.0%(IRR,0.81;95%CI,0.79-0.84;P<.001),抢劫减少 22.6%(IRR,0.77;95%CI,0.75-0.80;P<.001),凶杀减少 21.9%(IRR,0.78;95%CI,0.71-0.86;P<.001)。当将分析限制在曾经接受过 BSRP 干预的街区时,每个额外的房产都会观察到总犯罪减少 25.4%(IRR,0.75;95%CI,0.73-0.77;P<.001)。还发现了与总犯罪的显著剂量依赖性减少,这种关联的幅度随着街区参与 BSRP 的房屋数量的增加而增加。
这项研究发现,BSRP 干预措施与犯罪的适度但显著减少有关。这些发现表明,在仍然受到结构性种族主义和种族隔离遗留问题影响的社区中,有针对性地对结构性、可扩展和可持续的基于场所的干预措施进行有计划和有针对性的财政投资,是实现健康公平的重要一步。