Marineau Lea A, Jones Kelly K, Small Amanda K, Buckman Dennis W, Uzzi Mudia, Sona Melanie, Liedtke Erin I, Zenk Shannon N
National Institute on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, USA.
Information Management Services, Inc., 1455 Research Blvd, Suite 315, Rockville, MD, 20850, USA.
Prev Med Rep. 2025 Jun 6;55:103128. doi: 10.1016/j.pmedr.2025.103128. eCollection 2025 Jul.
To examine the association between racialized economic segregation and assault-related injury hospital visits in metropolitan neighborhoods spanning five American states, and whether this relationship varies by vacant housing and green space.
Data on assault visits from 2016 to 2019 Healthcare Cost and Utilization Project were linked with population, landcover, and park data for Arizona, Florida, Georgia, North Carolina, and New York. Racialized economic segregation was operationalized using Index of Concentration at the Extremes (ICE) for household income by race. All assault and firearm assault visits were aggregated by ZIP Code Tabulation Area and discharge year. Negative binomial regression was used to calculate incident rate ratios (aIRR) to estimate associations between segregation and assaults. Interaction terms between segregation and each green space and vacant housing moderator were included in separate models, adjusting for state, year of discharge, and population demographics.
For each 1-SD increase in ICE (increased advantage), all assault and firearm assault visit rates decreased (aIRR 0.62[0.60,0.64] and aIRR 0.43[0.41,0.45], respectively). Higher levels of vacant housing were associated with more all assault visits in the most disadvantaged neighborhoods but not in advantaged neighborhoods. Higher levels of forest space were protective for all assault and firearm assault visits in the most disadvantaged neighborhoods but not in advantaged neighborhoods.
Neighborhoods with the least economic and social resources had higher all assault and firearm assault visit rates than neighborhoods with more. Our results highlight the potential mitigating role of forest space on the relationship between segregation and assault hospital visits.
研究美国五个州大都市社区中种族化经济隔离与因袭击相关受伤而就医之间的关联，以及这种关系是否因空置住房和绿地情况而有所不同。
将2016年至2019年医疗成本和利用项目中因袭击就医的数据与亚利桑那州、佛罗里达州、佐治亚州、北卡罗来纳州和纽约州的人口、土地覆盖和公园数据相链接。使用极端集中度指数（ICE）按种族计算家庭收入的种族化经济隔离情况。所有因袭击和持枪袭击就医的数据按邮政编码分区和出院年份进行汇总。采用负二项回归计算发病率比（aIRR），以估计隔离与袭击之间的关联。在单独的模型中纳入隔离与每个绿地和空置住房调节因素之间的交互项，并对州、出院年份和人口统计学特征进行调整。
ICE每增加1个标准差（优势增加），所有袭击和持枪袭击的就诊率均下降（aIRR分别为0.62[0.60,0.64]和0.43[0.41,0.45]）。在最贫困社区，较高水平的空置住房与更多的所有袭击就医相关，但在优势社区并非如此。在最贫困社区，较高水平的森林空间对所有袭击和持枪袭击就医具有保护作用，但在优势社区并非如此。
经济和社会资源最少的社区比资源较多的社区有更高的所有袭击和持枪袭击就诊率。我们的研究结果凸显了森林空间在隔离与袭击就医关系中的潜在缓解作用。
