The independent associations of recorded crime and perceived safety with physical health in a nationally representative cross-sectional survey of men and women in New Zealand

The Built Environment and Pediatric Health

Buildings, parks, and roads are all elements of the "built environment," which can be described as the human-made structures that comprise the neighborhoods and communities where people live, work, learn, and recreate (https://www.epa.gov/smm/basic-information-about-built-environment). The design of communities where children and adolescents live, learn, and play has a profound impact on their health. Moreover, the policies and practices that determine community design and the built environment are a root cause of disparities in the social determinants of health that contribute to health inequity. An understanding of the links between the built environment and pediatric health will help to inform pediatricians' and other pediatric health professionals' care for patients and advocacy on their behalf. This technical report describes the range of pediatric physical and mental health conditions influenced by the built environment, as well as historical and persistent effects of the built environment on health disparities. The accompanying policy statement outlines community design solutions that can improve pediatric health and health equity, including opportunities for pediatricians and the health care sector to incorporate this knowledge in patient care, as well as to play a role in advancing a health-promoting built environment for all children and families.

Gun carrying among US adolescents: the mutual impact of violence experiences, safety concerns, and substance use behaviors

OBJECTIVES

Youth firearm carriage significantly contributes to firearm-related injuries and deaths in the United States (US). This study examined the sex-specific patterns and cumulative effects of violence experiences, safety concerns, and substance use behaviors on youth firearm carriage.

STUDY DESIGN

Cross-sectional study.

METHODS

Based on a nationally representative sample (N = 13,526), the multigroup structural equation modeling (SEM) was used to examine the interplay of violence experiences (weapon threats, physical fights, and sexual violence), safety concerns, and substance use behaviors (cigarette, electronic vapor, alcohol, marijuana, and prescription opioid), and their direct, indirect, and total effects on youth gun carrying behavior.

RESULTS

About one in 50 females and one in 15 males reported firearm carriage in the past year. Sex-specific patterns existed. Among female adolescents, gun carrying was strongly correlated with violence experiences (standardized coefficient (β) = 0.77, P < 0.001), but no direct connection was observed with substance use behaviors. Among males, both violence experiences (β = 0.56, P < 0.001) and substance use behaviors (β = 0.26, P < 0.001) were significantly correlated with gun carrying. Although safety concerns did not show a direct effect on gun carrying, a significant indirect effect was observed via the pathway of violence experiences. Collectively, the three clusters of predictors explained about 59.9% of variance in gun carrying among females and 54.6% of variance among males.

CONCLUSIONS

Violence experiences have a robust impact on gun carrying behavior in both female and male adolescents. Effective violence prevention programs and sex-specific strategies (e.g., substance use intervention for males) are needed to reduce youth firearm carriage.

Subjective and objective indicators of neighbourhood safety and physical activity among UK adolescents

BACKGROUND

The health benefits of regular physical activity in adolescence are well-documented and many health-related behaviours are established in adolescence. The neighbourhood environment is a key setting for physical activity for adolescents and feeling unsafe in their neighbourhood may be a potential barrier to physical activity.

AIM

This study aimed to examine associations between neighbourhood safety and physical activity using objective and subjective measures for both.

METHODS

Participants (n = 10,913) came from the Millennium Cohort Study, a nationally representative UK longitudinal birth cohort. Linear regression and Zero Inflated Poisson models were used to examine associations between subjective and objective indicators of safety (self-reported safety, Index of Multiple Deprivation crime, Reported Crime Incidence) and physical activity (self-reported weekly and device-measured physical activity).

RESULTS

Adolescents who feel unsafe in their neighbourhood, or who live in areas with high IMD crime or violent crime rates report 0.29 (95% CI -0.49, -0.09) 0.32 (95% CI -0.47, -0.16) and 0.20 (95% CI -0.39, -0.20) fewer days of physical activity, respectively. No associations were found between Reported Crime Incidence and either objective or subjective measures of physical activity.

CONCLUSIONS

This study demonstrates varying associations between subjective safety and objective crime with physical activity levels in adolescence, highlighting the complexities around subjective and objective measurements and their associations with health outcomes.

Perceived neighborhood environment walkability and health-related quality of life among predominantly Black and Latino adults in New York City

BACKGROUND

Measures of the built environment such as neighborhood walkability have been associated with health behaviors such as physical activity, the lack of which in turn may contribute to the development of diseases such as obesity, diabetes, cardiovascular disease, and cancer. However, limited research has examined these measures in association with health-related quality of life (HR-QoL), particularly in minoritized populations. We examined the relationship between perceived neighborhood environment and HR-QoL in a sample of mostly Black and Latino residents in New York City (NYC).

METHODS

This study utilized the baseline survey data from the Physical Activity and Redesigned Community Spaces (PARCS) Study among 1252 residents [34.6% Black, 54.1% Latino, 80.1% female, mean(±SD) age = 38.8 ± 12.5) in 54 park neighborhoods in NYC. Perceived built environment was measured using Neighborhood Environment and Walkability Survey, and mental and physical HR-QoL was estimated using Short Form (SF)-12. Using factor analysis, we identified two subscales of neighborhood walkability: enablers (e.g., trails, sidewalks, esthetics) vs. barriers (e.g., high crime and traffic). In addition, we included a third subscale on neighborhood satisfaction. Generalized Estimating Equation models adjusted for demographics and BMI and accounted for the clustering effect within neighborhood. Multiple imputation was used to account for missing data.

RESULTS

Mental HR-QoL was associated with barriers of walkability (β ± SE = - 1.63 ± 0.55, p < 0.01) and neighborhood satisfaction (β ± SE = 1.55 ± 0.66, p = 0.02), after adjusting for covariates. Physical HR-QoL was associated with only barriers of walkability (β ± SE = - 1.13 ± 0.57, p < 0.05).

CONCLUSIONS

Among NYC residents living in minoritized neighborhoods, mitigating negative aspects of the neighborhood environment may be more crucial than adding positive features in terms of HR-QoL. Our study points to the need to investigate further the role of the built environment in urban, minoritized communities.

Perceived neighbourhood environment and falls among community-dwelling adults: cross-sectional and prospective findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)

We investigated the association between perceived neighbourhood characteristics and falls in community-dwelling adults, using data from Wave 5 and 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). We included 25,467 participants aged 50 to 103 years (mean age 66.2 ± 9.6, 58.5% women), from fourteen European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Israel, Italy, Luxembourg, Slovenia, Spain, Sweden, Switzerland). At baseline, we recorded individual-level factors (socio-demographic, socio-economic and clinical factors), contextual-level factors (country, urban versus rural area, European region) and perceived neighbourhood characteristics (vandalism or crime, cleanliness, feeling part of neighbourhood, helpful neighbours, accessibility to services) for each participant. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The associations between neighbourhood characteristics and falls were analysed by binary logistic regression models; odds ratios (95% confidence intervals) were calculated. Participants reporting-versus not reporting-vandalism or crime had an increased falls risk of 1.16 (1.02-1.31) at follow-up, after full adjustment; lack of cleanliness, feeling part of the neighbourhood, perceiving neighbours as helpful and difficult accessibility to services were not associated with falls. Vandalism or crime was consistently associated with increased falls risks in women, adults without functional impairment and urban areas residents. In conclusion, adverse neighbourhood environments may account for inequality in falls risk among middle-aged and older adults and could be added to fall risk stratification tools.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00685-3.

Environmentally related gender health risks: findings from citizen science cross-sectional study

Background

Public engagement in the research of environmental epidemiological problems is becoming an important measure to empower citizens to identify the local environmental and health problems and to explain different environmental exposures affect estimates for males and females. This HORIZON2020 CitieS-Health Kaunas Pilot study examines the relationship between urban built and social environment, health behaviors, and health in men and women.

Methods

This cross-sectional study included 1086 18–74-year-old participants residing in 11 districts of Kaunas city, Lithuania. Using GIS, we measured traffic flow, noise, NO2, PM2.5, PM10, and greenness NDVI for the participants’ home addresses, determined participants’ perceptions of environmental quality, linked this information with personal sociodemographic data, and used multivariate logistic regression to assess the associations with health issues (physician-diagnosed chronic disease and self-rated general health) in men and women.

Results

Men and women similar rated the quality of the neighborhood environment, except for air pollution and satisfaction with the public transport in the district. The traffic-related health associations were stronger for women than for men. The prevalence of poor health increased with the increasing age of men and women, yet no significant differences between gender health risks were found in the total sample. Perceived air pollution, irregular visits to green space, and chronic diseases were consistently associated with poor health risks in men and women, yet part-time jobs and low income had a higher impact on women’s poor health.

Conclusions

Quality of the built neighborhood, air pollution, irregular visits to the green space, and chronic disease had a joint effect on the magnitude of the prevalence of poor health in men and women. Our results suggest that decreasing air pollution and improving the urban built neighborhood supporting citizens’ physical activity in green spaces, might reduce health risks for all.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13824-3.

Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan

INTRODUCTION

Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one's neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health.

METHODS

In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety.

RESULTS

In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (β = - 2.34, p = 0.017), depression scores (β = - 4.22, p = 0.006), and BMI (β = - 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots.

CONCLUSION

Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity-via stress reduction and concomitant effects on cardiometabolic health.

Changes in the Recreational Built Environment and Youth Body Mass Index

OBJECTIVE

Many cities have implemented programs to improve the recreational built environment. We evaluated whether neighborhood recreational built environmental changes are associated with change in body mass index (BMI).

METHODS

We performed a longitudinal assessment of association between the recreational built environment and BMI percent of 95th percentile (BMIp95). Patient data from 2012 to 2017 were collected from electronic medical records including height, weight, sex, race/ethnicity, insurance type, and address. BMIp95 was calculated. Environmental data including sidewalks, trails, Healthy Mile Trails, and parks were collected. Patients' neighborhood environments were characterized using proximity of features from home address. Multilevel linear regressions with multiple encounters per patient estimated effects of recreational features on BMIp95 and stratified models estimated effect differences.

RESULTS

Of 8282 total patients, 27.7% were non-Hispanic White, half were insured by Medicaid, and 29.5% changed residence. Median BMIp95 was 86.3%. A decrease in BMIp95 was associated with park proximity in the full cohort (-2.85; 95% CI [confidence interval]: -5.47, -0.24; P = .032), children with obesity at baseline (-6.50; 95% CI: -12.36, -0.64; P = .030) and privately insured children (-4.77; 95% CI: -9.14, -0.40; P = .032). Healthy Mile Trails were associated with an increase in BMIp95 among children without obesity (1.00; 95% CI 0.11, 1.89; P = .027) and children living in higher income areas (6.43; 95% CI: 0.23, 12.64; P = .042).

CONCLUSIONS

Differences in effect indicate that built environment changes may improve or exacerbate disparities. Improving obesity disparities may require addressing family-level barriers to the use of recreational features in addition to proximity.

Cross-Sectional Associations of Neighborhood Perception, Physical Activity, and Sedentary Time in Community-Dwelling, Socioeconomically Diverse Adults

Background: Little is known about the role of perceived neighborhood environment as a determinant of physical activity (PA) and sedentary time (ST) in understanding obesity-related health behaviors. We focus on a biracial, socioeconomically diverse population using objectively measured ST, which is under-represented in the literature.

Methods: We examined the association between self-reported neighborhood perception (Likert-scale questions), PA using the Baecke questionnaire, and both non-sedentary time and ST using accelerometry from wave 4 of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 2,167). After applying exclusion criteria, the sample size was n = 1,359 for analyses of self-reported PA and n = 404 for analyses of accelerometry data. Factor analysis identified key neighborhood characteristics to develop a total neighborhood perception score (NPS). Higher NPS indicated less favorable neighborhood perception. Linear regression was used to determine the relationship between NPS, PA, non-sedentary time, and ST.

Results: Complete data were available for n = 1,359 [age 56.6(9.0) years, 59.5% female, 62.2% African American] for whom we identified four neighborhood perception factors: (1) concern about crime, (2) physical environment, (3) location of violent crime, and (4) social environment. Worsening perception of the overall neighborhood [β = −0.13 (SE = 0.03); p = 0.001], the physical environment [−0.11 (0.05); p = 0.03], and the social environment [−0.46 (0.07); p < 0.0001] were associated with decreased PA. Worsening perception of the overall neighborhood [1.14 (0.49); p = 0.02] and neighborhood social environment [3.59 (1.18); p = 0.003] were associated with increased ST over the day. There were no interactions for race, sex, poverty status, or economic index.

Conclusion: Poor overall neighborhood perception, perceived social environment, and perceived neighborhood physical environment are associated with PA and ST in a multi-racial, socioeconomically diverse cohort of urban adults.

Clinical Trial Registration: The HANDLS study is registered at ClinicalTrials.gov as NCT01323322.

Assessing the role of criminality in neighbourhood safety feelings and self-reported health: results from a cross-sectional study in a Dutch municipality

Background

Neighbourhood safety has repeatedly been shown to be associated with the health and well-being of the residents. Criminality is often seen as one of the key factors affecting neighbourhood safety. However, the relationship between crime, fear of crime and feelings of safety remains underexplored.

Methods

Data on socio-demographic, health and safety perceptions was extracted from the Maastricht municipality survey (the Netherlands) (n = 9656 adults) and merged with data on official neighbourhood crime rates from the Police Registry. Pearson correlation coefficients and multilevel logistic regression models were computed to assess the association between aspects of objective and perceived criminality, individuals’ feelings of safety and health.

Results

The correlation between the police recorded crime and residents’ perceptions of the neighbourhood crime rates was weak (0.14–0.38), with the exception of violent crime (0.59), which indicates that other factors contribute to the perceptions of safety. In turn, the perception of higher rates of violent crime and more nuisance (on the scale 0–10) but not other types of crime or nuisance was positively associated with feeling unsafe (OR 1.27 [1.22;1.32] and 1.39 [1.33;1.46], respectively). Lower general feelings of safety at both the individual and neighbourhood level were consistently associated with worse self-rated health. Among different indicators of safety, the general feelings of safety had the most pronounced association with health, while subjective or objective measures of crime showed limited to no direct relationship with health.

Conclusions

Public health policies targeting safety as a social determinant of health should consider prioritizing areas of violent crime and nuisance to improve general feelings of safety. Further research is needed to understand which factors aside from criminality are driving residents’ feelings of safety.

The impact of social capital, land use, air pollution and noise on individual morbidity in Dutch neighbourhoods

BACKGROUND

Both social and physical neighbourhood factors may affect residents' health, but few studies have considered the combination of several exposures in relation to individual health status.

AIM

To assess a range of different potentially relevant physical and social environmental characteristics in a sample of small neighbourhoods in the Netherlands, to study their mutual correlations and to explore associations with morbidity of residents using routinely collected general practitioners' (GPs') data.

METHODS

For 135 neighbourhoods in 43 Dutch municipalities, we could assess area-level social cohesion and collective efficacy using external questionnaire data, urbanisation, amount of greenspace and water areas, land use diversity, air pollution (particulate matter (PM) with a diameter <10 μm (PM₁₀), PM <2.5 μm (PM_2.5) and nitrogen dioxide (NO₂), and noise (from road traffic and from railways). Health data of the year 2013 from GPs were available for 4450 residents living in these 135 neighbourhoods, that were representative for the entire country. Morbidity of 10 relevant physical or mental health groupings was considered. Individual-level socio-economic information was obtained from Statistics Netherlands. Associations between neighbourhood exposures and individual morbidity were quantified using multilevel mixed effects logistic regression analyses, adjusted for sex, age (continuous), household income and socio-economic status (individual level) and municipality and neighbourhood (group level).

RESULTS

Most physical exposures were strongly correlated with degree of urbanisation. Social cohesion and collective efficacy tended to be higher in less urbanised municipalities. Degree of urbanisation was associated with higher morbidity of all disease groupings. A higher social cohesion at the municipal level coincided with a lower prevalence of depression, migraine/severe headache and Medically Unexplained Physical Symptoms (MUPS). An increase in both natural and agricultural greenspace in the neighbourhood was weakly associated with less morbidity for all conditions. A high land use diversity was consistently associated with lower morbidities, in particular among non-occupationally active individuals.

CONCLUSION

A high diversity in land use of neighbourhoods may be beneficial for physical and mental health of the inhabitants. If confirmed, this may be incorporated into urban planning, in particular regarding the diversity of greenspace.

Neighbourhood social and physical environment and general practitioner assessed morbidity

The aim of our study was to investigate the association between health enhancing and threatening, and social and physical aspects of the neighbourhood environment and general practitioner (GP) assessed morbidity of the people living there, in order to find out whether the effects of environmental characteristics add up or modify each other. We combined GP electronic health records with environmental data on neighbourhoods in the Netherlands. Cross-classified logistic multilevel models show the importance of taking into account several environmental characteristics and confounders, as social capital effects on the prevalence of morbidity disappear when other area characteristics are taken into account. Stratification by area socio-economic status, shows that the association between environmental characteristics and the prevalence of morbidity is stronger for people living in low SES areas. In low SES areas, green space seems to alleviate effects of air pollution on the prevalence of high blood pressure and diabetes, while the effects of green space and social capital reinforce each other.

Analyzing Walking Route Choice through Built Environments using Random Forests and Discrete Choice Techniques

Walking is a form of active transportation with numerous benefits, including better health outcomes, lower environmental impacts and stronger communities. Understanding built environmental associations with walking behavior is a key step towards identifying design features that support walking. Human mobility data available through GPS receivers and cell phones, combined with high resolution walkability data, provide a rich source of georeferenced data for analyzing environmental associations with walking behavior. However, traditional techniques such as route choice models have difficulty with highly dimensioned data. This paper develops a novel combination of a data-driven technique with route choice modeling for leveraging walkability audits. Using data from a study in Salt Lake City, Utah, USA, we apply the data-driven technique of random forests to select variables for use in walking route choice models. We estimate data-driven route choice models and theory-driven models based on predefined walkability dimensions. Results indicate that the random forest technique selects variables that dramatically improve goodness of fit of walking route choice models relative to models based on predefined walkability dimensions. We compare the theory-driven and data-driven walking route choice models based on interpretability and policy relevance.

Is More Area-Level Crime Associated With More Sitting and Less Physical Activity? Longitudinal Evidence From 37,162 Australians

Does a rise in crime result in increased sitting time and a reduction in physical activity? We used unobserved ("fixed")-effects models to examine associations between change in objectively measured crime (nondomestic violence, malicious damage, breaking and entering, and stealing, theft, and robbery) in Australia and measures of sitting time, walking, and moderate-to-vigorous physical activity (MVPA) in a residentially stable sample of 17,474 men and 19,688 women at baseline (2006-2008) and follow-up (2009-2010). Possible sources of time-varying confounding included age, income, economic status, relationship (couple) status, and physical functioning. In adjusted models, an increase in all crimes of 10 counts per 1,000 residents was associated with an increase in sitting time (hours/day) among men (β = 0.21, 95% confidence interval (CI): 0.17, 0.25) and women (β = 0.18, 95% CI: 0.15, 0.22). Counterintuitively, the same increase in crime was also associated with an increase in the weekly number of ≥10-minute walking sessions (men: rate ratio (RR) = 1.01 (95% CI: 1.01, 1.02); women: RR = 1.00 (95% CI: 0.99, 1.01)) and MVPA sessions (men: RR = 1.02 (95% CI: 1.02, 1.03); women: RR = 1.01 (95% CI: 1.00, 1.02)). Similar associations were found for the other area-level crime indicators. While area-level crime prevention may be considered a lever for promoting more active lifestyles, these results suggest that the association is not unequivocal.

Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes: the Diabetes Study of Northern California (DISTANCE)

While stress has been linked to poor health outcomes, little is known about the impact of objective measures of neighborhood crime on stress in patients with chronic disease. Using the Kaiser Permanente Diabetes Study of Northern California (DISTANCE), we examined associations between police-recorded crime (2005-2007) and stress (Perceived Stress Scale-4) in four large Northern California cities (Oakland, Sacramento, San Francisco, and San Jose). We performed stratified analysis by gender and race/ethnicity using generalized linear regression models. In our study sample (n = 3188, mean age 59, range 30-77), 10 % reported high stress. In adjusted analyses, higher neighborhood all crimes rate was associated with modest increase in high stress for African-American (OR = 1.10; 95 % CI 1.02-1.22) and Latina women (OR = 1.36; 95 % CI 1.10-1.67) and property crime showed similar associations with stress for these groups of women. Visible crime was associated with stress only for Latina women (OR = 1.43; 95 % CI 1.14-1.78). We found no association between crime and stress among men or other racial/ethnic groups of women. High crime levels may disproportionately impact health among certain subpopulations. Studies using additional measures of stress are necessary to differentiate the health impact of crime-related stress from other forms of stressors among individuals living with diabetes.

The Effect of Neighborhood Recorded Crime on Fear: Does Neighborhood Social Context Matter?

A number of individual and neighborhood-level factors may influence the relationship between recorded crime in one's neighborhood and fear of crime. Understanding these factors may assist in reducing fear, which has been associated with poorer physical and mental health. The aim of this study was to evaluate whether the effect of recorded crime rates on fear differs based on the neighborhood social context (social fragmentation) using hierarchical regression modelling, with separate analyses by crime type. Recorded crimes (2008-2010) and national (New Zealand) survey data were used. Higher crime in a neighborhood was associated with higher fear of crime, with only small effect size differences in feelings of fear by recorded type of crime. However, when stratified, the associations between violent and drug/alcohol crimes and fear of crime were larger for those living in highly fragmented neighborhoods compared with less fragmented neighborhoods. Efforts to alleviate fear of crime should focus on the broader neighborhood social context in which these feelings are espoused.

Does rising crime lead to increasing distress? Longitudinal analysis of a natural experiment with dynamic objective neighbourhood measures

Identifying 'neighbourhood effects' to support widespread beliefs that where we live matters for our health remains a major challenge due to the reliance upon observational data. In this study we reassess the issue of local crime rates and psychological distress by applying unobserved ('fixed') effects models to a sample of participants who remain in the same neighbourhoods throughout the study. Baseline data was extracted from the 45 and Up Study between 2006 and 2008 and followed up as part of the Social Economic and Environmental Factors (SEEF) Study between 2009 and 2010. Kessler 10 scores were recorded for 25,545 men and 29,299 women reported valid outcomes. Annual crime rates per 1000 (including non-domestic violence, malicious damage, break and enter, and stealing, theft and robbery) from 2006 to 2010 inclusive were linked to the person-level data. Change in exposure to crime among participants in this study, therefore, occurs as a result of a change in the local crime rate, rather than a process of neighbourhood selection. Gender stratified unobserved effects logistic regression adjusting for sources of time-varying confounding (age, income, employment, couple status and physical functioning) indicated that an increase in the risk of experiencing psychological distress was generally associated with an increase in the level of neighbourhood crime. Effect sizes were particularly high for women, especially for an increase in malicious damage (Odds Ratio Tertile 3 vs Tertile 1 2.40, 95% Confidence Interval 1.88, 3.05), which may indicate that damage to local built environment is an important pathway linking neighbourhood crime with psychological distress. No statistically significant association was detected for an increase in non-domestic violence, although the effect was in the hypothesised direction. In summary, the application of unobserved effects models to analyse data that takes into account the temporally dynamic characteristics of where people live warrants further investigation.

Does walkable neighbourhood design influence the association between objective crime and walking?

Background

Few studies have investigated associations between objectively measured crime and walking, and findings are mixed. One explanation for null or counterintuitive findings emerges from criminology studies, which indicate that the permeable street layouts and non-residential land uses that underpin walkable neighbourhoods are also associated with more crime. This study examined associations between objective crime and walking, controlling for the characteristics of walkable neighbourhoods.

Methods

A population representative sample of adults (25–65 years) (n = 3,487) completed the Western Australian Health and Wellbeing Survey (2006–2008) demographic and walking frequency items. Objective environmental measures were generated for each participant’s 400 m and 1600 m neighbourhood areas, including burglary, personal crime (i.e., crimes committed against people) in public space, residential density, street connectivity and local destinations. Log-linear negative binomial regression models were used to examine associations between crime and walking frequency/week, with progressive adjustment for residential density, street connectivity and local destinations.

Results

Burglary and personal crime occurring within a participant’s 400 m and 1600 m neighbourhoods were positively and significantly associated with walking frequency. For example, for every additional 10 crimes against the person/year within 400 m of a participant’s home, walking frequency increased by 8% (relative change = 1.077, p = 0.017). Associations remained constant after controlling for residential density and street connectivity, but attenuated after adjusting for local destinations (e.g., for personal crime in 400 m: relative change = 1.054, p = 0.104). This pattern of attenuation was evident across both crime categories and both neighbourhood sizes.

Conclusions

The observed positive associations between objective crime and walking appear to be a function of living in a more walkable environment, as the presence of destinations has the capacity to both promote walking and attract crime. This study provides a plausible explanation for some mixed findings emerging from studies examining crime as a barrier to walking. In some settings, the hypothesised deterrent effect of crime on walking may be insufficient to outweigh the positive impacts of living in a more walkable environment.