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Jay J, Kondo MC, Lyons VH, Gause E, South EC. Neighborhood segregation, tree cover and firearm violence in 6 U.S. cities, 2015-2020. Prev Med 2022; 165:107256. [PMID: 36115422 PMCID: PMC10903784 DOI: 10.1016/j.ypmed.2022.107256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022]
Abstract
Neighborhood segregation by race and income is a structural determinant of firearm violence. Addressing green space deficits in segregated neighborhoods is a promising prevention strategy. This study assessed the potential for reducing firearm violence disparities by increasing access to tree cover. Units of analysis were census tracts in six U.S. cities (Baltimore, MD; Philadelphia, PA; Richmond, VA; Syracuse, NY; Washington, DC; Wilmington, DE). We measured segregation using the index of concentration at the extremes (ICE) for race-income. We calculated proportion tree cover based on 2013-2014 imagery. Outcomes were 2015-2020 fatal and non-fatal shootings from the Gun Violence Archive. We modeled firearm violence as a function of ICE, tree cover, and covariates representing the social and built environment. Next, we simulated possible effects of "tree equity" programs, i.e., raising tract-level tree cover to a specified baseline level. In our fully-adjusted model, higher privilege on the ICE measure (1 standard deviation, SD) was associated with a 42% reduction in shootings (incidence rate ratio (IRR) = 0.58, 95% CI [0.54 0.62], p < 0.001). A 1-SD increase in tree cover was associated with a 9% reduction (IRR = 0.91, 95% CI [0.86, 0.97], p < 0.01). Simulated achievement of 40% baseline tree cover was associated with reductions in firearm violence, with the largest reductions in highly-deprived neighborhoods. Advancing tree equity would not disrupt the fundamental causes of racial disparities in firearm violence exposure, but may have the potential to help mitigate those disparities.
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Affiliation(s)
- Jonathan Jay
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
| | - Michelle C Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, PA, USA
| | - Vivian H Lyons
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA
| | - Emma Gause
- Firearm Injury and Policy Research Program, Harborview Injury Prevention and Research Program, University of Washington, Seattle, WA, USA
| | - Eugenia C South
- Urban Health Lab, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kiang MV, Tsai AC, Alexander MJ, Rehkopf DH, Basu S. Racial/Ethnic Disparities in Opioid-Related Mortality in the USA, 1999-2019: the Extreme Case of Washington DC. J Urban Health 2021; 98:589-595. [PMID: 34664185 PMCID: PMC8566633 DOI: 10.1007/s11524-021-00573-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
In 2019, there were nearly 50,000 opioid-related deaths in the US, with substantial variation across sociodemographic groups and geography. To systematically investigate patterns of racial/ethnic inequities in opioid-related mortality, we used joinpoint regression models to estimate the trajectory of the opioid epidemic among non-Hispanic Black versus non-Hispanic white residents in Washington DC, 45 states, and 81 sub-state areas. We highlight the unique inequities observed in Washington DC. In 2019, the observed opioid-related mortality rate among Black DC residents was 11.3 times higher than white DC residents, resulting in 56.0 more deaths per 100,000 (61.5 vs. 5.5 per 100,000). This inequity was substantially higher than any other jurisdiction on both the relative and absolute scales. Most opioid-related deaths in DC involved synthetic opioids, which was present in 92% (N=198) of deaths among Black DC residents and 69% (N=11) of deaths among white DC residents. Localized, equitable, culturally-appropriate, targeted interventions are necessary to reduce the uniquely disproportionate burden of opioid-related mortality among Black DC residents.
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Affiliation(s)
- Mathew V Kiang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
- Harvard FXB Center for Health and Human Rights, Boston, MA, USA.
- Center for Population Health Sciences, Stanford University, 1701 Page Mill Road, CA, 94304, Palo Alto, USA.
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Monica J Alexander
- Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
- Department of Sociology, University of Toronto, Toronto, ON, Canada
| | - David H Rehkopf
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Sanjay Basu
- Institute of Health Policy, Management, and Evaluation, University of Toronto, ON, Toronto, Canada
- School of Public Health, Imperial College, London, UK
- Center for Primary Care, Harvard Medical School, Boston, MA, USA
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Abstract
Although the black-white gap in life expectancy has been shrinking in the U.S., national improvement conceals ongoing disparities. Nowhere is this more evident than Washington D.C., where the black-white gap has persistently exceeded 10 years. Using 1999-2017 mortality data from the National Center for Health Statistics, we employed demographic techniques to pursue three aims: first, we created period life tables to examine longevity trends in Washington D.C.; second, we decomposed black-white life expectancy differences into 23 causes of death in three time periods (2000, 2008, 2016); third, we assessed age-specific contributions for each cause of death. Findings revealed that heart disease (4.14 years), homicide (2.43 years), and cancer (2.30 years) contributed most to the 17.23-year gap among males in 2016. Heart disease and cancer contributed most at ages 55-69; homicide contributed most at ages 20-29. Among females in 2016, heart disease (3.24 years), cancer (2.36 years), and unintentional injuries (0.85 years) contributed most to the 12.06-year gap. Heart disease and cancer contributed most at ages 55-69, and unintentional injuries at ages 50-59. Our investigation provides detailed evidence about contributors to the black-white longevity gap in Washington D.C., which can aid in the development of targeted public health interventions.
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Affiliation(s)
- Max Roberts
- Department of Sociology, Social Work and Anthropology, Utah State University, Logan, UT, 84322, USA.
| | - Eric N Reither
- Department of Sociology, Social Work and Anthropology, Utah State University, Logan, UT, 84322, USA
| | - Sojung Lim
- Department of Sociology, Social Work and Anthropology, Utah State University, Logan, UT, 84322, USA
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Abstract
The mass incarceration of African Americans is both a driver of racial health inequalities in the USA. Systemic social biases which associate African American men with criminality, violence, and as a particular threat to white women may partially explain their over-representation in the criminal justice system. We combined data from the Washington, DC Metro Police Department (MPD) and the American Community Survey to test whether neighborhood-level gender, race, and economic makeup were associated with elevated drug-related arrest disproportions for African American men. We found that African American men were significantly overrepresented in all drug-related arrests across the District, and that this arrest disproportion was significantly higher in neighborhoods that had a higher percentage of white female residents. The association between race and gender was somewhat attenuated, but not completely eliminated, when we introduced socio-economic variables to our model. Addressing the social determinants of criminal justice disparities must account for the intersection of race, gender, and economics, rather than considering race in isolation.
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Affiliation(s)
- Rebecca Fielding-Miller
- Department of Medicine, Center on Gender Equity and Health, University of California, San Diego, CA, USA.
| | - Hannah L F Cooper
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Sharon Caslin
- Department of Epidemiology and Biostatistics, Georgia State University School of Public Health, Atlanta, GA, USA
| | - Anita Raj
- San Diego School of Medicine, Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA, USA
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Fielding-Miller R, Davidson P, Raj A. Blacks face higher risk of drug arrests in White neighborhoods. Int J Drug Policy 2016; 32:100-3. [PMID: 27129793 DOI: 10.1016/j.drugpo.2016.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Rebecca Fielding-Miller
- University of California, San Diego, Division of Global Public Health, 9500 Gilman Drive #0507, San Diego, CA 92093, United States.
| | - Peter Davidson
- University of California, San Diego, Division of Global Public Health, 9500 Gilman Drive #0507, San Diego, CA 92093, United States
| | - Anita Raj
- University of California, San Diego, Division of Global Public Health, 9500 Gilman Drive #0507, San Diego, CA 92093, United States
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