Increasing visibility of violence prevention: linking strategies to prevent violence and promote healthy eating and active living

Cohen, Lori; Lee, V; Davis, Rufus

doi:10.1136/ip.2010.029215.641

Cited by 4 publications

(5 citation statements)

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“…44,45 Our work suggests that coordination of SNAP and other programs that target FI may be a pipeline to reduce the incidence of gun-related trauma overall. 46 Importantly, our analysis is unable to identify whether such programs may help prevent gunrelated trauma immediately or for future generations. Further studies are needed to examine the efficacy of SNAP and other programs, particularly as they may relate to gun violence.…”

Section: Discussionmentioning

confidence: 94%

The association between food insecurity and gun violence in a major metropolitan city

Ali¹,

Broome²,

Tatum³

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:Food insecurity (FI) is an important social determinant of health that is associated with many forms of violence. We hypothesized that FI would be associated with gun violence. METHODS:Firearm injury data was collected from 2016 to 2020 (n = 3115) at a single institution that serves as the only Level I trauma center in a major southern US city. The data were linked with Map the Meal Gap data, a publicly available data set, which estimates rates of county-level FI based on state-level FI and social determinants, including unemployment, poverty, disability, and other factors.Regression analysis was utilized to examine the relationship between FI with rates of overall gun trauma and odds of gun-related violence. Food insecurity by county of patient residence was categorized by rates less than the national average of 11.5% (low), between the national and state average (16.5%) (moderate), and greater than the state average (high). Out of state residents were excluded from the analyses. RESULTS:Of the 3,115 patients with firearm injuries identified, 138 (4.4%) resided in counties with low FI rates, 1048 (33.6%) in moderate FI, and 1929 (62.0%) in counties with high FI. Patients in regions of high FI were more likely to be a Level I trauma activation, a victim of assault, and have Medicaid or be self-pay. There was no significant difference in mortality by levels of FI. Food insecurity was significantly associated with firearm injury, with each percent increase in FI being related to approximately 56 additional gunrelated injuries per 100,000 people (95% confidence interval, 54-59) and increased odds of the injury classified as assault (odds ratio, 1.13; 95% confidence interval, 1.07-1.19). CONCLUSION:Violence prevention initiatives targeting food insecure communities may help alleviate the US gun violence epidemic. Further, trauma center screening for household FI and in-hospital interventions addressing FI may help reduce gun violence recidivism.

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Section: Discussionmentioning

confidence: 94%

The association between food insecurity and gun violence in a major metropolitan city

Ali¹,

Broome²,

Tatum³

et al. 2022

J Trauma Acute Care Surg

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“…For instance, individuals residing in neighborhoods with high levels of violence often have fewer healthy food outlets available in the neighborhood due to structural barriers, including disinvestment, 26 and consequently might attempt trips to grocery stores only during perceived safe hours 27 , 28 ; either instance would limit access to food resources at home for hypertension self-care. 29 , 30 Likewise, individuals with limited availability of food resources at home might be less motivated to use neighborhood resources, such as parks, for physical activity. We found no evidence suggesting that the availability of kitchen appliances in the home might be associated with perceived neighborhood health and hypertension self-care.…”

Section: Discussionmentioning

confidence: 99%

“…This synergism underscores the importance of simultaneously addressing contextual neighborhood and in-home resources to optimize hypertension self-management. For instance, individuals residing in neighborhoods with high levels of violence often have fewer healthy food outlets available in the neighborhood due to structural barriers, including disinvestment, and consequently might attempt trips to grocery stores only during perceived safe hours; either instance would limit access to food resources at home for hypertension self-care . Likewise, individuals with limited availability of food resources at home might be less motivated to use neighborhood resources, such as parks, for physical activity.…”

Section: Discussionmentioning

confidence: 99%

Association of Perceived Neighborhood Health With Hypertension Self-care

et al. 2023

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ImportanceHypertension self-management is recommended for optimal blood pressure (BP) control, but self-identified residential contextual factors that hinder hypertension self-care are understudied.ObjectiveTo quantify perceived neighborhood health and hypertension self-care and assess interactions with the area deprivation index (ADI) and healthy food availability at home.Design, Setting, and ParticipantsA cross-sectional study was conducted in Baltimore, Maryland, including primary care adults enrolled in the Achieving Blood Pressure Control Together trial between September 1, 2013, and June 30, 2014. Participants were Black and had at least 2 BP readings greater than or equal to 140/90 mm Hg in the 6 months before enrollment. Analyses were conducted from August 5, 2021, to January 28, 2022.ExposuresParticipants’ perceived neighborhood health, defined as the mean standardized score across 4 subdomains of aesthetic quality, walkability, safety, and violence, with a higher score signifying better neighborhood health.Main Outcomes and MeasuresHypertension self-care behavior and self-efficacy. Multivariable generalized linear models were fit regressing each outcome on perceived neighborhood health (higher scores on each domain signify better perceived neighborhood health), adjusted for confounders, and interaction terms between neighborhood health and potential modifiers (ADI [higher percentiles correspond to more deprivation] and healthy food availability [higher scores indicate greater availability]) of the primary association were included.ResultsAmong 159 participants (median [IQR] age, 57 [49-64] years; mean [SD] age, 57 (11) years; 117 women [74%]), median (IQR) hypertension self-care behavior was 50 (45-56) and self-efficacy was 64 (57-72). Better perceived neighborhood health was associated with greater hypertension self-care behavior (β, 2.48; 95% CI, 0.63-4.33) and self-efficacy (β, 4.42; 95% CI, 2.25-6.59); these associations persisted for all neighborhood health subdomains except aesthetic quality. There were no statistically significant interactions between perceived neighborhood health or its subdomains with ADI on self-care behavior (P = .74 for interaction) or self-efficacy (P = .85 for interaction). However, better perceived neighborhood aesthetic quality had associations with greater self-care behavior specifically at higher healthy food availability at home scores: β at −1 SD, −0.29; 95% CI, −2.89 to 2.30 vs β at 1 SD, 2.97; 95% CI, 0.46-5.47; P = .09 for interaction). Likewise, associations of perceived worse neighborhood violence with lower self-care behavior were attenuated at higher healthy food availability at home scores (β for −1 SD, 3.69; 95% CI, 1.31-6.08 vs β for 1 SD, 0.01; 95% CI, −2.53 to 2.54; P = .04 for interaction).Conclusions and RelevanceIn this cross-sectional study, better perceived neighborhood health was associated with greater hypertension self-care among Black individuals with hypertension, particularly among those with greater in-home food availability. Thus, optimizing hypertension self-management may require multifaceted interventions targeting both the patients’ perceived contextual neighborhood barriers to self-care and availability of healthy food resources in the home.

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“…Moreover, these attributes are uninviting and discourage outdoor activities, thus limiting the number of people and “eyes” on the streets (Cohen, Davis, Lee, & Valdovinos, 2010). Community-wide fear resulting from violence can lead to feelings of distrust, suspicion, seclusion, minimal social interactions (Cohen et al, 2010), and a consequent underutilization of local health promoting assets. Our findings suggest that these social cohesion–type factors may be related to food access in Springfield.…”

Section: Discussionmentioning

confidence: 99%

Food Access and Its Relationship to Perceived Walkability, Safety, and Social Cohesion

Calise

Chow

Ryder

et al. 2018

Health Promotion Practice

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Understanding social inequalities in terms of neighborhood characteristics and the context to which individuals belong is important for reducing disparities. This article describes how perceptions of food access are related to three physical and social environmental factors: perceived neighborhood walkability, safety, and social cohesion. A cross-sectional survey was conducted with a random sample of 1,500 households in Springfield, Missouri. The main outcome measures were ease of purchase; availability of a large selection and quality; and affordability of fresh fruits and vegetables (FVs) and low-fat products (LFPs). Overall, 63% of respondents reported consuming <5 servings of FVs daily in the past month. Most agreed it was easy to purchase FVs (70%) and LFPs (76%) in their neighborhood and felt there was a large selection available (70% and 71%, respectively). High walkability (odds ratio [OR]: 1.8), low crime (OR: 1.6), and high social cohesion (OR: 1.7) were significantly associated with having greater selection of FVs. High walkability (OR: 1.6) and low crime (OR: 1.6) were associated with greater access to FVs. Given that healthy food access is an important component to improving health outcomes, understanding how to alter environmental features that influence behaviors like eating is important.

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Increasing visibility of violence prevention: linking strategies to prevent violence and promote healthy eating and active living

Cited by 4 publications

References 0 publications

The association between food insecurity and gun violence in a major metropolitan city

The association between food insecurity and gun violence in a major metropolitan city

Association of Perceived Neighborhood Health With Hypertension Self-care

Food Access and Its Relationship to Perceived Walkability, Safety, and Social Cohesion

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