Neighborhood Violence and its Association with Mothers’ Health: Assessing the Relative Importance of Perceived Safety and Exposure to Violence

Abstract

This paper presents a cross-sectional study examining the influence of neighborhood violence on multiple aspects of mothers' health. While the influence of neighborhood violence on health is important to understand for all populations, mothers are especially important as they play a key role in protecting their children from the consequences of violence. Three hundred and ninety-two Baltimore City mothers of children 5 years and younger completed a self-administered survey that included questions about perceptions of their safety as well as their personal experiences with neighborhood violence. Separate models were run to compare the relationship between each measurement of neighborhood violence and five diverse health-related determinants and outcomes: self-reported health status, smoking, exercise, average hours of sleep a night, and sleep interruption. Controlling for mother's age, child's age, maternal education, and marital status, mothers with high exposure to neighborhood violence were twice as likely to report poorer health, smoking, never exercising, and poor sleep habits. Maternal perception of neighborhood safety was not related to any of the assessed health-related determinants and outcomes. This study emphasizes the importance of measuring exposure to neighborhood violence rather than solely assessing perceived safety. Neighborhood violence was a common experience for mothers in this urban sample, and should be considered by health professionals in trying to understand and intervene to improve the health of mothers and their children.

Neighborhood Factors as Predictors of Poor Sleep in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos

“…These findings are consistent with previous studies that reported an association between short sleep duration and low neighborhood safety. [10][11][12][13][14][15][20][21][22] These prior studies however, relied on self-reported sleep duration, raising concern that the associations might reflect known systematic biases in the accuracy of self-report, rather than an actual effect on sleep per se. Our results demonstrate that the perception that one lives in an unsafe neighborhood is associated with an objective measure of short sleep.…”

“…10 This suggests that effects of neighborhood characteristics on sleep may represent one pathway by which neighborhood environment has an impact on health outcomes. Exposure to violence and crime and feeling unsafe in one's neighborhood have been associated with reductions in both sleep duration [11][12][13] and sleep quality, 10,[12][13][14] and worse insomnia symptoms. 15 Similarly, increased noise in the neighborhood has been associated with higher prevalence of self-reported sleep disturbances.…”

“…11,[15][16][17][18][19] However, a major limitation of the existing literature linking adverse neighborhood features such as crime and violence with sleep has been the reliance on unvalidated measures of sleep. [10][11][12][13][14][20][21][22] While studies using actigraphy have evaluated the relationship between sleep and noise, these studies have been limited by small sample size, in-laboratory testing or low levels of noise that may limit generalizability of findings. 23,24 Our goal was to evaluate the relationship between neighborhood environment and validated measures of sleep in a large cohort of US Hispanics/Latinos, the largest racial/ethnic minority group in the United States and a group with a high prevalence of cardiovascular disease risk factors such as diabetes, obesity, and hypertension.…”

A Randomized Trial on Screening for Social Determinants of Health: the iScreen Study

“…34 Other items were based on existing validated survey items on income security, 37 food security, 38 and neighborhood safety. 39 Likert-scale response options were as follows: 1 = "not at all stressful," 2 = "a little bit stressful," 3 = "moderately stressful," 4 = "very stressful, " 5 = "extremely stressful," and 0 "issue listed is not applicable to my family." Each social need was coded in a binary format as either 0 (if "not at all stressful" or "not applicable to my family") or 1 (if "a little stressful" to "extremely stressful") to indicate a positive disclosure.…”

Mental health impact assessment: population mental health in Englewood, Chicago, Illinois, USA

“…This comprehensive approach emphasizes the importance of integrating mental health into HIA methodology (Quigley et al 2006). Additionally, mental health plays a critical role in mediating the relationship between social conditions and physical health outcomes (Leventhal and Brooks-Gunn 2000, Stafford et al 2007, Curry et al 2008, Echeverria et al 2008, Collins et al 2009, Johnson et al 2009, O'Campo et al 2009, Raphael 2009, Roman et al 2009, Geronimus et al 2010, Mair et al 2010, Matthews et al 2010.…”