Abstract
BackgroundHomicide is a major cause of death and contributes to health disparities in the United States. This burden overwhelmingly affects people from racial and ethnic minority populations as homicide occurs more often in neighborhoods with high proportions of racial and ethnic minority residents. Research has identified that environmental factors contribute to variation in homicide rates between neighborhoods; however, it is not clear why some neighborhoods with high concentrations of racial and ethnic minority residents have high homicide rates while neighborhoods with similar demographic compositions do not. The aim of this study was to assess whether relative socioeconomic disadvantage, (i.e., income inequality), or absolute socioeconomic disadvantage (i.e., income) measured at the ZIP code- and state-levels, is associated with high homicide rates in US ZIP codes, independent of racial and ethnic composition.MethodsThis ecological case–control study compared median household income and income inequality in 250 ZIP codes with the highest homicide rate in our sample in 2017 (cases) to 250 ZIP codes that did not experience any homicide deaths in 2017 (controls). Cases were matched to controls 1:1 based on demographic composition. Variables were measured at both the ZIP code- and state-levels.ResultsLower median household income at the ZIP code-level contributed most substantially to the homicide rate. Income inequality at the state-level, however, was additionally significant when controlling for both ZIP code- and state-level factors.ConclusionsArea-based interventions that improve absolute measures of ZIP code socioeconomic disadvantage may reduce gaps in homicide rates.
Highlights
Homicide is a major cause of death and contributes to health disparities in the United States
ZIP codes eligible for inclusion were in the 34 United States (US) states and four counties in California that participated in the National Violent Death Reporting System (NVDRS) during that year (n = 23,949)
Matched case and control ZIP codes were similar in the mean percent of the population aged 15–24, racial demographics, and percent male
Summary
Homicide is a major cause of death and contributes to health disparities in the United States. This burden overwhelmingly affects people from racial and ethnic minority populations as homicide occurs more often in neighborhoods with high proportions of racial and ethnic minority residents. Homicide is a leading cause of mortality and contributes to heath disparities in the United States. Homicide is the leading cause of death for Black men aged ≤ 44 and is a major contributor to differences in life expectancy between White and Black men (CDC 2016). The disproportionate exposure to homicide among Black and Hispanic people adds to disparities in physical injury and Gobaud et al Injury Epidemiology (2022) 9:7 long-term mental and physical health (Sheats et al 2018). Identifying conditions that contribute to the occurrence of homicide is an essential step towards developing effective preventive interventions that reduce the absolute health burden and sociodemographically structured health disparities
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