Abstract
BackgroundNumerous area-based initiatives have been implemented in deprived areas across Western-Europe with the aim to improve the socio-economic and environmental conditions in these areas. Only few of these initiatives have been scientifically evaluated for their impact on key social determinants of health, like perceived area safety. Therefore, this study aimed to assess the impact of a Dutch area-based initiative called the District Approach on trends in perceived area safety and underlying problems in deprived target districts.MethodsA quasi-experimental design was used. Repeated cross-sectional data on perceived area safety and underlying problems were obtained from the National Safety Monitor (2005–2008) and its successor the Integrated Safety Monitor (2008–2011). Study population consisted of 133,522 Dutch adults, including 3,595 adults from target districts. Multilevel logistic regression analyses were performed to assess trends in self-reported general safety, physical order, social order, and non-victimization before and after the start of the District Approach mid-2008. Trends in target districts were compared with trends in various control groups.ResultsResidents of target districts felt less safe, perceived less physical and social order, and were victimized more often than adults elsewhere in the Netherlands. For non-victimization, target districts showed a somewhat more positive change in trend after the start of the District Approach than the rest of the Netherlands or other deprived districts. Differences were only statistically significant in women, older adults, and lower educated adults. For general safety, physical order, and social order, there were no differences in trend change between target districts and control groups.ConclusionsResults suggest that the District Approach has been unable to improve perceptions of area safety and disorder in deprived areas, but that it did result in declining victimization rates.
Highlights
Numerous area-based initiatives have been implemented in deprived areas across Western-Europe with the aim to improve the socio-economic and environmental conditions in these areas
Adults in target districts were more often under 35 years old, of non-Dutch origin, and lower educated compared to adults in all control groups (Table 1). They reported lower levels of general safety, physical order, social order, and non-victimization compared to adults in the rest of the Netherlands (Fig. 2)
The current study provides limited evidence to suggest that area-based initiatives (ABIs) may improve health in deprived areas by improving key social determinants of health such as area safety
Summary
Numerous area-based initiatives have been implemented in deprived areas across Western-Europe with the aim to improve the socio-economic and environmental conditions in these areas. Few of these initiatives have been scientifically evaluated for their impact on key social determinants of health, like perceived area safety. ABIs are defined as large-scale programmes that aim to improve both the physical and social environmental conditions of deprived areas, as well as the socio-economic position of its residents. These initiatives have the potential to improve health and reduce health inequalities by improving. There is strong quantitative and qualitative evidence for the association between disorder and safety concerns [7, 8]
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