Perceived Neighborhood Safety Research Articles

The four stages of neighborhood trust: Classic grounded theory.

Neighborhoods are often overlooked as a determinant of health.Among recent research, the focus on "place-based effects," due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is toidentify and examine how a healthy neighborhood is intentionally created to describe a transferable process-driven theory. A classic grounded theory approach was used in these studies. Data sources include individual in-depth interviews, historical documents, and a member-checking focus group, collected over 3-years. Analysis generated theFour Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules-based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging. We present the development of a process-driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process.

Neighborhood Safety and Perinatal Mental Health

Neighborhood safety (NS) has important implications for mental health, yet research is needed to clarify how different constructs that measure NS associate with mental health problems. Research is particularly underdeveloped on NS among low-income, postpartum individuals, who may experience greater vulnerability. This study examined two measures of NS, self-reported and coder-rated, and their associations with prenatal and postnatal depression and PTSD symptoms, and lifetime adversity. Participants were 121 perinatal individuals living in a major metro area. Both types of NS were significantly intercorrelated. Neither prenatal nor postnatal depression symptoms predicted self-reported or coder-rated NS. However, higher lifetime adversity and higher postnatal PTSD symptoms predicted lower self-reported postnatal NS (but not coder-rated NS). After controlling for prenatal PTSD symptoms, lower self-reported NS also predicted higher postnatal PTSD symptoms. Findings underscore the importance of focusing on individuals’ lived experiences in their neighborhoods to understand links between perceptions of NS and PTSD symptoms.

Associations between neighbourhood safety, social cohesion, sleep quality and sleep duration among older adults in India: Findings from the Study on Global Aging and Adult Health (WHO-SAGE), 2015.

Most studies on later-life health in India focus on families, with far less attention given to the health repercussions of neighbourhood conditions among older Indians. We address this limitation in existing research by examining the associations between perceptions of neighbourhood safety and social cohesion and sleep duration and sleep quality among older adults in India. Data come from the Study on Global Aging and Adult Health (WHO-SAGE), India 2015 wave 2, with a sample of 7118 adults aged 50 years and above. Sleep quality and duration were assessed using subjective responses. Multivariable logistic and linear regression analyses were employed to test the research hypotheses. Prevalence of poor sleep quality was higher among older adults living in unsafe neighbourhoods (4.46%) than peers residing in safe neighbourhoods (3.52%), and it was also higher among those living in neighbourhoods with poor social cohesion (5.31%) than counterparts who lived in socially cohesive communities (3.10%). Older adults in neighbourhoods with poor social cohesion had higher odds of reporting compromised sleep quality (adjusted odds ratio 1.75, CI: 1.22-2.51) than those living in socially cohesive neighbourhoods. Moreover, compared to those who perceived they were living in safe neighbourhoods, their peers who perceived their neighbourhoods as unsafe reported shorter sleep duration, with a negative beta coefficient of -0.27 (CI: -0.45 to -0.085). That perceived unsafety and poor social cohesion within one's neighbourhood are associated with compromised sleep reflects the significance of making neighbourhoods safer and more integrated for later-life sleep health. In addition to micro-level strategies (e.g., balanced nutrition and physical activity), efforts to improve sleep health should optimise macro-level opportunities, such as rehabilitating and revitalising neighbourhoods, which may alleviate sleep disturbances and improve sleep outcomes among older adults.

The built environment, purpose-specific walking behaviour and overweight: evidence from Wuhan metropolis in central China

The impact of objective and subjective environmental factors on health outcomes has been a topic of significant debate, with a growing body of research acknowledging the role of a physically active lifestyle in promoting health. However, consensus regarding their precise influence remains elusive. This study contributes to these discussions by exploring how individual health outcomes correlate with transport and leisure walking behaviours, set against both the objective and subjective aspects of environmental influences in the context of Wuhan, an inland Chinese megacity. Street view images, multi-source geospatial data and a questionnaire survey were employed to characterise the “5D + Greenery” objective and perceived characteristics of the neighbourhood environment. Multi-group structural equation modelling was utilised to unravel the complex relationship and gender heterogeneity among environmental factors, purpose-specific walking, and overweight. Our results suggest that both objective land use diversity and perceived convenience are significantly associated with overweight. The accessibility of local service facilities and visible greenery promote both transport and leisure walking. While perceived neighbourhood safety encourages transport walking, perceived walkability is positively correlated with leisure walking. Notably, leisure walking, usually considered beneficial, presents a positive association with overweight conditions, acting as a mediation. Gender disparities exist in pathways between the environment and purpose-specific walking, as well as weight. The findings lend support to the planning of an activity-supporting built environment as a crucial strategy for obesity prevention.

Impacts of sociodemographic factors, identities and neighbourhood safety on the relationship between urban green space and adolescent mental well-being: Findings from Tāmaki Makaurau Auckland, Aotearoa New Zealand

This study explored the relationship between green space accessibility (GSA) in residential area and adolescents’ mental well-being, and whether the relationship was moderated by sociodemographic factors (sex, ethnicity, neighbourhood deprivation), identities (gender and sexuality minority, disability) and perceived neighbourhood safety simultaneously. Data from 3813 adolescents who lived in Tāmaki Makaurau Auckland, Aotearoa New Zealand were obtained from the Youth19 Rangatahi Smart Survey. A Gaussian-based two-step floating catchment area method was employed to measure the spatial accessibility to green space at the neighbourhood level. The World Health Organization-5 Well-being Index was used to assess emotional well-being (EW), and the Reynolds Adolescent Depression Scale-short form was employed to measure depressive symptoms (DS). Through moderation analyses, results showed that perceived neighbourhood safety plays a vital role in the GSA – mental well-being association, with a negative trend in adolescents who reported being less safe in neighbourhoods. Adverse associations of GSA were found in gender and sexuality minority, disabled, Asian and Pacific adolescents, under the condition of not feeling safe in neighbourhoods all the time. The results showed marginalised adolescents tended to feel less safe in neighbourhoods, have lower EW and a higher level of DS. Additionally, the results from bivariate correlations showed there were inequalities in GSA for adolescents who lived in most deprived neighbourhoods and adolescents of Māori ethnicity. This study provides novel evidence of the importance of safe and inclusive green space for effectively promoting mental health and mitigating health inequalities of adolescents in urban areas.

NEIGHBORHOOD DISADVANTAGE AND PHYSICAL FUNCTIONING: EXPLORING GENDER-SPECIFIC MECHANISMS

Abstract The relationship between poverty status and functional limitation among late middle age and older adults is well-established. However, the contextual effect of neighborhood disadvantage on physical functioning is less clear. First, the potential pathways linking the two are largely unexplored. Extant evidence shows that perceived neighborhood safety and order are significant predictors of physical functioning. Moreover, stress eating is a common coping strategy for stressful life events and contexts. These three explanations potentially mediate the relationship between poverty rate and physical functioning. Second, even though existing evidence finds stark gender difference in physical functioning, the explanations for the gender difference remains largely unknown. We propose that gender-specific mechanisms can explain the gender difference in physical functioning. The goal of the study was to test the gender-specific mechanism thesis based on a nationally representative sample of adults 55 to 93 years of age in the MIDUS 2 and 3 data (N = 2099). We employed Multilevel Generalized Structural Equation Modeling to test the gender-specific mediating roles of the three mediators. Results showed that county-level poverty rate is significantly associated with instrumental activities of daily living (IADL) among women and men. In contrast, perceived neighborhood safety and stress eating significantly mediate the relationship between poverty rate and physical functioning among women but not men. Furthermore, the indirect effect among women is significantly larger than among men. The important findings support gender-specific mechanisms linking neighborhood disadvantage and health and highlight the role of subjective neighborhood indicators among older women.

NEIGHBORHOOD CHARACTERISTICS AND INEQUALITIES IN SENSORY HEALTH AMONG OLDER ADULTS IN THE UNITED STATES

Abstract Sensory function plays a crucial role in older adults’ navigation of the environment, maintenance of personal safety, and in quality of everyday life. The residential neighborhood context is a significant social determinant of later life health and health disparities, but it has been understudied with respect to sensory function. We consider that residential neighborhoods are key sites of social and economic resources, social engagement, and environmental stimulation that could influence sensory health and inequalities in sensory impairment. We use data from 2,251 older adults who were interviewed at Rounds 1 and 2 of the National Social Life, Health and Aging Project in a series of longitudinal random effects models that examine how self-reported and objectively measured neighborhood characteristics are associated with self-rated vision and hearing. We find that older adults who reside in census tracts with higher levels of concentrated disadvantage report significantly worse self-rated vision and hearing compared with older adults who live in areas with less concentrated disadvantage. Residing in a more densely populated tract, however, is associated with better self-rated hearing. Black and Hispanic older adults’ self-rated hearing benefits significantly more from living in a densely populated tract than does White older adults’ self-rated hearing. In cross-sectional models, higher perceptions of neighborhood safety and social ties are associated with better self-rated vision. Our findings prompt a more nuanced understanding of how the social environment affects sensory health and highlight sensory function as a potential underexplored pathway through which neighborhood characteristics shape health disparities in later life.

ACCESS TO LOCAL ESTABLISHMENTS AND NEIGHBORHOOD PERCEPTIONS: A FOCUS ON THE ROLE OF LOCAL BANKING

Abstract As an increasing number of older adults are aging-in-place, individuals’ perceptions of their neighborhood environments have emerged as significant social-contextual issues for healthy aging. Prior studies have focused on how neighborhood characteristics shape perceptions of residential neighborhoods. Far less research has focused on the role of local banking, despite the intersections between local banking establishments and a host of key community social and economic resources, particularly for the older adult population. We use nationally representative data from older adults interviewed at Rounds 2 and 3 of the National Social Life, Health, and Aging Project (N=4,589) linked with the National Establishment Time Series database to examine neighborhood perceptions as a function of local banking establishment density. We find that older adults who live in areas with higher rates of banking establishments report significantly higher levels of neighborhood safety, even when adjusting for a host of individual and neighborhood characteristics. Importantly, other types of establishments also shape perceived neighborhood safety, however, the significance of certain associations only emerges when we adjust for the presence of local banking. We suggest that local banks may be a lynchpin in catalyzing the broader socioeconomic vitality of a place, supporting older residents’ favorable perceptions of neighborhood safety. We discuss the implications of our findings for inequality in aging in light of unequal access to local banking across social groups, potentially increasing the vulnerability of older adults who are less likely to adopt mobile banking solutions and who are more likely to be susceptible to financial exploitation.

Associations of objective and subjective neighborhood measures with cognitive change in a repeated measurement burst design

AbstractBackgroundPrior studies have reported associations between neighborhood characteristics and late‐life cognition. These studies assessed neighborhood using either objective (e.g., area‐level data from public database) or subjective (individual‐level perception) measures. However, little research has been done to examine effects of objective and subjective measures simultaneously. The present study aims to investigate the independent associations of objective and subjective neighborhood characteristics with cognitive change in older adults.MethodParticipants include 316 individuals in the Einstein Aging Study (mean age = 77; 67% females; 45% non‐Hispanic Whites, 40% non‐Hispanic Blacks). Subjective neighborhood measures included perceived neighborhood safety, aesthetic quality, social cohesion, and availability of healthy foods (range = 1 poor to 5 excellent). Objective neighborhood measures included violent crime, neighborhood deprivation, volunteering rates, percentage of healthy food retailers, and low access to healthy food. Processing speed was assessed using the brief, smartphone‐administered Symbol Search Test, and was completed 6x/day over two weeks; this was repeated annually from 2017 to 2022. To account for non‐linear retest/practice effects, double negative exponential models were used to estimate the relation of neighborhood measures to asymptotic performance (i.e., fastest response time) at baseline and to change in asymptotic performance over time.ResultMost subjective and objective neighborhood measures were significantly correlated with each other (Table 1). In models containing both objective and subjective neighborhood measures, better perceived safety was associated with greater annual improvement in asymptotic performance (40 milliseconds/year for one point increase in safety) while the objective measure of violent crime was not. Perceived availability of healthy foods was independently associated with a faster baseline asymptotic processing speed (estimate = 160 milliseconds) and with greater annual improvement rate (estimate = 54 milliseconds/year) while the objective measures of food environment were not (Table 2).ConclusionSubjective rather than objective neighborhood characteristics were strongly associated with annual rates of change in processing speed over five years in community‐dwelling older adults. Perception of one’s neighborhood may be a more proximal predictor of cognitive health as it may reflect an individual’s lived experiences and determine one’s psychological states and health‐related behaviors. Alternatively, more fine‐grained objective neighborhood measures (e.g., individual‐level) would be necessary to better characterize objective neighborhood environments.

Property Victimization, Perception of Neighborhood Safety, and Perceived Fairness of the Criminal Justice System Within the Chinese Context

Property Victimization, Perception of Neighborhood Safety, and Perceived Fairness of the Criminal Justice System Within the Chinese Context

Insights into parents’ perceived worry before and during the COVID-19 pandemic in Australia: inequality and heterogeneity of influences

BackgroundExcessive worry is an invisible disruptive force that has adverse health outcomes and may advance to other forms of disorder, such as anxiety or depression. Addressing worry and its influences is challenging yet crucial for informing public health policy.MethodsWe examined parents’ worries, influences, and variability before and during COVID-19 pandemic and across geography. Parents (n = 340) and their primary school-aged children from five Australian states completed an anonymous online survey in mid-2020. After literature review, we conceptualised the influences and performed a series of regression analyses.ResultsWorry levels and the variables contributing to parents’ worry varied before to during the pandemic. The proportion of parents who were "very worried all the time" increased by 14.6% in the early days of the pandemic. During the pandemic, ethnic background modified parents’ worry and parents’ history of daily distress symptoms was a significant contributor (p < 0.05). Excessive exposure to news remained significant both before and during the pandemic. The primary predictor of parents’ worry before COVID-19 was perceived neighbourhood safety, while the main predictor during COVID-19 was financial risk due to income change. Some variable such as neighbourhood safety and financial risk varied in their contribution to worry across geographical regions. The proportion of worried children was higher among distraught parents.ConclusionParents’ worry during the health pandemic was not triggered by the health risks factors but by the financial risk due to income change. The study depicts inequality in the impact of COVID-19 by ethnic background. Different policies and reported virus case numbers across states may have modified the behaviour of variables contributing to the geography of parents’ worry. Exposure to stressors before the COVID-19 pandemic may have helped parents develop coping strategies during stressful events. Parents are encouraged to limit their exposure to stressful news. We advocate for parents-specific tailored policies and emphasise the need for access to appropriate mental health resources for those in need. Advancing research in geographical modelling for mental health may aid in devising much-needed location-targeted interventions and prioritising resources in future events.

What is there to be happy about? The impact of race and resilience in the United States

PurposeThe purpose of this study is to investigate racial differences in the moderating role of factors linked with resilience on the relationship between economic stress and happiness for Black and White residents of the USA.Design/methodology/approachSecondary data were downloaded from the World Values Survey Wave 7 for adult respondents living in the USA. The entire sample of respondents who self-identified as belonging to the Black race (n = 209) was statistically matched (based on sex – 50% male and average age – 39 years) with a similarly sized random sample of respondents who self-identified as belonging to the White race (n = 217).FindingsThe results suggest that economic stress had the potential to trigger a resilience response. However, the protective factors in the resilience process differed by race of the respondent. The relationship between economic stress and perceptions of neighborhood safety was conditional on level of control for the White sample. The relationship between economic stress and happiness for the Black sample was conditional on the importance of faith.Originality/valueThe study was able to demonstrate the importance of race-based contextual differences in the roles of faith and control in the resilience process. The findings also increase the understanding of how life circumstances and individual characteristics, including race, impact happiness and how much or little resilience may play a part in the achievement of happiness.

Effect of socio-community environment on the impacts of the Coronavirus Disease 2019 pandemic and well-being among older people in Hong Kong

Abstract Objectives: This study examined the effects of the socio-community environment on the impacts of the coronavirus disease 2019 (COVID-19) pandemic among older people in Hong Kong. Methods: A random sample of 1200 60+ participants completed a telephone survey in 2020. Socio-community environment variables covering trust toward politicians, government officials, and medical professionals, and community safety factors covering confirmed cases in the building of the participant, perceived neighborhood safety, and perceived safety in Hong Kong were the independent variables. The dependent variables were impacts of COVID-19 related to social activities, finance and routines, interpersonal relationships, and the workplace. Hierarchical regression analysis was conducted with variables on trust and community safety entered as separate blocks while adjusting the effects of the participants’ demographics. Results: Older people in a community environment that was perceived as less safe reported more negative impacts of COVID. A higher level of trust toward the various types of authorities is also demonstrated to have different effects on the perceived negative impacts of COVID in different aspects of older people’s daily lives. Conclusion: Trustworthy government policies and measures, as well as building a safe community environment, are important directions for addressing concerns and the negative impacts of a pandemic in the future.

Perceived Neighborhood Conditions, Psychosocial Factors, and Sleep Problems Among Urban and Rural Older Adults in China.

To examine the associations between perceived neighborhood conditions and older Chinese adults' sleep problems, and whether these associations are mediated by psychosocial factors and moderated by urban-rural residence. Data were from the World Health Organization Study on global Ageing and Adult Health. We used OLS, binary, and multinomial logistic regression analyses. Karlson-Holm-Breen decomposition method was used to test mediation effects. Positively perceived neighborhood social cohesion was associated with fewer insomnia symptoms and decreased odds of poor sleep quality, sleepiness, lethargy, and short sleep duration. Positively perceived neighborhood safety was related to decreased risks of poor sleep quality and sleepiness. Depression and perceived control partially mediated the effects of perceived neighborhood on sleep. Furthermore, the protective effects of neighborhood cohesion against sleep problems were more pronounced among older urban adults than their rural counterparts. Interventions that make neighborhoods safer and more integrated will improve late-life sleep health.

Do surveillance cameras improve perceived neighborhood safety? A case study of Nanjing, China

Increasing residents' safety perception is essential for their health and wellbeing, and is of great importance when it comes to neighborhood planning and policy design. Despite the rich body of literature that explores the correlates of perceived neighborhood safety (PNS), the research on the effects of camera-based surveillance technologies on PNS is limited. Most existing studies merely examine the differences in individual perceptions and acceptance of surveillance technologies, but overlook important neighborhood context. Therefore, this study explores how surveillance cameras, as a typical example of camera-based surveillance technologies, can influence PNS and how this influence varies according to neighborhood features or is moderated by other security strategies (i.e., gating). The results show that perceived amounts of surveillance cameras is the most important factor determining PNS and its effect relies on neighborhood characteristics. Increasing the number of surveillance cameras and making them visible to residents may be efficient strategies for improving PNS, however, tailored policies should be formulated by accounting for neighborhood peculiarity.

Perceived Neighborhood Safety and Depressive Symptoms: The Role of Perceived Neighborhood Cohesion and Perceived Control.

Few have examined mechanisms explaining the link between perceived neighborhood unsafety, neighborhood social processes, and depressive symptoms for Black adolescents. The goal of this study was to examine the role of perceived control as a mechanism linking perceptions of neighborhood unsafety and depressive symptoms, and neighborhood cohesion as a protective factor. Participants were 412 Black adolescents living in a major Mid-Atlantic urban center in the United States (49% female, Mage = 15.80, SD = 0.36). Participants reported perceptions of neighborhood unsafety at grade 10, neighborhood cohesion at grade 10, perceived control at grades 10 and 11 and depressive symptoms in grades 10 and 12. High neighborhood unsafety was associated with low perceived control and in turn high depressive symptoms only when neighborhood cohesion was high. The results highlight the role of neighborhood unsafety and perceived control in the development of depressive symptom and the possible downsides of neighborhood social factors.

Identity, experience, and threat: Assessing key correlates of firearm ownership and related behaviors in a representative sample of five US States

The purpose of this study was to examine psychosocial, experiential, and demographic correlates of firearm ownership, carrying, and storage methods. We used a representative survey of 3,510 people living in five US states (Colorado, Minnesota, Mississippi, New Jersey, and Texas) conducted in 2022. Individuals provided information on past experiences with firearms, perceptions of threat and neighborhood safety, discrimination, and tolerance of uncertainty alongside demographic items. The analysis was conducted in November 2022. Past experiences with firearms and prior victimization are associated with increased firearm ownership and carrying practices. Threat sensitivity is associated with owning more guns while poorer perceptions of neighborhood safety correspond with owning fewer guns but greater risk for unsafe storage practices like storing a loaded gun in a closet or drawer. Intolerance of uncertainty is associated with owning fewer guns and lower risk for carrying outside of the home but greater risk for unsafe storage. Prior experience of discrimination is associated with risk for carrying firearms outside of the home. Demographic characteristics related to sex, rurality, military service, and political conservatism predict risky firearm-related behaviors related to firearm ownership, carrying frequency, and unsecure storage. Taken together, we find firearm ownership and risky firearm behaviors (e.g. carrying, unsafe storage) are more prominent among groups such as politically conservative males living in rural areas while also being influenced by threatening experiences, uncertainty, and perceptions of safety.

Perception of Neighborhood Safety and Maternal and Neonatal Health Outcomes

This cross-sectional study examines whether perceived neighborhood safety is independently associated with adverse birth outcomes.

Individual and Neighborhood Environmental Factors Affecting Healthy Eating Among Korean Rural Adults.

Although it is recognized that social and environmental factors influence healthy eating behaviors, few studies have investigated the association between environmental factors and healthy eating among rural adults in Korea. We aimed to identify individual and neighborhood environmental factors influencing adherence to fruit and vegetable intake among adults living in rural areas using an ecological approach. The study sample comprised 1,582 adults from 38 rural areas from Chungbuk Province, South Korea in 2017 who provided individual- and neighborhood-level data. Neighborhood-level data were obtained by aggregating individual-level responses measured for each residential town resulting in an average value for each neighborhood-level variable for the 38 rural areas. The data were merged and used for a series of multilevel logistic regression analyses. Among the individual-level factors, age, alcohol drinking, physical activity, self-efficacy for healthy eating, and social support for healthy eating were significantly associated with adherence to fruit and vegetable intake. Among the neighborhood-level factors, social cohesion and perceived neighborhood safety were significantly associated with adherence to fruit and vegetable intake. Multifaceted intervention strategies to increase consumption of fruits and vegetables should include behavioral modification, social support, and improvement of neighborhood environments.

Correlates of intimate partner violence among pregnant and parenting adolescents: a cross-sectional household survey in Blantyre District, Malawi

BackgroundDespite efforts from the government and developmental partners to eliminate gender-based violence, intimate partner violence (IPV) remains a pervasive global health and human rights problem, affecting up to 753 million women and girls globally. Few studies on IPV have focused on pregnant and parenting adolescent (PPA) girls in Africa, although the region has the highest rates of adolescent childbearing. This limited attention results in the neglect of pregnant and parenting adolescents in policies and interventions addressing IPV in the region. Our study examined IPV prevalence and its individual, household, and community-level correlates among pregnant and parenting adolescent girls (10–19 years) in Blantyre District, Malawi.MethodsWe collected data from a cross-section of pregnant and parenting adolescent girls (n = 669) between March and May 2021. The girls responded to questions on socio-demographic and household characteristics, lifetime experience of IPV (i.e., sexual, physical, and emotional violence), and community-level safety nets. We used multilevel mixed-effect logistic regression models to examine the individual, household, and community-level factors associated with IPV.ResultsThe lifetime prevalence of IPV was 39.7% (n = 266), with more girls reporting emotional (28.8%) than physical (22.2%) and sexual (17.4%) violence. At the individual level, girls with secondary education (AOR: 1.72; 95% CI: 1.16–2.54), who engaged in transactional sex (AOR: 2.29; 95% CI: 1.35–3.89), and accepted wife-beating (AOR: 1.97; 95% CI: 1.27–3.08) were significantly more likely to experience IPV compared to those with no education/primary education, who never engaged in transactional sex and rejected wife beating. Girls aged 19 (AOR: 0.49; 95% CI: 0.27–0.87) were less likely to report IPV than those aged 13–16. At the household level, girls with fair and poor partner support had higher odds of experiencing IPV, but the effect size did not reach a significant level in the parsimonious model. A high perception of neighborhood safety was associated with a lower likelihood of experiencing IPV (AOR: 0.81; 95% CI: 0.69–0.95).ConclusionIntimate partner violence is rife among pregnant and parenting adolescent girls in Malawi, underscoring the need for appropriate interventions to curb the scourge. Interventions addressing IPV need to target younger adolescents, those engaging in transactional sex, and those having weaker community-level safety nets. Interventions to change social norms that drive the acceptance of gender-based violence are also warranted.