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The United States has experienced increasing structural trends in recent years towards increasing violent crime rates in some metropolitan neighborhoods and a widening gap in wealth and income inequality between social classes. Currently, social disorganization theory is primarily utilized to explain neighborhood crime, while institutional anomie theory is one of the main theories linking economic inequality to crime outcomes. However, while there is an increasing trend in the literature towards integrating current theoretical perspectives to better explain macro-level crime, no integrated theoretical framework has been developed to explain neighborhood crime by simultaneously testing neighborhood-level social disorganization measures and county-level institutional anomie measures using a multilevel modeling approach. To fill this gap, this study develops and empirically tests an integrated theory of macro-level crime utilizing data from 9,593 neighborhoods nested within 64 urban counties in the United States entitled the anomic disorganization theory. The results replicate previous findings on the direct effects of economic inequality and structural social disorganization measures on neighborhood crime rates, show how the strength of commitment to noneconomic institutions conditions the relationship between social disorganization measures and neighborhood crime using cross-level interaction terms, and finally, provide criminal justice policymakers with actionable interventions to reduce crime in communities.