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Background: Despite evidence linking neighborhood crime to diabetes, little is known about the potentially distinct roles of reported neighborhood crime and perceived neighborhood safety. This study aimed to examine the differential associations of neighborhood crime and perceived neighborhood safety with diabetes.
Methods: Participants (n=745; African American adults=94%) were drawn from the 2018 Pittsburgh Hill/Homewood Research on Neighborhood Change and Health study. Self-reported diabetes status (yes/no) was used as the outcome. Total crime was defined as the 2017-2018 average crime events within a 1/10-mile radius of participants’ home addresses. Perceived neighborhood safety was assessed such that higher scores indicated greater safety. Using median splits of neighborhood crime and perceived safety, participants were categorized into four groups (high-crime/low-safety, high-crime/high-safety, low-crime/low-safety, and low-crime/high-safety [reference]). We examined the associations between these groups and diabetes using multivariable logistic regression, adjusting for covariates.
Results: Participants living in high-crime/low-safety and high-crime/high-safety areas had greater odds of diabetes (OR=2.53; 95% confidence interval [CI]=1.58, 4.04; OR=1.94; 95% CI=1.26, 2.99, respectively) compared with those living in low-crime/high-safety areas.
Conclusions: Living in high-crime areas was associated with greater odds of diabetes regardless of perceived safety levels. Actual crime and perceived safety may be mismatched and affect diabetes synergistically or antagonistically.
Kosuke Tamura, National Institute on Minority Health and Health Disparities, National Institutes of Health
Kelsey R. Leonard, University of Pittsburgh
Andrea S. Richardson, RAND
Robin Beckman, RAND
Yangyang Deng, National Institute on Minority Health and Health Disparities, National Institutes of Health
Sana Khan, National Institute on Minority Health and Health Disparities, National Institutes of Health
Mohammad Moniruzzaman, National Institute on Minority Health and Health Disparities, National Institutes of Health
Lu Hu, NYU Grossman School of Medicine
Jonathan H. Cantor, RAND
Ram Jagannathan, Emory University
Tamara Dubowitz, University of Pittsburgh