The ecology of unhealthy places: Violence, birthweight, and the importance of territoriality in structurally disadvantaged communities

The present study tested the relationships between macro-level violence and birthweight in structurally disadvantaged communities in the District of Columbia. The study hypothesized that both rates of violence and violence “uncertainty” (the latter was operationalized as within-census tract residual change scores in violence), should be inversely associated with birthweight among all live singleton births in DC from 2000 to 2002. Using mixed models, the study found that (1) patterns of violence and violence uncertainty were significantly associated with birthweight among mothers residing in structurally disadvantaged communities, and (2) these findings held for Black and Hispanic, but not white, mothers. The study argues that urban ecological researchers should begin to consider not just how rates (or levels) of violence influence health and other social outcomes in communities, but also the effects of violence uncertainty as a source of unpredictable risk and territorial disruption.

► Proposes new method for measuring and conceptualizing neighborhood violence as a determinant of health in USA.
► Conducts racially/ethnically disaggregated analyses of how violence and disadvantage influence birthweight.
► Identifies the importance of “predictable” local environments in studies of birthweight.
► Highlights the amplification effects of violence and violence “uncertainty” on birthweight in structurally disadvantaged communities.
► Demonstrates the protective effects (on birthweight) of residing in “ethnic enclaves” for Black and Latino mothers.