Racialized Economic Segregation, the Built Environment, and Assault-Related Injury: Moderating Role of Green Space and Vacant Housing

Authors

• LA Marineau
• KK Jones
• AK Small
• M Sona
• E Liedtke
• SN Zenk

Abstract

We examined the moderating role of green space and vacant housing in the association between racialized economic segregation and assault-related injuries (ARI) in metropolitan ZIP codes spanning five U.S. states (Arizona, Florida, Georgia, North Carolina, New York). Cross-sectional data on ARIs from the 2016-2019 HCUP State Emergency Department and State Inpatient Databases were linked with the American Community Survey, National Land Cover Database, and park data. Racialized economic segregation was operationalized using Index of Concentration at the Extremes (ICE) for household income by race. ARIs among people 15-50 years were aggregated at the ZIP level. Negative binomial regression was used to calculate incident rate ratios (IRR) to estimate associations between segregation and ARIs. Interaction terms between segregation and each moderator (proportion park area, developed open space, vacant housing) were included in separate models, adjusting for state and population demographics. For each one unit increase in standard deviation of segregation ICE scores (increase in advantage), ARIs decreased by 36%. Proportion of vacant housing (segregation x vacant housing aIRR 0.94, 95% CI 0.91, 0.98) and developed open space (segregation x open space aIRR 0.98, 95% CI 0.96, 0.99) moderated the relationship between segregation and ARIs. Park space was not a moderator. Spaces with the least economic and social resources had higher ARI rates than those with more economic and social resources. Higher levels of vacant housing and developed open space, compared to lower levels, disproportionately impacted ARI rates in the most disadvantaged areas yet had little effect in the most advantaged areas.

Scientific Focus Area: Health Disparities

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