The association between county-level injury rates and racial segregation revisited: a multilevel analysis.
OBJECTIVE
We investigated whether within-county racial segregation was associated with increased odds of violent injury beyond individual risk.


METHODS
In a cross-sectional study, data on 75 310 patients admitted with an injury to Pennsylvania hospitals from 1997 to 1999 were analyzed to determine the association between county-level racial segregation and violent injury. We used multilevel analysis to adjust for individual- and county-level factors. Principal components analysis allowed us to separate the effect of segregation from other county-level variables.


RESULTS
After adjustment, greater segregation was associated with increased odds of violent injury among Whites (odds ratio [OR] = 1.20; 95% confidence interval [CI] = 1.11, 1.30) and non-Whites (OR = 1.45; 95% CI = 1.28, 1.64). The association was stronger for non-Whites.


CONCLUSIONS
Our results suggested that living in a county with high levels of racial segregation was associated with increased odds of violence not explained by an individual's own risk. These findings represent an important step in understanding the nature of observed links between race and violence. Future work should develop prevention strategies that simultaneously target community and individual risks.
Fabio
Anthony
A
Department of Neurosurgery, Center for Injury Research and Control, University of Pittsburgh, Pittsburgh, PA 15261, USA. fabioa@upmc.edu
Sauber-Schatz
Erin K
EK
Barbour
Kamil E
KE
Li
Wei
W
D000293:Adolescent; D000328:Adult; D019352:Censuses; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011287:Prejudice; D025341:Principal Component Analysis; D011822:Race Relations; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014754:Violence / Q000208:ethnology*; D014947:Wounds and Injuries / Q000208:ethnology*; D055815:Young Adult