title: The association between county-level injury rates and racial segregation revisited: a multilevel analysis.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Center for Injury Research and Control, University of Pittsburgh, Pittsburgh, PA 15261, USA. fabioa@upmc.edu
authors.forename: Anthony
authors.initials: A
authors.lastname: Fabio
authors.forename: Erin K
authors.initials: EK
authors.lastname: Sauber-Schatz
authors.forename: Kamil E
authors.initials: KE
authors.lastname: Barbour
authors.forename: Wei
authors.initials: W
authors.lastname: Li
mesh_terms: 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