title: Association between district-level perceived safety and self-rated health: a multilevel study in Seoul, South Korea.
abstract: OBJECTIVE
  Several studies have reported the relationship between residents' perceived neighbourhood safety and their health outcomes. However, those studies suffered from unreliability of neighbourhood safety measure and potential residual confounding related to crime rates. In this study, using multilevel analysis to account for the hierarchical structure of the data, we examined associations between district-level perceived safety and self-rated health after adjusting for potential confounders including the district-level crime rate.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  We used the first wave of Seoul Welfare Panel Study, which has 7761 individuals from 3665 households in 25 administrative districts in Seoul, South Korea. District-level perceived safety was obtained by aggregating responses from the residents that are representative samples for each administrative district in Seoul. To examine an association between district-level safety and residents' self-rated health, we used mixed effect logistic regression.
  
  
  RESULTS
  Our results showed that higher district-level perceived safety, an aggregated measure of district residents' responses towards neighbourhood safety, was significantly associated with poor self-rated health after controlling for sex, age, education level, job status, marital status and household income (OR=0.87, 95% CI 0.78 to 0.97). Furthermore, this association was still robust when we additionally adjusted for the district-level crime rate (OR=0.86, 95% CI 0.77 to 0.95).
  
  
  CONCLUSIONS
  Our study highlights the importance of improving neighbourhood perceived safety to enhance residents' health.
authors: Department of Public Health Sciences, Korea University, Seoul, Republic of Korea Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA Department of Environmental and Occupational Health, The George Washington University School of Public Health and Health Services, Washington DC, USA Department of Healthcare Management, Korea University, Seoul, Republic of Korea.
authors: Seung-Sup
authors: SS
authors: Kim
authors: Department of Economics, Sungkyunkwan University, Seoul, Republic of Korea.
authors: Jaesung
authors: J
authors: Choi
authors: Department of Healthcare Management, Korea University, Seoul, Republic of Korea.
authors: Kisoo
authors: K
authors: Park
authors: Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.
authors: Yeonseung
authors: Y
authors: Chung
authors: Department of Communication, Seoul National University, Seoul, Republic of Korea.
authors: Sangjo
authors: S
authors: Park
authors: Public Health Joint Doctoral Program, San Diego State University & University of California, San Diego, California, USA.
authors: Jongho
authors: J
authors: Heo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003415:Crime / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012449:Safety; D066106:Seoul; D055815:Young Adult
keywords: Multilevel Analysis; Neighborhood Crime Rate; Perceived Neighborhood Safety; Self-Rated Health; Seoul Welfare Panel Study