Police-Recorded Crime and Disparities in Obesity and Blood Pressure Status in Chicago

J Am Heart Assoc. 2018 Mar 24;7(7):e008030. doi: 10.1161/JAHA.117.008030.

Abstract

Background: The purpose of this study was to examine associations between several types of police-recorded crime (violent, nonviolent, and homicide) and cardiometabolic health (obesity and elevated blood pressure [BP]), and to determine if associations were modified by age and sex.

Methods and results: We analyzed cross-sectional data (N=14 799 patients) from 3 primary care clinics at an academic medical center in Chicago, IL. Patient-level health data were obtained from the electronic health record (June 1, 2014-May 31, 2015), including body mass index and BP, and linked to the City of Chicago Police Data Portal. Geocoded crime counts were aggregated to census tract and calculated as the annual crime rate per 1000 population. Generalized linear mixed models were used to assess obesity and BP status as a function of crime rate quartile, controlling for patient, clinic, and neighborhood characteristics. Median violent crime rates in each quartile ranged from 15 to 84 per 1000 population. Median age was 56 years (interquartile range, 38-72 years); 42% of patients were obese and 33% had elevated BP. Compared with patients living in the lowest quartile, patients living in the highest quartile for violent crime had 53% higher adjusted odds of obesity (95% confidence interval, 1.15-2.03) and 25% higher adjusted odds of elevated BP (95% confidence interval, 1.01-1.56). In subanalyses examining homicide, a relatively rare event, exposure was not associated with obesity and was inconsistently associated with elevated BP.

Conclusions: In a densely populated, high-poverty region in Chicago, recurrent exposure to high rates of violent crime was consistently associated with obesity and elevated BP, but rare exposure to homicide was not.

Keywords: epidemiology; high blood pressure; obesity; risk factors; women.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Blood Pressure*
  • Body Mass Index
  • Chicago / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Homicide*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Obesity / physiopathology
  • Poverty
  • Risk Factors
  • Social Determinants of Health
  • Violence*
  • Young Adult