Abstract 11417: Association Between Community-Level Violent Crime and Cardiovascular Mortality in Chicago - A Longitudinal Analysis

Introduction: Prior studies suggest an association between neighborhood crime levels and cardiovascular (CV) risk factors and disease but have been limited by cross-sectional designs. We investigated whether longitudinal changes in violent crime are associated with CV mortality at the community level in a large US city - Chicago. Methods: Chicago is divided into 77 community areas. Using the Illinois Department of Public Health Division of Vital Records, we obtained age-adjusted mortality rates by community area for heart disease, stroke, and coronary artery disease deaths from 2000-2014 aggregated at 5-year intervals. Annual violent crime data were obtained from the City of Chicago Police Data Portal and were geocoded to the community area level. Violent crime was defined as assault, battery, criminal sexual assault, robbery, and homicide. Using a two-way fixed effects estimator, a robust longitudinal estimation method that accounts for measured or unmeasured time-invariant confounders, we assessed the association between longitudinal changes in violent crime and CV mortality after accounting for changes in demographic (proportion of racial/ethnic minorities) and economic (household income, unemployment, housing vacancy, education attainment) variables for each community area. Results: Between 2000 and 2014, the median violent crime rate in Chicago decreased from 3620 per 100,000 [IQR 2256, 7777] in the 2000-2004 period to 2390 [IQR 1507, 5745] in the 2010-2014 period (p=0.005 for trend). In the fixed effects model, after accounting for changes in demographic and economic variables, a 1% increase in community-area violent crime was independently associated with a 0.21% (95% CI 0.09, 0.33) increase in heart disease deaths (p=0.0006) and a 0.19% (95% CI 0.04, 0.33) increase in deaths from coronary artery disease (p=0.01). There was no significant association between change in violent crime and stroke deaths [0.17% (95% CI -0.08, 0.42; p=0.017)]. Conclusions: From 2000 to 2014, an increase in violent crime at the community level was associated with an increase in heart disease and coronary artery disease deaths in Chicago. Detecting rises in community-level violent crime may identify areas with worsening CV health independent of other factors.