Spatial Association of Area-Level Credit Scores and Firearm Violence: A Novel Measure of Socioeconomic Position for Violence and Injury Research.

Abstract

Scholars use socioeconomic position measures to describe the relationship of social inequities with violence and injury. Area-level credit scores are a novel measure of socioeconomic position that reflect elements of a geographic area's social and economic structure beyond what traditional measures capture. This study assessed the spatial association between area-level credit scores and firearm violence. An ecologic cross-sectional study was performed on 1,324 census block groups in Philadelphia, Pennsylvania. A quasi-Poisson spatial regression analysis was conducted to determine the association between area-level credit scores in 2017 and block group-level firearm violence in 2018. The regression model included several socioeconomic position and structural factors as control variables and eigenvector spatial filtering accounted for residual spatial autocorrelation. Census block groups with subprime area-level credit scores had a firearm violence incidence rate that was more than 4 times higher (incidence rate ratio, 4.74; 95% CI=2.60, 8.96; p<0.001) than that of block groups with prime scores, even after controlling for other social and economic factors. For every 1 standard deviation increase in credit scores, the rate of firearm violence decreased by 63%. There is a significant spatial association between area-level credit scores and firearm violence. This association is notably stronger than other measures of socioeconomic position, including education and poverty. Area-level credit scores are a novel measure of socioeconomic position that can provide critical insights into the socioeconomic environment of a geographic area and could be a valuable target for reparative social and economic policies to reduce violence and injury.