Characterizing the spatial mismatch between intimate partner violence related healthcare services and arrests in Miami-Dade County, Florida

Research output: Contribution to journalArticle

Abstract

Background: Routine screening and intervention for intimate partner violence (IPV) in healthcare settings constitutes an important secondary prevention strategy for identifying individuals experiencing IPV early and connecting them with appropriate services. Considerable variation in available IPV-related healthcare services exists and interventions are needed to improve the quality of these services. One way to prioritize intervention efforts is by examining the level of services provided in communities most at risk relative to local incidence or prevalence of IPV. To inform future interventions, this study examined the spatial relationship between IPV-related healthcare services and IPV arrests in Miami-Dade County, Florida, and identified predictors of the observed spatial mismatch. Methods: Survey data collected in 2014 from 278 health facilities pertaining to IPV services were geocoded, computed into a density layer, and aggregated at the census tract level to create a population-based normalized comprehensiveness score (NCS) as a proxy for IPV-related healthcare resources. IPV arrests from 2011 to 2015, collected from the county court, were geocoded and summarized by census tracts to serve as a proxy for IPV prevalence. These measures were combined into a resource disparity score (RDS) that compared relative service density to relative arrest rates, where positive RDS represented over-resourced neighborhoods and negative RDS corresponded to under-resourced neighborhoods. We used correlation analyses and a two-phase spatial modeling approach to evaluate correlates of NCS and RDS. Results: A spatial lag model did not yield an association between NCS and IPV arrests, demonstrating a spatial mismatch, which we visualized using a Geographic Information System (GIS). A spatial error model revealed that the percentage of white non-Hispanic residents was positively associated with RDS, while percent black non-Hispanic, median age, ethnic heterogeneity, and economic disadvantage were negatively associated with RDS. Conclusions: These findings underscore the need to further evaluate the adequacy of IPV-related healthcare resources for secondary prevention relative to local IPV arrest rates, particularly within economically disadvantaged neighborhoods. Our approach demonstrates the utility of GIS for identifying potential priority regions for IPV prevention efforts and resource allocation.

Original languageEnglish (US)
Article number1085
JournalBMC Public Health
Volume18
Issue number1
DOIs
StatePublished - Aug 31 2018

Fingerprint

Delivery of Health Care
Geographic Mapping
Geographic Information Systems
Proxy
Censuses
Secondary Prevention
Intimate Partner Violence
Specific Gravity
Resource Allocation
Health Facilities
Vulnerable Populations
Economics
Incidence

Keywords

  • Domestic violence
  • Geographic information systems
  • Health services accessibility
  • Healthcare disparities

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Characterizing the spatial mismatch between intimate partner violence related healthcare services and arrests in Miami-Dade County, Florida",
abstract = "Background: Routine screening and intervention for intimate partner violence (IPV) in healthcare settings constitutes an important secondary prevention strategy for identifying individuals experiencing IPV early and connecting them with appropriate services. Considerable variation in available IPV-related healthcare services exists and interventions are needed to improve the quality of these services. One way to prioritize intervention efforts is by examining the level of services provided in communities most at risk relative to local incidence or prevalence of IPV. To inform future interventions, this study examined the spatial relationship between IPV-related healthcare services and IPV arrests in Miami-Dade County, Florida, and identified predictors of the observed spatial mismatch. Methods: Survey data collected in 2014 from 278 health facilities pertaining to IPV services were geocoded, computed into a density layer, and aggregated at the census tract level to create a population-based normalized comprehensiveness score (NCS) as a proxy for IPV-related healthcare resources. IPV arrests from 2011 to 2015, collected from the county court, were geocoded and summarized by census tracts to serve as a proxy for IPV prevalence. These measures were combined into a resource disparity score (RDS) that compared relative service density to relative arrest rates, where positive RDS represented over-resourced neighborhoods and negative RDS corresponded to under-resourced neighborhoods. We used correlation analyses and a two-phase spatial modeling approach to evaluate correlates of NCS and RDS. Results: A spatial lag model did not yield an association between NCS and IPV arrests, demonstrating a spatial mismatch, which we visualized using a Geographic Information System (GIS). A spatial error model revealed that the percentage of white non-Hispanic residents was positively associated with RDS, while percent black non-Hispanic, median age, ethnic heterogeneity, and economic disadvantage were negatively associated with RDS. Conclusions: These findings underscore the need to further evaluate the adequacy of IPV-related healthcare resources for secondary prevention relative to local IPV arrest rates, particularly within economically disadvantaged neighborhoods. Our approach demonstrates the utility of GIS for identifying potential priority regions for IPV prevention efforts and resource allocation.",
keywords = "Domestic violence, Geographic information systems, Health services accessibility, Healthcare disparities",
author = "Jessica Williams and Nicholas Petersen and Stoler, {Justin B}",
year = "2018",
month = "8",
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doi = "10.1186/s12889-018-5985-5",
language = "English (US)",
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journal = "BMC Public Health",
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T1 - Characterizing the spatial mismatch between intimate partner violence related healthcare services and arrests in Miami-Dade County, Florida

AU - Williams, Jessica

AU - Petersen, Nicholas

AU - Stoler, Justin B

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N2 - Background: Routine screening and intervention for intimate partner violence (IPV) in healthcare settings constitutes an important secondary prevention strategy for identifying individuals experiencing IPV early and connecting them with appropriate services. Considerable variation in available IPV-related healthcare services exists and interventions are needed to improve the quality of these services. One way to prioritize intervention efforts is by examining the level of services provided in communities most at risk relative to local incidence or prevalence of IPV. To inform future interventions, this study examined the spatial relationship between IPV-related healthcare services and IPV arrests in Miami-Dade County, Florida, and identified predictors of the observed spatial mismatch. Methods: Survey data collected in 2014 from 278 health facilities pertaining to IPV services were geocoded, computed into a density layer, and aggregated at the census tract level to create a population-based normalized comprehensiveness score (NCS) as a proxy for IPV-related healthcare resources. IPV arrests from 2011 to 2015, collected from the county court, were geocoded and summarized by census tracts to serve as a proxy for IPV prevalence. These measures were combined into a resource disparity score (RDS) that compared relative service density to relative arrest rates, where positive RDS represented over-resourced neighborhoods and negative RDS corresponded to under-resourced neighborhoods. We used correlation analyses and a two-phase spatial modeling approach to evaluate correlates of NCS and RDS. Results: A spatial lag model did not yield an association between NCS and IPV arrests, demonstrating a spatial mismatch, which we visualized using a Geographic Information System (GIS). A spatial error model revealed that the percentage of white non-Hispanic residents was positively associated with RDS, while percent black non-Hispanic, median age, ethnic heterogeneity, and economic disadvantage were negatively associated with RDS. Conclusions: These findings underscore the need to further evaluate the adequacy of IPV-related healthcare resources for secondary prevention relative to local IPV arrest rates, particularly within economically disadvantaged neighborhoods. Our approach demonstrates the utility of GIS for identifying potential priority regions for IPV prevention efforts and resource allocation.

AB - Background: Routine screening and intervention for intimate partner violence (IPV) in healthcare settings constitutes an important secondary prevention strategy for identifying individuals experiencing IPV early and connecting them with appropriate services. Considerable variation in available IPV-related healthcare services exists and interventions are needed to improve the quality of these services. One way to prioritize intervention efforts is by examining the level of services provided in communities most at risk relative to local incidence or prevalence of IPV. To inform future interventions, this study examined the spatial relationship between IPV-related healthcare services and IPV arrests in Miami-Dade County, Florida, and identified predictors of the observed spatial mismatch. Methods: Survey data collected in 2014 from 278 health facilities pertaining to IPV services were geocoded, computed into a density layer, and aggregated at the census tract level to create a population-based normalized comprehensiveness score (NCS) as a proxy for IPV-related healthcare resources. IPV arrests from 2011 to 2015, collected from the county court, were geocoded and summarized by census tracts to serve as a proxy for IPV prevalence. These measures were combined into a resource disparity score (RDS) that compared relative service density to relative arrest rates, where positive RDS represented over-resourced neighborhoods and negative RDS corresponded to under-resourced neighborhoods. We used correlation analyses and a two-phase spatial modeling approach to evaluate correlates of NCS and RDS. Results: A spatial lag model did not yield an association between NCS and IPV arrests, demonstrating a spatial mismatch, which we visualized using a Geographic Information System (GIS). A spatial error model revealed that the percentage of white non-Hispanic residents was positively associated with RDS, while percent black non-Hispanic, median age, ethnic heterogeneity, and economic disadvantage were negatively associated with RDS. Conclusions: These findings underscore the need to further evaluate the adequacy of IPV-related healthcare resources for secondary prevention relative to local IPV arrest rates, particularly within economically disadvantaged neighborhoods. Our approach demonstrates the utility of GIS for identifying potential priority regions for IPV prevention efforts and resource allocation.

KW - Domestic violence

KW - Geographic information systems

KW - Health services accessibility

KW - Healthcare disparities

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