Communities across the country are being heavily impacted by rising levels of violence, particularly among youth and young adults. In recent years, local health departments have been playing a larger role in addressing violence using the public health model. Recently, in Cleveland, Ohio, the Cleveland Department of Public Health took a closer look at youth violence data at a more granular level, by neighborhood and political ward. Epidemiologist Vinothini Sundaram, MPH presented the results in a poster presentation for the 2016 Council of State and Territorial Epidemiologists Annual Conference in Anchorage, Alaska. The poster was selected as a Poster Award Finalist in the Environmental Health / Occupational Health / Injury Steering Committee.
The neighborhood of Goodrich-Kirtland had the highest rates of the following youth violence indicators: delinquency offenses (555.96), violent offenses (280.1), assaults (118.83), domestic violence (106.1), and sexual assaults (16.98). The St. Clair-Superior neighborhood had the highest rate of weapon law violations (12.07). The Goodrich-Kirtland and St. Clair-Superior neighborhoods are adjacent to each other. Political Ward 7 had the highest rates of the delinquency offenses (158.23), violent offenses (79.4), assaults (31.53), domestic violence assaults (21.4), and sexual assaults (6.19). Political Ward 1 had the highest rate of weapon law violations (4.67). Part of the Goodrich-Kirtland neighborhood is within the political Ward 7. However, the St. Clair-Superior neighborhood and political Ward 1 are located on opposite sides of the city.
Along with examining the violence data, it was important to start examining the state of youth in those neighborhoods most impacted by violence. Two factors of particular interest were poverty and lead poisoning. In the Kirtland-Goodrich Park neighborhood 16.63% of the neighborhood population is age 0-17 (n=644). 519 children between ages 0-17 were living below the poverty line, making the child poverty rate in this neighborhood 80.59. The child poverty rate for the state of Ohio is only 22.9.
In the St. Clair-Superior neighborhood, 25.59% of the neighborhood population is age 0-17 (n=1690). 860 children between ages 0-17 were living below the poverty line, making the child poverty rate in this neighborhood 51.44, higher than the rate for the state.
There is a great deal of research illustrating the link between lead exposure in early childhood and delinquent behavior in adolescence. Lead levels as low as 5 μg/dL have been shown to harm a child’s ability to reason and be successful in school. In November of 2014, the state of Ohio adopted 5 μg/dL as the new threshold for elevated blood lead levels in children. In 2014, there were 303 children under the age of 6 that were tested for lead in Kirtland-Goodrich Park; 12.5% of the tests were greater than or equal to 5 μg/dL. St. Clair-Superior had 256 children under the age of 6 that were tested for lead; 23.4% of the tests were greater than or equal to 5 μg/dL.
The City of Cleveland is a participating agency of the National Forum on Youth Violence and received funding to create a comprehensive plan to address youth violence in Cleveland. The Cleveland Collaborative on Youth Violence Prevention (CCYVP), also known as the Cleveland Plan, has four main goals; one of these goals is to use a public health model to support a data-driven, community-based violence intervention strategy. The findings from this research will be used to support a public health model, and provide guidance on where to prioritize efforts in the city. These findings will also be shared with Healthy Cleveland, an initiative of Mayor Frank Jackson, to address the health and well-being of Cleveland citizens. Through the Healthy Cleveland Initiative, the findings will be further disseminated to the general public and community stakeholders.
Vinothini Sundaram, MPH is epidemiologist in the Office of Communicable Disease Surveillance & Epidemiology at the Cleveland Department of Public Health. For more information on related issues, please join subcommittees under the Environmental Health / Occupational Health / Injury Steering Committee.