Objectives We investigated associations of officially recorded crime and perceived neighbourhood safety with physical health, evaluating potential effect modification by gender.

Setting Nationally representative population-based survey in New Zealand.

Participants Individual-level data from 6995 New Zealand General Social Survey (2010–2011) participants with complete data on physical health status, perceived neighbourhood safety, sociodemographic characteristics and smoking. Crime rate for each participant's home census was estimated based on data from the New Zealand Police (2008–2010).

Primary outcome measure The Transformed Physical Composite Score from the SF-12, a physical health summary score based on self-report ranging from 0 to 100.

Results We used cluster robust multivariable regression models to examine the associations among neighbourhood crime rates, perceived neighbourhood safety and the physical health summary score. Crime rates predicted adults’ perception that it was unsafe to walk in their neighbourhood at night: for each additional crime per 100 000 residents adults were 1.9% more likely to perceive their neighbourhood as unsafe (95% CI 1.2% to 2.5%). While relatively uncommon, the rate of crime with a weapon strongly predicted perceived safety: for each additional crime per 100 000 residents in this category, adults were 12.9% more likely to report the neighbourhood as unsafe (95% CI 8.8% to 17.0%). Police-recorded violent and night crime rates were associated with worse physical health among women: for each additional crime per 100 000 residents in these category women had a 0.3 point lower physical health score (95% CIs −0.6 to −0.1 for violent crime and −0.5 to −0.1 for crime at night, gender interaction p values 0.08 and 0.01, respectively). Perceiving the neighbourhood as unsafe was independently associated with 1.0 point lower physical health score (95% CI −1.5 to −0.5).

Conclusions Gender may modify the associations of officially recorded crime rates with physical health. Perceived neighbourhood safety was independently associated with physical health.