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Public health
Research
Association between district-level perceived safety and self-rated health: a multilevel study in Seoul, South Korea
  1. Seung-Sup Kim1,2,3,4,
  2. Jaesung Choi5,
  3. Kisoo Park4,
  4. Yeonseung Chung6,
  5. Sangjo Park7,
  6. Jongho Heo8
  1. 1Department of Public Health Sciences, Korea University, Seoul, Republic of Korea
  2. 2Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
  3. 3Department of Environmental and Occupational Health, The George Washington University School of Public Health and Health Services, Washington DC, USA
  4. 4Department of Healthcare Management, Korea University, Seoul, Republic of Korea
  5. 5Department of Economics, Sungkyunkwan University, Seoul, Republic of Korea
  6. 6Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
  7. 7Department of Communication, Seoul National University, Seoul, Republic of Korea
  8. 8Public Health Joint Doctoral Program, San Diego State University & University of California, San Diego, California, USA
  1. Correspondence to Jongho Heo; joheo{at}ucsd.edu

Abstract

Objectives Several studies have reported the relationship between residents’ perceived neighbourhood safety and their health outcomes. However, those studies suffered from unreliability of neighbourhood safety measure and potential residual confounding related to crime rates. In this study, using multilevel analysis to account for the hierarchical structure of the data, we examined associations between district-level perceived safety and self-rated health after adjusting for potential confounders including the district-level crime rate.

Design Cross-sectional study.

Setting We used the first wave of Seoul Welfare Panel Study, which has 7761 individuals from 3665 households in 25 administrative districts in Seoul, South Korea. District-level perceived safety was obtained by aggregating responses from the residents that are representative samples for each administrative district in Seoul. To examine an association between district-level safety and residents’ self-rated health, we used mixed effect logistic regression.

Results Our results showed that higher district-level perceived safety, an aggregated measure of district residents’ responses towards neighbourhood safety, was significantly associated with poor self-rated health after controlling for sex, age, education level, job status, marital status and household income (OR=0.87, 95% CI 0.78 to 0.97). Furthermore, this association was still robust when we additionally adjusted for the district-level crime rate (OR=0.86, 95% CI 0.77 to 0.95).

Conclusions Our study highlights the importance of improving neighbourhood perceived safety to enhance residents’ health.

  • Perceived Neighborhood Safety
  • Self-Rated Health
  • Neighborhood Crime Rate
  • Seoul Welfare Panel Study
  • Multilevel Analysis

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bmjopen-2013-004695

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