Broken windows: A simple indicator of neighborhood health

BACKGROUND: Signs of neighborhood deterioration have been associated with a variety of health and social outcomes, independent of poverty. We examine associations between the presence of broken windows and the rate of recruitment in a pilot for the National Children's Study (NCS). The NCS will follow 100,000 prenatally-recruited children until age 21 to examine the effects of environment on health. Current data stem from a recruitment pilot addressing one urban Primary Sampling Unit (PSU) from a multistage national probability sample. Eligible women reside in randomly selected segments of the PSU and are pregnant or trying to conceive. 



METHODS: The presence of broken windows was noted for each household (HH) during listing for each of the segments within the PSU. We then enumerated and recruited door-to-door, using community engagement and media messaging as enhancements to recruitment. Analyses used descriptive statistics and Spearman's correlation to compare the proportion of HHs with broken windows to the number recruited per segment.

RESULTS: We listed 13,850 dwellings, contacted approximately 95% of HHs and enumerated 28.5%. By January 2012, we identified 200 eligible women and consented 150 (64.7%). The proportion of HHs with broken windows was not correlated with the number recruited per segment, but was significantly correlated with vacancy rates (r=0.84; p<0.001), HH income (r=-0.85; p<0.001), and unemployment (r=0.93; p<0.001).

CONCLUSIONS: Although unrelated to recruitment rate, this yes/no measure was associated with social disorder and neighborhood deterioration variables. Simple and practical, it provides an alternative to neighborhood condition scales for community assessment and research.