Spatial Association of Area-Level Credit Scores and Firearm Violence: A Novel Measure of Socioeconomic Position for Violence and Injury Research

Introduction: Scholars use socioeconomic position measures to describe the relationship of social inequities with violence and injury. Area-level credit scores are a novel measure of socioeconomic position that reflect elements of a geographic area's social and economic structure beyond what traditional measures capture. This study assessed the spatial association between area-level credit scores and firearm violence. Methods: An ecologic cross-sectional study was performed on 1,324 census block groups in Philadelphia, Pennsylvania. A quasi-Poisson spatial regression analysis was conducted to determine the association between area-level credit scores in 2017 and block group-level firearm violence in 2018. The regression model included several socioeconomic position and structural factors as control variables and eigenvector spatial filtering accounted for residual spatial autocorrelation. Results: Census block groups with subprime area-level credit scores had a firearm violence incidence rate that was more than 4 times higher (incidence rate ratio, 4.74; 95% CI=2.60, 8.96; p<0.001) than that of block groups with prime scores, even after controlling for other social and economic factors. For every 1 standard deviation increase in credit scores, the rate of firearm violence decreased by 63%. Conclusions: There is a significant spatial association between area-level credit scores and firearm violence. This association is notably stronger than other measures of socioeconomic position, including education and poverty. Area-level credit scores are a novel measure of socioeconomic position that can provide critical insights into the socioeconomic environment of a geographic area and could be a valuable target for reparative social and economic policies to reduce violence and injury.