Citation

Cerdá M, Tracy M, Ahern J, Galea S. Am. J. Public Health 2014; 104(Suppl 4): S609-S619.

Affiliation

Magdalena Cerdá, Melissa Tracy, and Sandro Galea are with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Jennifer Ahern is with the Department of Epidemiology, University of California, Berkeley.

Copyright

(Copyright © 2014, American Public Health Association)

DOI

10.2105/AJPH.2014.302055

PMID

25100428

Abstract

OBJECTIVEs. As a case study of the impact of universal versus targeted interventions on population health and health inequalities, we used simulations to examine (1) whether universal or targeted manipulations of collective efficacy better reduced population-level rates and racial/ethnic inequalities in violent victimization; and (2) whether experiments reduced disparities without addressing fundamental causes.

METHODS. We applied agent-based simulation techniques to the specific example of an intervention on neighborhood collective efficacy to reduce population-level rates and racial/ethnic inequalities in violent victimization. The agent population consisted of 4000 individuals aged 18 years and older with sociodemographic characteristics assigned to match distributions of the adult population in New York City according to the 2000 US Census.

RESULTS. Universal experiments reduced rates of victimization more than targeted experiments. However, neither experiment reduced inequalities. To reduce inequalities, it was necessary to eliminate racial/ethnic residential segregation.

CONCLUSIONS. These simulations support the use of universal intervention but suggest that it is not possible to address inequalities in health without first addressing fundamental causes.

Language: en