Different concepts of neighborhood safety and child internalizing and externalizing behaviors

Neighborhood safety is defined inconsistently across epidemiologic studies-a conceptual problem that results in incomparable measurements, hampering the design of health interventions. Using child behavior problems (measured via the Child Behavior Checklist) as the outcome of interest, this study directly compared 4 measures of neighborhood safety: 2 of experienced safety and 2 of perceived safety, with each one measured at family and community levels. These included children's direct experience of harm, parental perceptions, community crime statistics, and community perceptions. In a sample of 3291 10-year-olds from the Generation R cohort (living in municipal Rotterdam, Netherlands, 2013), all 4 measures were correlated (chi(2) >= 9.2, P < .002 in pairwise chi(2) comparisons) but ultimately identified different levels of risk for behavioral health. Direct experiences of harm, parental perceptions, and community crime statistics were all associated with increased child internalizing behaviors (beta = 3.12, beta = 2.10, and beta = 1.77, respectively), while only experiences of harm and parental perceptions were associated with increased externalizing behaviors (beta = 2.75 and beta = 1.31, respectively). These results provide novel evidence that the conceptual distinctions underlying different measures of neighborhood safety are meaningful for child mental health and should be considered in intervention design.