Associations Between the Social Determinants of Health and Risk of Interpersonal Violence Among Black Americans in Rural Alabama

Abstract

Prior research has linked the social determinants of health, such as food insecurity and housing instability, to experiences of interpersonal violence. However, little is known about how the social determinants of health are related to the risk for interpersonal violence among Black Americans living in rural, high-poverty communities in the Deep South. The intersection of rurality, racialized identity, and economic hardship makes this population particularly vulnerable to interpersonal violence, yet this population is underrepresented in the literature. This study examines the association between several social determinants of health (food insecurity, housing instability, transportation problems, social support, and health literacy) and odds of interpersonal violence while controlling for demographic factors and mental and physical health status. Data were obtained from a sample of 182 individuals (98% Black Americans) from two rural sites in Alabama. Logistic regression was used to model the relationship between the social determinants of health and current experiences of interpersonal violence. Moderate-to-severe depression (OR = 2.70, p < .05) and being married or partnered (OR = 2.96, p < .05) were associated with higher odds of interpersonal violence. Higher levels of social support were associated with lower odds of interpersonal violence (OR = 0.87, p < .01). Findings suggest that violence prevention efforts should be tailored to the local cultural context and include efforts to reduce social isolation and address symptoms of depression.