Death by Neighborhood: Preliminary Results on Disparities in Violent Deaths by Neighborhood Opportunity With the Child Opportunity Index 3.0.

Introduction: This study examines inequities in violent death rates among children aged 0-19 years across different levels of neighborhood opportunity. Methods: The authors combined nationally representative 2020 data from the National Violent Death Reporting System, the Decennial Census, and the Child Opportunity Index 3.0 to estimate death rates by neighborhood opportunity. Results: The crude violent death rate declines monotonically with neighborhood opportunity from 15.3 deaths per 100,000 children in very low-opportunity to 3.8 per 100,000 children in very high-opportunity neighborhoods. Homicide death rates are 13.3 times higher in very low- (10.5 deaths per 100,000 children) than in very high-opportunity (0.8 deaths per 100,000 children) neighborhoods. There were 3.3 suicide deaths per 100,000 children in very low- compared with 2.7 deaths per 100,000 children in very high-opportunity neighborhoods. Conclusions: The findings highlight the Child Opportunity Index's value in analyzing stark geographic disparities in children's violent death risk. They underscore neighborhood context as a key risk factor and suggest that place-based interventions could help mitigate these disparities. However, neighborhood differences in suicide mortality were minor, warranting further research on the suitability of neighborhood indices for predicting spatial variations in suicide risk.