Abstract:

This article examines the fact that there is a strong association exists between gonorrhea rates and a “broken windows” index that measures housing quality, levels of graffiti, trash, public school deterioration, and the presence of abandoned cars. Specifically, they note that in high-poverty neighborhoods, gonorrhea rates for block groups with high broken windows scores were significantly higher than the rates for block groups with low broken windows scores. In seeking to explain the meaning of this association, the authors offer a number of hypotheses. The first, an individual-level explanation, is that people who are most likely to engage in high-risk sexual behavior or reduced health care–seeking behavior are also likely to contribute to neighborhood deterioration. The second, a structural-level explanation, is that a deteriorating neighborhood itself contributes to these behaviors. The third hypothesis, which is a combination of the first two, is that there is a dynamic relationship between environmental conditions and health behaviour.