Schizophrenia and offending: area of residence and the impact of social disorganisation and urbanicity

Frank Morgan, Vera Morgan, Joe Clare, Giulietta Valuri, Richard Woodman, Assen Jablensky Report to the Criminology Research Council Grant: CRC 30/04-05

March 2007

This is a project supported by a grant from the Criminology Research Council. The views expressed are the responsibility of the author and are not necessarily those of the Council.

 INTRODUCTION Schizophreniaisthemostcommonofthepsychoticdisordersandischaracterisedby fundamentaldistortionsofthought(delusions),perception(hallucinations)andemotional response.Itisadisablingillness,withalifetimepopulationprevalenceof0.5%to1.7% (Jablenskyetal1992).Theestimatedonemonthtreatedprevalenceofpsychoticillnessin Australiais4.7per1000estimatedresidentpopulationaged1864(Jablenskyetal2000).This figuredoesnotincludethosepersonsnotincontactwithtreatmentservices.Theplaceinsociety andthecareofpeoplewithseverementalillnesssuchasschizophreniaconstitutesoneofthe thorniestissuesinpublichealthandsocialpolicyworldwide.Inrecentyears,advancesinthe managementofthisdisorderhavemadeitpossibleforanincreasingnumberofindividualswith schizophreniatoleadsemidependentorindependentlivesinthecommunity.However, irrespectiveofthedeinstitutionalisationofmentalhealthcareandtheconcomitantfocusonthe humanrightsofthementallyill,thecapacityofcommunitiesandofsocietyatlargetodealwith emergingproblemsofcriminalisationofmentalillnessandofmarginalisation,homelessness, povertyandvictimisationhasbeenputtoaseveretest.Thishasbeencompoundedby widespreadstereotypingandstigmatisationofindividualswithmentalillness.The1996General SocialSurvey(US)revealedanunderlyingnegativeattitudetopersonswithmentalhealth problems,anexaggerationoftheimpairmentsorthreatassociatedwiththesedisorders,anda startlingnegativitytowardsindividualswithsubstancedependenceproblems(Pescosolidoetal 1999). Informationontheprevalenceofpolicecontactforindividualsdiagnosedwithschizophreniaand otherpsychiatricdisordersisofvitalimportanceforpublicpolicy.Resourcesareavailablein courtsandcorrectionstoidentifyandprovideservicesforindividualswithmentalhealth problems.However,theadequacyofservicelevelsandtheirgeographicspreadisunknown. Furthermore,thereisaneedtoidentifytrendsinthedemandforservicesovertime.Moreover, offendersdonotformahomogenousgroupandratesofoffendingvarywithindifferentgroups andacrossdifferentareas(Silver2000).Inparticular,littleisknowninAustraliaaboutthesocial ecologyofoffendingbypersonswithschizophrenia,includingtheimpactofneighbourhoodon ratesandpatternsofoffending.Theseissuesareincreasinglyimportantinthecontextof deinstitutionalisation,withsomearguingthatinadequatesupportforpersonswithamental illnesshasledtothecriminalisationofmentalillness(Coidetal1993).Otherfindingssuggest thatpersonswithamentalillnessareparticularlyvulnerabletodetectionandarrestwhenthey dobreakthelaw(Robertson1988).However,whilefactorsrelatedtolocalityofresidencemay affecttimelyaccesstoappropriateservices,Silver(2000)arguesthatthelevelofsocial disorganisationwithinaneighbourhoodexertsasignificantindependenteffectthatisnot mediatedbytheavailabilityofsocialsupport. ApioneeringstudyofareaeffectsinChicago(Faris&Dunham1939)foundhighratesof schizophreniaininnercityareasandproposedthatadeficiencyinsocialintegrationcombined withindividualcharacteristicstoproducetheseobservedratesinsociallydisorganisedareas. Sincethentherehasbeenanexpectationthatneedsforservicesareconnectedwith neighbourhoodcharacteristics(Goldsmithetal1998)andarecentstudyonschizophrenia,

 neighbourhoodandcrime(Lgdbergetal2004)foundthattheprevalenceofschizophrenia covariedwithindicesofsocialdisorganization.Nevertheless,therelativeimportanceof individualandareabasedfactorsinthedeterminationofneedshasbeenquestioned.Recently, severalstudieshaveusedmultilevelmodelingtoexaminethejointimpactofindividualsocio demographicfactorsandareacharacteristicstoaddressthisissue.Thesestudieshavegenerally shownthatareacharacteristicsremainsignificantpredictorsofschizophreniaprevalence,even thoughtheyareattenuatedwhenarangeofindividualandhouseholdfactorsareincludedinthe predictivemodels(Goldsmithetal1998,Silveretal2002,VanOsetal2000). Researchintothedistributionofcrimeacrossareashasanevenlongerhistory(Quetelet 1842,1996)andsocialdisorganisationtheoryhasmadeanimportantcontributiontoour understandingofthewaysinwhichneighbourhoodsinfluencecrimerates(Shaw&McKay1942). Socialdisorganisationhasbeendefinedastheinabilityofacommunitystructuretorealisethe commonvaluesofitsresidentsandmaintainsocialcontrols.Itsstructuralcorrelatesinclude disadvantage,socialmobilityandethnicheterogeneitywhicharehypothesisedtodestabilise neighbourhoodcohesion,trustandcommunication.Aftersufferingaperiodofdisinterest,social disorganisationtheoryhasreemergedstronglyincriminologyoverthepast20years(Bursik& Grasmick1993,Sampson2000,Sampsonetal1999,Sampsonetal1997).Thenewtheoristsof socialdisorganization,whileretainingcontinuitieswithShawandMcKay,emphasizetheneedfor directmeasuresofsocialdisorganisation,notsimplytheirstructuralantecedents.Inparticular RobertSampsonhasdevelopedtheconceptofcollectiveefficacy,acharacteristicof neighbourhoods,thatlinksmutualtrustbetweenresidentsandawillingnesstointerveneforthe commongood(Sampson2000).Thisconstructishypothesisedtomediatetheeffectsof neighbourhoodsocialstructure. Howeverthereislittledataonwhethersocialdisorganisationandotherneighbourhoodfactors haveadifferentialimpactonoffendingbypersonswithschizophreniacomparedtothose withoutamentalillness.Inoneofthemostambitiousstudiesoftheassociationbetween violenceandmentalillnesstodate,theMacArthurStudy,(Steadmanetal1998)foundthatthe prevalenceofviolencecommittedbypatientsandnonpatientslivinginthesame neighbourhoodswassimilarintheabsenceofsubstanceabuse.Furthermoreanimportant paper(Silver2000),usingdatafromtheMacArthurStudy,appliedsocialdisorganisationtheory totheoffendingofpsychiatricpatientsandfoundthatkeyneighbourhoodcharacteristics (specificallyneighbourhooddisadvantageandmobility)predictedviolenceafterhospitalrelease, evenwhenindividuallevelfactorsweretakenintoaccount. AIMS Theaimsofthisstudyweretoidentifytheinfluenceofareaofresidenceontheidentificationof mentalillnessandoffending.Areaofresidencehasbeencharacterisedaccordingtothreemain categoriesdisadvantage,socialdisorganisation,andurbanicity.Specificquestionsinclude: Whatistheprevalenceofschizophreniaandarrestindifferenttypesofarea? Doesareaofresidenceinfluencethejointprevalenceofarrestandschizophrenia? Doesareaofresidenceinfluencethesequenceofcontactforindividualswithboth recordedarrestsandschizophrenia?

 METHODS Thisisastudybasedonrecordlinkagebetweentwopopulationbasedregisters,theWestern AustralianMentalHealthInformationSystem(MHIS)andtheWesternAustralianOffenders Database(WAOD),usingaprobabilisticdatamatchingstrategy(Jaro1994)andundertaken priortothisstudybyanindependentthirdparty,theDataLinkageUnit.UsingtheDataLinkage Unit,whichwasestablishedwithintheDepartmentofHealth,WesternAustraliawiththeexpress purposeofundertakingrecordlinkagebetweensensitiveStatedatabases,obviatedtheneedfor anydirectexchangeofdatabetweendatacustodiansinpoliceandmentalhealthdepartments, andthestudyresearchersweregivenanonymiseddataonly. TheWesternAustralianMentalHealthInformationSystemandtheWesternAustralianOffenders Database,areStatewide,computerisedregisterswithacomprehensivecoverageoftheir respectiveareas.TheMentalHealthInformationSystemcommencedin1966andcovers inpatientandambulatorycarecontactswiththerangeofpublicmentalhealthservicesin WesternAustralia,aswellasinpatientcontactsatprivatehospitals.TheOffendersDatabase includesbasicsociodemographicdataonalloffenderssincethe1940s,withfulldataoncharges, arrestsand,atthetimeoflinkage,convictionsfrom1984to1996.Duetoincomplete ascertainmentofoffencesforthefirstyearofthefulldatabase,1984wasexcludedfromthe analysisofwholeofpopulationdata. Studypopulations Threestudypopulationswereidentifiedforanalysisinthisstudy.Thefirstsetwasthetotalstudy populationconsistingof:(i)allindividualsontheMentalHealthInformationSystemwitha diagnosisofschizophrenia;(ii)individualsontheOffendersDatabasewitharecordedarrest between1985and1996and(iii)individualsontheMentalHealthInformationSystemwithboth anarrestandaschizophreniadiagnosisrecordedbetween1985and1996. Diagnosticclassification Psychiatricdisorderswereclassifiedusingthediagnosismadeatthetimeofthelastcontact recordedonthementalhealthregister.Ifthisdiagnosiswasnotavailable,themostrecent diagnosisrecordedontheregisterwasused.TheICD9CMdiagnosticclassificationsystem (WorldHealthOrganisation1979)wasused.Inthestudy,diagnoseswerelimitedto schizophrenia(ICD9295).Thereliabilityofregisterdiagnosesonthementalhealthregister, includingthebestmethodofextractingaregisterdiagnosisforepidemiologicalresearch,has beenindependentlyvalidated(Jablenskyetal2005). Offenceclassification Offenceswereclassifiedusingthe3digitAustralianBureauofStatisticsAustralianNational ClassificationofOffences(ANCO)offencecategoriesforanalysis.(AustralianBureauofStatistics 1985).Theprincipalanalysesinthisstudyarebasedonanarrestforanyoffence,however breakdownsarealsogivenbybroadcategoryofoffence. Individuallevelmeasures Severaldemographicvariableswereavailableforanalysisattheindividuallevel.Theseincluded sex,indigenousstatusandage.

 Areabasedmeasures Inadditiontoindividualcharacteristics,measuresofsocialdisorganisation(disadvantage, mobilityandethnicheterogeneity)andurbanicitywereconstructedatarealevelasdescribed below.Postcodeswereallocatedintoquartilesforeachindicatorsothatapproximatelyaquarter ofthepopulationisassignedtoeachofthefourlevelsoftheindicator.Urbanicitywasan exceptiontothiscodingstrategy,since74%ofWesternAustraliansliveinmetropolitanPerth (ABS2007). Socialdisorganisation:Socioeconomicdisadvantage,inequality,residentialmobilityandethnic heterogeneity Socioeconomicdisadvantagewasmeasuredusingthe1991IndexofRelativeSocioEconomic DisadvantageconstructedbytheAustralianBureauofStatistics.Adescriptionofthemethod usedtoconstructthisindexisgiveninABS(1994).Usingsmallspatialunitsknownascollectors districtsasbuildingblocks,aSEIFAscoremaybecalculatedforlargerareas,andforthecurrent studythespatialunitforassigningSEIFAwaspostcode.InadditiontotheSEIFAscoreforeach postcodeameasureofwithinpostcodeinequalitywasgenerated,bycalculatingthevarianceof theSEIFAmeasuresforcollectiondistrictswithineachpostcode. Othersocialdisorganisationindicatorswereconstructedatthepostcodelevel,byaggregating individualandhouseholdlevelcensusdata.Variablesincludedresidentialmobilityandethnic heterogeneity.Residentialmobilitywasbasedonthepercentagesofhouseholderswhowereat adifferentaddress5yearsago,andethnicheterogeneitywasdeterminedusingtheformula:

1 i ,wherethePiareproportionsandiisdefinedaccordingtothefactors(a)percent
2

whosefirstlanguageisnotEnglish,and(b)percentIndigenous.Thismeasureisatitsgreatest whenthediversitywithinapopulationishighest. Urbanicity Urbanicitywasmeasuredbyallocatingpostcodesintooneofthreecategories:townsorrural areaswithpopulationlessthan8,000,townswithpopulationsfrom8,000to20,000;andcities andtownswithpopulationsofover20,000.ThemajorityofindividualsresideinPerthpostcodes andareassignedtothelastcategory. Locationofresidenceandofoffender Therelevantpostcodeforschizophreniaprevalencewaspostcodeofresidenceatthetimeoffirst prevalentcontactwithmentalhealthserviceswithintheprevalenceperiod.Forarrestprevalence andalsoforanalysisofthelinkedschizophreniaarrestcases,therelevantpostcodewaspostcode ofarrestforthetimeoffirstarrestintheprevalenceperiod. Prevalenceanalysis:definitionsandpopulationdenominators Theanalysisthatfollowsisbasedontheprevalenceofschizophreniadiagnosis,arrest,andboth schizophreniaandarrestfortheentireperiod1985to1996.Populationandthesocial disorganisationandurbanicityindicatorsweretakenfrom1991censusdata,anapproximate midpointoftheperiodoverwhichdataforschizophreniaandarrestwereobserved.Population denominatorsweredeterminedusingAustralianBureauofStatisticsCensusdatainthefollowing

 way.Forarrestprevalencerates,andforthelinkedarrestandschizophreniadiagnosisrates,the denominatorwasthetotalpopulationineachpostcode.Fortheprevalenceratesof schizophreniadiagnosis,thedenominatorwasthepopulationaged1554ineachpostcode, matchingtheagegroupusedintheschizophreniadiagnosisnumerator. RESULTS Thefirstaimofthestudywastoseparatelydeterminetheprevalenceofarrest,schizophrenia, andalsotheprevalenceofarrestinpersonsdiagnosedwithschizophreniainWesternAustralia overtheperiod1985to1996.Thestatewidefindingswithrespecttoprevalenceareshownin Table1. Table1: Populationprevalenceofarrest,ofadiagnosisofschizophrenia,andjoint prevalenceofhavinganarrestandadiagnosisofschizophreniainWestern Australia,19851996,perthousandofrelevantpopulation(seeabove) Persons arrested Personswitha diagnosisof schizophrenia Personswith schizophreniadiagnosis whowerearrested

Prevalencetype

Populationprevalence1985 1996perthousandpersons Allpersons Males Females

145.3 227.1 64.5

2.0 2.9 1.3

1.1 1.8 0.3

TheTableclearlyshowsthehighprevalenceofarrestacrosstheStateofWesternAustralia.Over the12yearsofthestudy,14.5percentofthepopulationhadexperiencedanarrest.By comparison,schizophreniaitselfwasmuchlessprevalentinthepopulation,andthejoint prevalenceofhavingadiagnosisofschizophreniaandanarrestwasrarerstill. TheprevalenceswithinspecificoffencecategoriesareshowninTable2. Table2: BroadoffencecategoryforarrestprevalenceinWesternAustralia19851996 perthousandtotalpopulation Offences againstthe person 21.0 Property offences Drug offences Traffic offences Otheroffences

Allpersons

53.2

27.3

68.8

35.5

 Thesespecificformsofarrestprevalenceadduptoahigherfigurethantotalprevalencefor personsarrestedbecauseanindividualmayappearintheprevalencecolumnformorethanone offencecategory.Serioustrafficoffencesmakeamajorcontributiontototalarrestprevalence, andthecategoryisdominatedbydrinkdrivingcharges.Ontheotherhand,arrestforoffences againstthepersonismuchlessprevalent. Thecurrentstudywasparticularlyfocusedontheextenttowhichurbanicityandthestructural antecedentsofsocialdisorganisationarecorrelatesofarrest,schizophreniadiagnosis,andalso schizophreniadiagnosisandarrest.Asdiscussed,socialdisorganisationindicatorsweregathered atpostcodelevelandthethreeformsofprevalenceweremeasuredindifferentareatypes.In ordertoshowtheinfluenceoftheseareatypesmostclearly,thefollowingchartsarenormalised sothatthevalueoflowestquartileissetto1andthevaluesofsuccessivequartilesareexpressed asrateratioswithrespecttothisreferencepoint.Theresultingchartsalloweasyvisual assessmentoftherelativeinfluenceofeachsocialdisorganisationvariableoneachformof prevalence. Figure1showsthatprevalenceofarrestwascorrelatedwiththeindicatorsofsocial disorganisationatpostcodelevel.However,theriseinarrestprevalenceisstrongestinthe highestquartileofeachindicator.Themainexceptiontothistrendoccurswithurbanicitywhere thereislittlevariation.PostcodeswithinthePerthmetropolitanareaandcountrytownsof 20,000populationormoreexhibitedlowerratesofarrestthanpostcodesassociatedwithtowns oflessthan20,000.Thispatternheldformostoffencecategories(notshown)exceptforoffences againsttheperson,wheretherewasagradualbutverysmallriseinprevalencewithincreasing urbansize.Themostevengradientacrosspostcodequartilelevelsoccursfordisadvantage,but thelargesteffectisstillinthemostdisadvantagedquartile.Forthisindicator,arrestprevalence isalmost5timesashighasitisinthelowestquartile. Figure2indicatesamuchshallowergradientforurbanicityandsocialdisorganisationfactorsat postcodelevelinthecaseofschizophreniaprevalence.Inparticular,thereislittledifferencein prevalencefordifferentquartilesofresidentialmobility.Urbanicityhasamodesteffect, althoughthereisamoreconsistentgradientthanthereisforarrest,withprevalenceincreasing slightlywithincreasingurbansize.Postcodeinequalityhasamoreevengradientfor schizophreniaprevalence,eventhoughtheprevalenceratiobetweenthehighestandlowest quartilesisnotasgreatasitisforarrest.Asethnicheterogeneityacrosspostcodes,disadvantage acrosspostcodes,andwithinpostcodeinequalityincreasefromquartile1toquartile4 schizophreniaprevalencedoubles Thejointprevalenceofarrestandschizophreniadiagnosismorecloselyresemblesthearrest profilesthantheschizophreniaprofiles.Asforarrest,thelargestdifferencesacrosspostcodes occurbetweenthehighestquartileofeachindicatorandtheotherthree.Furthermore,there doesnotseemtobeamultipliereffectforthejointdistributionofschizophreniaandarrest prevalenceastherateratiosforarrestandforthejointdistributionofarrestandschizophrenia diagnosisarecomparablewitheachother.

 Thestudyalsoexaminedthetemporalrelationshipbetweenschizophreniadiagnosisandarrest acrosspostcodes.ItisknownthatforthemajorityofindividualsinWesternAustraliawithboth anarrestandadiagnosisofschizophrenia,thearrestwillprecedetheschizophreniadiagnosis (Jablenskyetal2004).Thisstudyhasexaminedsequencesofarrestanddiagnosisacross postcodesandfoundsomeinconsistencyandcomplexityintheresultsacrossdifferentindicators ofsocialdisorganisation.Whilethetabulationsarenotpresentedinthistrendsandissuespaper, thereissomeevidenceofashiftinsequenceacrossareas,withdiagnosisbeingmorelikelyto precedearrestaspostcodesbecomemoresociallydisorganised.Thisisamatterworthyof furtherinvestigationandhypothesistestinganditisnotputforwardasaclearresultemerging fromthisstudy.

 Figure1:Arrestprevalencerateratios:198596
(a)

5 4

(b)

5 4

Rate ratio

Rate ratio

3 2 1 0 Lowest Highest quartile quartile Ethnic Heterogeneity across Postcodes

3 2 1 0 Lowest Highest quartile quartile Residential Mobility across Postcodes

(d)

(c)

5 4 Rate ratio 3 2 1 0 Lowest Highest quartile quartile Disadvantage across Postcodes

5 4

Rate ratio

3 2 1 0 Lowest Highest quartile quartile Within-Postcode Inequality

(e)

5 4

Rate ratio

3 2 1 0 <8,000 >20,000 Urbanicity across Postcodes

 Figure2:Schizophreniaprevalencerateratios:198596
(a)

5 4 3 2 1 0 Lowest Highest quartile quartile Ethnic Heterogeneity across Postcodes

(b)

5 4

Rate ratio
(d)

Rate ratio

3 2 1 0 Lowest Highest quartile quartile Residential Mobility across Postcodes

(c)

5 4

5 4

Rate ratio

3 2 1 0 Lowest Highest quartile quartile Disadvantage across Postcodes

Rate ratio

3 2 1 0 Lowest Highest quartile quartile Within-Postcode Inequality

(e)

5 4 Rate ratio 3 2 1 0 <8,000 >20,000 Urbanicity across Postcodes

10

 Figure3:Rateratiosofthejointprevalenceofschizophreniadiagnosisandarrest:198596
(a)

5 4 Rate ratio 3 2 1 0 Lowest Highest quartile quartile Ethnic Heterogeneity across Postcodes

(b)

5 4

Rate ratio
(d)

3 2 1 0 Lowest Highest quartile quartile Residential Mobility across Postcodes

(c)

5 4 Rate ratio 3 2 1 0 Lowest Highest quartile quartile Disadvantage across Postcodes

5 4

Rate ratio

3 2 1 0 Lowest Highest quartile quartile Within-Postcode Inequality

(e)

5 4

Rate ratio

3 2 1 0 < 8,000 >20,000 Urbanicity across Postcodes

11

 DISCUSSION Thestudyhasshownthatsociostructuralcharacteristicsofpostcodesareassociatedwiththe prevalenceof(a)arrest,(b)schizophreniadiagnosisand(c)withthejointprevalenceof schizophreniadiagnosisandarrest.Oneoutcomeoftheresearchisthepresentationofarrest prevalenceovera12yearperiod,inadditiontoprevalences(b)and(c).Inthecaseofarrest, prevalenceistypicallyexaminedinoneyearperiods.However,theexaminationoflongertime periodsrevealsthatarelativelylargeproportionofthepopulationhassomecontactwithpolice. ForexampleresearchintheUnitedKingdomrevealsthat33%ofmalesand9%offemalesbornin 1953havebeenconvictedofanoffencebytheageof46(Primeetal2001). Whilethestudyshowsthatareaindicatorsarecorrelatedwiththeprevalenceofboth schizophreniaandarrest,itisnotinapositiontodeterminewhetherthecorrelationsarelinked torealareabasedgeneratingmechanismsforcrimeorschizophrenia,orwhethertheyresult fromvariationsinindividualmechanismsSuchanalysiswouldrequireasimultaneousanalysisof afullrangeofindividualandareainfluencesandisbeyondthescopeofthecurrentstudy. Thestudyhasbeeninformedbythestructuralaspectsofsocialdisorganisationtheory,butitwas notabletotestcollectiveefficacyaspectsofmodernversionsofthetheory.Norwasit designedtotestthetheoryagainstothermorespecificallystructuraltheoriessuchasstrain theory. Ontheotherhand,thestudyhasshownthatthereisagreaterneedforservicesforthose diagnosedwithschizophreniainareaswhicharesociallydisorganised.Itisalsoofinterestthat thegradientsofthesocialdisorganisationindicatorsacrosspostcodesaregreaterforarrest prevalencethantheyareforschizophrenia.Itiswelltobearinmindmeasurementissueswhen examiningthisissue.Forschizophreniathereisalwaysanacknowledgementthatitstreated prevalencewillbealittlelowerthanitstrueprevalence.Forarrestthemeasurementissueis arguablymoreproblematic.Takingoneindicatorasanexampleurbanicitytherehavebeen claimsthatcrimeislesslikelytobereportedtopoliceinruralareasthaninmetropolitanareas, althoughsolidAustralianevidenceonthisissueislacking.InWesternAustraliahowever,we knowthat,onceacrimeisreportedtopolice,individualsaremuchmorelikelytobearrestedin theregionsoutsideofPerththanareinthemetropolitanarea.Researchconductedatthe UniversityofWesternAustraliaCrimeResearchCentre(Hardingetal1997)indicatesthatthe ratioofarrestprevalencetoreportedcrimeinnonmetropolitanregionsisapproximatelydouble thesameratioforPerth.Furthermoretheratioofpolicetocitizensislowerinthemetropolitan areathanitisoutsideofit.Thismeansthatpatternsofarrestdonotnecessarilycorrelatewell withpatternsofoffending.Asimilardistortionofarrestpatternshasalsobeensuggestedwith respecttothementallyillbycomparisonwithothercitizens(Robertson1988).Onbalance,the resultsofthisstudymaypartiallyreflecttherelativebalanceofpoliceandmentalhealthservices.

12

 ACKNOWLEDGEMENTS Theresearchersgratefullyacknowledgeseveralfundingsources:aNationalHealthandMedical ResearchCouncilgrantwasusedtofundingtherecordlinkageandcleaningrequiredtoconstruct thestudydatabaseandundertakeprimaryanalyses,whilethecurrentstudyfocusingonareaof residenceandsocialdisorganisationwasfundedbyagrantfromtheCriminologyResearch Council.TheresearchersthanktheDataLinkageUnit(DepartmentofHealth,WesternAustralia) forundertakingthelinkagework,andTomPinder(DepartmentofHealth,WesternAustralia)for theprovisionofmentalhealthdataandforhisongoingsupport.TheyalsothanktheWestern AustraliaPoliceforaccesstoarrestdata.

13

 APPENDIX1: PopulationprevalenceratesofarrestforWesternAustralian19851996perhundredthousand oftotalpopulationfordifferentoffencecategories

EthnicHeterogeneity Against the person 1,008 1,463 1,454 4,416 Against the person 1,666 1,603 1,574 3,621 Against the person 4,350 1,945 1,249 753 Against the person 1,209 2,213 1,881 3,116 Against the person 3,540 3,386 1,795

Property

Drug

Traffic

Other

Total

Rate ratios 1.00 1.16 1.14 3.29

1stquartile(lowestheterogeneity) 2ndquartile 3rdquartile 4thquartile(highest heterogeneity) Residentialmobility

3,003 4,350 4,312 9,513 Property

2,002 2,212 1,905 4,756 Drug

4,188 4,180 4,270 14,713 Traffic

1,847 2,327 2,425 7,489 Other

8,777 10,137 9,965 28,888 Total

Rate ratios 1.00 0.90 1.05 2.70

1stquartile(lowestmobility) 2ndquartile 3rdquartile 4thquartile(highestmobility) Disadvantage

4,783 3,771 4,282 8,592 Property

1,923 1,961 2,680 4,456 Drug

4,286 3,969 4,376 15,259 Traffic

2,648 2,523 2,785 6,355 Other

10,392 9,363 10,901 28,060 Total

Rate ratios 4.77 2.06 1.46 1.00

1stquartile(highestdisadvantage) 2ndquartile 3rdquartile 4thquartile(lowestdisadvantage) Inequality

10,169 4,957 3,460 2,482 Property

4,950 2,624 2,022 1,225 Drug

14,694 5,873 3,890 2,700 Traffic

7,421 3,128 2,190 1,265 Other

29,475 12,736 9,017 6,179 Total

Rate ratios 1.00 1.75 1.20 2.66

1stquartile(lowestinequality) 2ndquartile 3rdquartile 4thquartile(highestinequality) Urbanicity

2,927 5,708 4,770 7,934 Property

1,840 3,275 1,958 3,841 Drug

4,353 6,776 4,096 12,289 Traffic

2,110 3,849 2,770 5,468 Other

8,789 15,410 10,567 23,371 Total

Rate ratios 1.00 1.08 0.72

Lessthan8,000people Between8,000and20,000people Over20,000people

5,468 6,356 5,228

4,283 3,452 2,448

8,991 11,235 6,259

5,956 5,719 3,034

18,839 20,387 13,470

TOTAL

2,100

5,323

2,730

6,881

3,546

14,527

14

Appendix2
PrevalenceratesofschizophreniadiagnosisforWesternAustralian19851996perhundred thousandofpopulationaged1554
Ethnicheterogeneity Category 1stquartile(lowestethnicheterogeneity) 2ndquartile 3rdquartile 4thquartile(highestethnic heterogeneity) Residentialmobility Category 1stquartile(lowestresidentialmobility) 2ndquartile 3rdquartile 4thquartile(highestresidentialmobility) Disadvantage Category 1stquartile(highdisadvantage) 2ndquartile 3rdquartile 4thquartile(lowdisadvantage) Inequality Category 1stquartile(lowestinequality) 2ndquartile 3rdquartile 4thquartile(highestinequality) Urbanicity Category Lessthan8,000people Between8,000and20,000people Over20,000people GrandTotal Rate 151.4 198.8 208.3 201.0 Rate 132.7 205.3 207.9 263.6 Rateratio 1.00 1.31 1.33 Rate 296.6 191.3 176.5 138.6 Rateratio 1.00 1.55 1.99 1.99 Rate 185.7 184.0 209.3 226.5 Rateratio 2.14 1.38 1.27 1.00 Rate 148.1 197.6 176.6 278.5 Rateratio 1.00 0.99 1.13 1.22 Rateratio 1.00 1.33 1.19 1.88

15

Appendix3

PrevalenceratesofarrestandschizophreniadiagnosisforWesternAustralian19851996per hundredthousandoftotalpopulation
Ethnicheterogeneity Category 1stquartile(lowestethnicheterogeneity) 2ndquartile 3rdquartile 4thquartile(highestethnic heterogeneity)

Rate 60.9 79.3 67.0 212.8

Rateratio 1.00 1.30 1.10 3.50

Residentialmobility Category 1stquartile(lowestresidentialmobility) 2ndquartile 3rdquartile 4thquartile(highestresidentialmobility)

Rate 73.2 75.5 77.9 200.1

Rateratio 1.00 1.03 1.06 2.73

Disadvantage Category 1stquartile(highdisadvantage) 2ndquartile 3rdquartile 4thquartile(lowdisadvantage)

Rate 220.4 86.2 61.1 49.4

Rateratio 4.46 1.75 1.24 2.14

Inequality Category 1stquartile(lowestinequality) 2ndquartile 3rdquartile 4thquartile(highestinequality)

Rate 49.2 106.2 79.31 188.7

Rateratio 1.00 2.16 1.61 3.84

Urbanicity Category Lessthan8,000people Between8,000and20,000people Over20,000people

Rate 88.5 113.0 107.7

Rateratio 1.00 1.28 1.22

GrandTotal

105.6

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