Community-Engaged Latent Class Analysis of Community Violence Exposure and Health-Related Quality of Life in Street-Identified Black Adults

This paper examines the association between community violence exposure (CVE) and health-related quality of life (HRQoL) among a large community sample of Black males and females who identify with street culture in two urban, high-violence neighborhoods. A cross-sectional analysis was conducted using data from 631 participants (ages 18-54), collected through surveys facilitated by Street Participatory Action Research (Street PAR). A three-step BCH bias-adjusted Latent Class Analysis (LCA) with differential item functioning on gender and age identified four groups based on CVE patterns-victims (46.2%), watchers (36.1%), bystanders (14.4%), and isolated (3.2%)-with HRQoL sub-scales modeled as distal outcomes. Modeling and interpretation were informed by participatory action researchers, making this the first instance of a "community-engaged LCA." Victims-who reported the highest levels of direct violence exposure-showed significantly lower scores on HRQoL domains of energy/fatigue, emotional health, social functioning, and general health compared to those who had not seen serious injury by violence (bystanders). Victims also had lower scores of emotional health, social functioning, and pain compared to those who had seen serious injury (watchers). No significant differences were found between any group in self-reported physical functioning. Findings reveal that, even when physical resilience appears intact in persons frequently exposed to violent injury in others, the consequence of victimization still carries a substantial emotional and social toll. These effects may go undetected in routine healthcare encounters, especially if no physical limitations are present.This study calls for more comprehensive assessments to address these unseen consequences of violence, particularly within structurally disadvantaged communities and those in street life. Longitudinal research is needed to further explore the causal mechanisms linking CVE and health outcomes.