“Because anyone can misuse this (a gun) and they can use it for weapon”: A Photovoice Exploration of Reasons Why Female Adolescents Feel Unsafe in Rural and Suburban Communities

Abstract

Adolescents' perceptions of safety vary by community contexts. While much is known about how violence activities and disadvantaged neighborhood environments harm youth's safe feelings in urban and high-crime areas, few studies have evaluated the extent to which environmental factors impact adolescents' perceptions of safety in rural areas. Moreover, although females tend to perceive their community as unsafe and are more likely to be impacted by violence and crimes than males, there is a dearth of research on what neighborhood features and characteristics can cause safety concerns among girls. To bridge the literature gaps, this study has utilized photovoice to explore risk factors contributing to female adolescents' unsafe perceptions in rural and suburban areas. While seven girls were recruited in West Central Florida using both online and in-person strategies, five of them (12–14 years of age) completed a training session, photo-taking activities, and the follow-up photo discussions. Photo discussions were guided by a revised SHOWeD framework and audio recorded. Abridged transcripts were used to match quotes with corresponding photos. A code book was developed for coding process. Thematic analysis was conducted, and four main themes were identified. In this study a total of 44 photos were collected from 5 female participants living in the rural and suburban communities. The main themes associated their unsafe feelings included the following: (1) traffic-related concerns, such as car crashes, speeding, in-vehicle distractions, improper road design, and unsafe road sharing; (2) disadvantaged community environments, such as broken infrastructure and constructions; (3) human trafficking and sexual offenders; and (4) gun-related issues, such as misuse of a gun as weapon and mass shootings. This photovoice study indicates researchers and professionals should focus on traffic issues and negative impacts on adolescents' safe feelings in rural and suburban areas. Media reports on gun violence and human trafficking may cause safety concerns among girls living in low-crime communities. Therefore targeted health promotion programs aiming to improve community traffic safety, facilitate clean physical environments, and limit the exposure to media reports on gun violence and human trafficking should be developed to increase female adolescents' perceptions of safety in rural and suburban areas.

Introduction

A safe community plays a critical role in adolescents' health and development. The level of community safety is defined as “the extent to which a child is free from fear and secure from physical and psychological harm within their social and physical environment” (CDC, 2019, p. 5). Certain features of the community, such as clean environments, access to community infrastructure and facility, supportive neighborhoods, and collective efficacy, contribute to children and adolescents' safe perceptions in the neighborhoods (Kochel and Nouri, 2021; Yang et al, 2022c). While a safe and stable community can help children thrive, exposure to violent crimes and disadvantaged neighborhood conditions not only makes adolescents feel unsafe but also impacts their physical, mental, and behavioral health (Mennis et al, 2016; Mmari et al, 2014b; Wright et al, 2017; Yang et al, 2022b).

Specifically, adolescents with low levels of perceived safety are more likely to report worse health situations and miss school because of illness, compared with their counterparts with high levels of safe perceptions (Burgess Dowdell, 2006; Eriksson et al, 2011). Moreover, adolescents exposed to community violence and those with strong concerns of community safety are more likely to carry a weapon (e.g., gun, knife) for protection or start using alcohol at a younger age than children living in safe environments (Burgess Dowdell, 2006; Yang et al, 2020b). Therefore, adolescents' perceived safety is an indicator of community violence and disadvantaged neighborhood conditions.

Perceptions of community safety are affected by multiple physical features and social characteristics, such as vacant/abandoned houses, gang activities, gun violence, and the presence of drug users (Teixeira, 2016; Yang et al, 2022a; Yang et al, 2022b). Besides community contexts, perceptions of community safety also depend on how youths and residents interpret violence and crimes that they are exposed to, Kochel and Nouri (2021).

Existing studies find that exposure to gun violence can significantly reduce the safe feelings among residents in places with moderate levels of violence and crimes (Kochel and Nouri, 2021). In contrast, youth living in high-crime neighborhoods may get used to violence and gang activities, so they tend to accept those issues as part of the daily life and may develop positive or negative coping strategies (e.g., resilience vs. delinquent behaviors such as weapon carrying and substance use) (Aisenberg and Herrenkohl, 2008; Bernard and Carlile, 2021; DaViera et al, 2020).

However, current studies on adolescents' perceptions of community safety have largely relied on quantitative methods and researchers' statistical analysis of survey data. There is a need to understand what community environments and neighborhood characteristics make adolescents feel unsafe from their perspectives (Teixeira and Gardner, 2017). Although a few studies have explored adolescents' perceptions of community using qualitative methods (Leung et al, 2017; Mmari et al, 2016; Mmari et al, 2014b; Teixeira and Gardner, 2017), they primarily focused on how environmental factors impact youth's physical health and behaviors. Limited information can be obtained from the existing qualitative research on adolescents' unsafe perceptions. Therefore, qualitative studies that highlight adolescents' viewpoints and involvements are needed to explore what community factors contribute to their unsafe feelings in the community.

Furthermore, how adolescents perceive their communities and physical environments may vary by gender (Mmari et al, 2014b). For example, vacant houses in the community are related to sexual and reproductive health from the perspectives of girls, but boys tend to link them with drug use and violent behaviors (Mmari et al, 2014b). Based on a nationally representative dataset, including both adolescents and adults, females are more likely to perceive their community as unsafe compared with males (Lovasi et al, 2014). Moreover, violent crimes and unsafe perceptions are significantly associated with poor physical health status among females (Lovasi et al, 2014). While there are studies focusing on male adolescents' perceptions on community safety (Thomas et al, 2016), less is known about how female adolescents perceive their communities in terms of features that cause their unsafe feelings compared to their male counterparts.

In addition, existing research on youth's perceived safety was predominantly conducted in urban areas with high levels of violence and crimes (Bernard and Carlile, 2021; DaViera et al, 2020; Thomas et al, 2016). As feelings of safety vary by community contexts, it remains unclear on how adolescents living in low-crime area perceive their community and the extent to which environmental and social factors make them feel unsafe. Such evidence will be of benefit to guide targeted and tailored intervention strategies to improve safe feelings among adolescents living in low-crime areas.

To bridge the research gaps mentioned above, a photovoice study has been conducted in Florida with the aim to explore risk factors that make female adolescents feel unsafe in the rural and suburban communities. Photovoice is a qualitative participatory research method, conceptualized based on feminist theory, critical consciousness, documentary photography, and health education (Wang and Burris, 1997; Wang et al, 1996). Photovoice provides an interactive way to engage adolescents to explore community issues (e.g., violence) that impact their health through photo taking and express their opinions about community environments through follow-up photo discussions (Irby et al, 2018; Mmari et al, 2014a; Saimon et al, 2015). Since early 2000s, photovoice has been applied to numerous community-based studies and topics that involve adolescents, such as violence, community safety, substance use behaviors, and neighborhood environments (Yang et al, 2020a).

In summary, the purpose of this qualitative study is to explore community-level factors contributing to female adolescents' unsafe perceptions in the rural and suburban communities using photovoice. The research question used for adolescents' photo taking is “what makes you feel unsafe in your community?.”

Materials and Methods

Study location

This study was conducted in Hillsborough County and surrounding rural areas during the summer and fall of 2019. Hillsborough County is the fourth most populous county in Florida and centrally located along the Florida's western coastline (Hillsborough County, 2019). County residents have a slightly higher proportion of black/African American and Latino/Hispanic population than the Florida State residents (18.4% vs. 17.0% and 30.3% vs. 26.8%, respectively), but are more racially and ethnically diverse compared with the general U.S. population (18.4% vs. 13.6% as black/African American and 30.3% vs. 18.9% as Latino/Hispanic) (United States Census Bureau, 2021). In Hillsborough County, violent crimes occur frequently in the downtown and urban area (17–49 incidents per 1000 people), but the rates remain relatively low in the rural and suburban area (0–17 incidents per 1000 people) (Safe and Sound Hillsborough, 2014).

Study design and participants

This photovoice study included a 30-min training session, a 2-week photo-taking session by each participant, and a 45-min follow-up photo discussion between participants and the researcher. Adolescents 12 years of age or older were welcome to join the study if they lived in Hillsborough County and surrounding areas. Participants were recruited using both online and in-person strategies, such as posted flyers on social media, community-based agency contacts, and on-site recruitment during community events. More descriptions of participant recruitment are available in related studies (Yang et al, 2022a; Yang et al, 2022c).

This study was approved by the Institutional Review Board (IRB) of University of South Florida (Yang, 2020). Signed parental consent forms were collected before female adolescents started any photovoice activity. Participants 12 years of age provided verbal assent and those 13 years of age and older signed child assent forms per IRB requirements. While seven female adolescents assented to participate in this study, five of them (12–14 years of age) completed the photo-taking session and follow-up photo discussions, resulting in a response rate of 71.4%. The five participants were racially and ethnically diverse. Three of them lived in suburban communities, and two lived in rural areas when this study was conducted. A total of 44 photos were collected regarding their unsafe feelings in the community, with each participant taking about 6–15 photos (mean = 8.8, SD = 3.6).

Procedure

Before photo taking, participants attended a brief training session (online or in-person depending on adolescents' choice) to get information on the ethical and technical use of cameras (e.g., no selfies, no identifiable information without written permission), the concept of photovoice, and the definition of community, which was referred to a group of individuals living in the same geographical area or people sharing common cultural and social characteristics (Sharma et al, 2014). Both physical and social perspectives of community were introduced to participants, and they were encouraged to define community according to their own perceptions. After the training session, participants were asked to take photos in their communities, which represented their unsafe feelings in 2 weeks. A flexible schedule was offered to adolescents if they needed more time to capture photos.

Upon the completion of photo taking, participants submitted their photos to the researcher. A follow-up photo discussion was typically scheduled within a week, either in-person or online depending on adolescents' preferences and availability. Photo discussions were guided by a revised SHOWeD framework. Rather than strictly following the five questions in the original SHOWeD framework (Wang, 1999), this revised version focused on how photos related to adolescents' unsafe feelings and what actions could be taken to address those issues. All photo discussions were audio recorded. Incentives were provided to participants who completed photo taking and the follow-up discussions.

Thematic analysis

Audio recordings were transcribed using the method of abridged transcript to match the discussions with corresponding photos. Several rounds of coding and peer discussions were conducted to identify main themes regarding unsafe perceptions among female adolescents. Specifically, an initial code book was developed based on the primary researcher's field notes. The code book was revised and adjusted in the process of transcription to include emerging themes. Through peer discussions, the code book was further revised and finalized. Upon the completion of transcription, the coding process started.

The entire data, including photos and transcripts, were coded by the primary researcher. After several rounds of revisions and modifications, main themes were identified based on the codes that were commonly photographed and mentioned in photo discussions. Preliminary findings were presented to a small scope of colleagues to make sure that photos and discussions were interpreted appropriately by the primary researcher. Collected data (e.g., field notes, digital photos, auto recordings) were kept confidential. No photo with recognizable features (e.g., faces, properties with addresses) was released or published.

Results

A total of 44 photos were collected in this study from the 5 female adolescents. On average, participants living in rural communities took more photos (mean = 11) than those in suburban areas (mean = 7.3). The main themes representing their unsafe feelings in the community included traffic-related concerns (e.g., car accidents, speeding, distracted drivers, unsafe road sharing), disadvantaged community environments (e.g., broken infrastructure, community constructions), human trafficking and sexual offenders, and gun-related issues (e.g., misuse of a gun as weapon, mass shootings).

Traffic-related concerns

Among the reasons that made participants feel unsafe in the community, traffic-related concerns were most photographed (n = 17, 38.6%) and mentioned in photo discussions. Car accidents and crashes were the most significant cause for their unsafe feelings. One participant living in a suburban community was able to capture a car accident at night and she was very concerned about her own safety on the scene, saying “I was thinking if that could happen to me or not .” (Fig. 1). Another participant living in the rural area also expressed her concerns on car crashes, saying “I compared to where I used to live and now there is a lot more cars crashing into each other, a whole bunch of accidences.”

FIG. 1.

Traffic-related concerns. “This one is a car accident. I was thinking if that could happen to me or not, and I was thinking if we were safe or not.”

In-vehicle distractions, such as drivers texting while driving, were believed to contribute to car accidents, as one participant living in the suburban area said, “Because the person who is driving is not paying attention, so you can get into a car crash.” Speeding was considered another reason that caused car crashes. While one participant living in the rural area took a photo showing the speed (84 miles/h) she went in a car, another adolescent highlighted the risks she faced in the school bus, saying, “My bus driver was speeding 18 miles per hour (over the speed limit). That is not the only time my bus driver did that. There were 30–40 kids on my bus. If it got crashed, that would danger all of us.”

Participants provided suggestions on how to prevent car accidents. One of them living in the rural area asked drivers to slow down and look out more. She also suggested pedestrians to stop using cell phones and pay more attention on moving vehicles when walking in places with high volume of traffic. Another participant living in a suburban community suggested drivers to “Be more focused on driving. Don't really drive at night unless you really have to. And be careful when you drive through the rain as it could cause serious accidents.”

In addition, busy roads and bad road design were also considered traffic issues that made participants feel unsafe. One of them photographed an intersection and explained, “That is like the busiest intersection in Florida. I do not think that two busy roads should intersect because so many cars, people try to get close. If it is red lights, some people just go and then (car crashes).” Moreover, unsafe road sharing was also a traffic concern that should be addressed. One participant living in the rural area shared a photo that showed a person was riding a bicycle in front of a car and said: “He is not using the little lane he is supposed to, which is unsafe because someone can easily hit him.”

Disadvantaged community environments

Issues related to community environments were commonly photographed (n = 13, 29.5%) and mentioned by four female participants as the reasons for their unsafe feelings. Specifically, broken infrastructures in the community, such as cracks on the sidewalk, giant potholes on the road, and half-fallen trees, were considered safety concerns because they could potentially cause injuries to residents (Fig. 2). One participant living in a suburban community said, “This one is a crack on the sidewalk. I am afraid that someone is going to trap or something. Maybe burst their elbow. It is really endangered.” She also expressed her concerns of a half-fallen tree at her community's tot lot, saying, “Someone is going to be under it or something and it is going to fall the way down and fall on top of them.”

FIG. 2.

Disadvantaged community environments. “This one is a giant pothole.I was afraid that maybe someone close to the road could get tripped or something.”

Meanwhile, constructions in the community caused concerns to participants because it would harm the living environments and worsen the global warming situation. One of them explained, “It hurts the environment. And when it is hurting the environment, it is hurting us because we live in the environments. So hurting the environment with all those construction makes me feel unsafe because it causes global warming to get even worse.” Community constructions may also affect residents' daily life, as one participant living in a rural community said, “Construction makes me feel very unsafe because if there was a storm, the house is not well built. (the pieces) just into my house or someone else's house.”

Human trafficking, kidnapping, and sexual offenders

A few participants took photos (n = 6, 13.6%) of news reports on human trafficking, websites showing sexual offenders, and places where kidnappings commonly occurred, to express their concerns on these issues. Particularly, one participant living in the rural area showed a media report titled, “Doctors and cops among 277 arrested in human trafficking, online prostitution sting in Florida” and said she felt very scared when reading this report and thinking about human trafficking.

Another participant living in the rural area searched the website of the Florida Department of Law Enforcement for sexual offenders who lived within 3 miles of her home. She felt very unsafe after she found out there were many sexual offenders living close to her, saying, “Some of them are actually child sexual offenders, who offend child living in my radius.They should not live in communities where children live because who says they won't do it again.” She hoped those sexual offenders would live a few miles away from her community, saying, “Where we used to live, they had to live two miles away. I mean they could still drive there, but it made me a little safer.”

Public garages, parking lots, and bus stops were considered places where children usually got abducted. One participant in a suburban community explained why public garage made her feel unsafe, especially at night, saying, “This is the most common place people are abducted. This makes me feel really unsafe” (Fig. 3). Another photo was taken at a bus stop during the daytime, with the explanation that, “It makes me so unsafe because I know a lot of people are there and someone can easily get to fight, or random cars can easily pick you up.” One participant in the rural area thought kidnapping happened due to the lack of gate in the community, and explained the reason: “So any car, random car could go in there either snatching of a kid or breaking into someone's house.”

FIG. 3.

Kidnapping. “It is at night. This is the most common place people are abducted. This makes me feel really unsafe.”

Gun-related issues

Two participants living in rural communities photographed guns-related items (n = 3, 6.8%) and expressed their concerns on this topic. One participant was worried about the misuse of guns and said, “Because anyone can misuse this and they can use it for weapon, like in the wrong way. So if anybody who has anger or whatever, someone makes you upset, they can easily pull up and hurt someone” (Fig. 4). She also shared her thoughts on how to prevent gun-related injuries, saying, “I think they should have people go through a test of mental stability if they would be able to hold a gun. And get a license for it.”

FIG. 4.

Gun-related issues. “They can use it for weapon, like in the wrong way.”

Another participant took a photo of a gun selling center in a retail store and questioned the process of buying a gun: “You should not be able to just walk into (a retail store) and feel like I am going to buy a gun with 200 bucks. That is not OK. You should not be able to do that. And the last mass shootings were in (the retail store).” In addition, this participant expressed her concerns of mass shootings happened at school, saying: “This is a picture of where I go to school. And when you get to my school, there is no gate in the front, and you can just walk right in. Seeing all these shootings at school, this makes me feel unsafe that there is no one standing out of school, there are people inside the school. When they get in, it just (makes situation happen).”

Discussion

Community not only provides adolescents a place to live in and do their daily activities but also has the potential to impact their physical, mental, and behavioral health (Burgess Dowdell, 2006; Wright et al, 2017). While children can benefit from a safe community environment, they are vulnerable and sensitive to violent crimes and community issues. To better understand how female adolescents perceive their community regarding safety concerns, this study has been conducted in Florida using the photovoice methodology. Based on collected photos and viewpoints from five female adolescents living in rural and suburban areas, this study finds that certain disadvantaged neighborhood conditions and safety concerns, including traffic issues, disadvantaged community environments, human trafficking and kidnapping, and gun violence, are considered significant risk factors that made them feel unsafe.

Traffic-related issues (e.g., car accidents, speeding, in-vehicle distractions, improper road design, unsafe road sharing), are the most commonly mentioned reasons for unsafe perceptions among female adolescents living in the rural and suburban area, because those issues increase their risk of traffic injuries and even threaten their life. This finding is consistent with the current literature, indicating that rural drivers are more likely to take risky driving behaviors and less likely to attend traffic safety interventions than urban drivers (Rakauskas et al, 2009).

To reduce adolescents' safety concerns, traffic issues should be addressed by better traffic designs, more traffic signs, and safe driving practice in the rural and suburban area (Rakauskas et al, 2009; Ryan et al, 2018; Yang et al, 2022c). Other strategies that can potentially increase their perceptions of traffic safety may include health education champions on road safety skills, proper road sharing, and positive attitude on road safety among adolescents and community residents (Alonso et al, 2018; Treviño-Siller et al, 2017).

Disadvantaged neighborhood environments (e.g., broken infrastructure, community constructions) are also commonly photographed and highlighted by participants as safety concerns, as those situations can potentially cause injuries among children and residents. This finding is consistent with an existing photovoice study indicating that disadvantaged neighborhood physical environments (e.g., trash, graffiti) are perceived as critical factors contributing to adolescents' violent behaviors (Chonody et al, 2013). On the contrary, clean neighborhood environments, easy access to basic infrastructures, and high levels of social cohesion are associated with safe perceptions (Austin et al, 2002; Yang et al, 2022c). In addition to increased risk of injuries in disadvantaged neighborhoods, other reasons that link community physical environments with adolescents' safety concerns may include the following: (1) the presence of drug users in abandoned homes, (2) violent behaviors and crimes in untended properties, and (3) inadequate sanitation that harms residents' health (Mmari et al, 2014b; Teixeira, 2016).

Female adolescents consider human trafficking, kidnapping, and sexual offenders as severe threats to their safety. This could be partially because girls are more vulnerable to sexual trafficking compared with boys, especially those exposed to violence, crimes, or drug sales in the community (Greenbaum, 2020; UN Office on Drugs and Crime, 2020). This study extends the literature by identifying that girls in rural and suburban communities with low crime rates also perceive human trafficking and sexual violence as significant safety concerns. Although none of the participants in this study considers themselves as victims or has been directly involved in those issues, they get relative information from media reports and internet. It is possible that increased media exposure and frequent sexual violence reports draw their attention on these issues and therefore cause their unsafe feelings (Egen et al, 2020).

Gun-related concerns (e.g., misuse of a gun as weapon, mass shootings) are considered risk factors that harm girls' safe perceptions in their neighborhoods, consistent with existing findings showing that females are more likely to perceive their community as unsafe compared with males, especially when weapon-involved crimes increase (Lovasi et al, 2014).

Although participants in this study live in rural and suburban areas, with relatively low rate of firearm violence, gun-related concerns are still highlighted by two of them. This is probably because during the period of data collection, a series of mass shootings and gunshots happened in a well-known retail chain and was broadly reported by the media. Media information may contribute to adolescents' unsafe feelings, consistent with existing studies showing that sniper-related TV viewing is significantly associated with lower levels of perceived safety during shooting events (Fullerton et al, 2019). Therefore, public health professionals, social workers, schools, and parents are recommended to educate adolescents on how to properly interpret these media information and limit media exposure during gunshot events.

Strengths and limitations

This study adds to the literature by identifying critical community issues contributing to female adolescents' unsafe feelings using photovoice and providing implications for community safety promotion programs for those living in low-crime neighborhoods. Specifically, these findings indicate that when exploring female adolescents' perceptions of community environments in rural and suburban areas, researchers should pay more attention on traffic concerns and its influence on their safe feelings and well-being, instead of predominantly focusing on the relationships with residents' walkability and outdoor physical activities (Sackett et al, 2018; Saimon et al, 2015). Moreover, this study finds that adolescents living in low-crime areas are also impacted by gun violence and human trafficking. Although they are not directly exposed to those crime activities, media reports cause or increase their safety concerns.

However, limitations do exist in this study. Some critical community issues, such as gang activities, abandoned homes, and property robbery, are not captured in this study. This is partially because participants are all from suburban or rural communities with low crime activities. It may not be feasible for them to capture relatively rare events in a 2-week time frame. Another possible explanation is that participants in this study are in the early adolescence, who are less likely to be exposed to community-level harms with parents' supervision and company, compared with older teenagers who spend more time on their own.

Moreover, our study has a relatively small sample size, which limits the capacity to generalize the findings to the youth population in rural and suburban areas. In addition, this study does not include viewpoints from adolescents living in high-crime area; therefore, it is impossible to make comparison with those living in low-crime communities. Future studies are recommended to explore female adolescents' safety concerns in a broader manner, which can cover more diverse communities and areas.

Conclusions

Through the photovoice methodology, this study has explored the main reasons that make female adolescents feel unsafe in rural and suburban communities, including traffic-related concerns (e.g., car accidents, speeding, unsafe road sharing), disadvantaged community environments (e.g., bad infrastructure, constructions), human trafficking and sexual offenders, and gun-related issues (e.g., misuse of a gun as weapon, mass shootings). This study finds that media exposure plays a critical role in adolescents' unsafe feelings by disseminating reports and information on gun violence, sexual violence, and human trafficking. This study implies that health promotion programs aiming to improve traffic safety and physical environments and to reduce the media influence of gun violence and human trafficking among female adolescents should be developed to improve their perceptions of community safety in rural and suburban areas.

Footnotes

Acknowledgments

The author would like to thank the adolescents who participated in this photovoice study for their time and valuable input. The author also wishes to acknowledge Karen Liller, PhD, Martha Coulter, DrPH, and Dina Martinez Tyson, PhD, for their support and guidance on photovoice program planning, data collection, and thematic analysis.

Author's Contributions

Y.Y., conceptualized the study, prepared the IRB protocols, collected data, transcribed the recordings, developed the code book, performed the thematic analysis, wrote each section of the article, and prepared the final version for submission.

Author's Bio

Yingwei Yang, PhD, is a postdoc at Duke University Social Science Research Institute in Durham, NC. She was a research associate when conducting this photovoice study at University of South Florida College of Public Health in Tampa, FL. Her research focuses on youth risk behaviors, injury prevention, community safety promotion, and health education.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

University of South Florida College of Public Health Student Research Scholarship (SRS).

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