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The present study tested the relationships between macro-level violence and birthweight in structurally disadvantaged communities in the District of Columbia. The study hypothesized that both rates of violence and violence “uncertainty” (the latter was operationalized as within-census tract residual change scores in violence), should be inversely associated with birthweight among all live singleton births in DC from 2000 to 2002. Using mixed models, the study found that (1) patterns of violence and violence uncertainty were significantly associated with birthweight among mothers residing in structurally disadvantaged communities, and (2) these findings held for Black and Hispanic, but not white, mothers. The study argues that urban ecological researchers should begin to consider not just how rates (or levels) of violence influence health and other social outcomes in communities, but also the effects of violence …