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26-04-2010 | Respiratory | Article

Community violence linked to childhood asthma

Abstract

Free abstract

MedWire News: Exposure to violence in the community in associated with an increased risk for asthma in children, study results show.

The findings support those from a previous study of a link between violent neighborhood crime and an increased risk for childhood asthma, as reported by MedWire News.

Writing in the European Respiratory Journal, the authors of the current study explain that in the USA, asthma rates and morbidity among children living in impoverished urban neighborhoods are higher than among children living in higher socioeconomic status and non-urban neighborhoods, and that such disparities are not adequately explained by physical environmental factors.

They add: “The recognized importance of the social environment in child health, coupled with knowledge of mechanisms linking psychological stress and asthma indicate that children may be raised in social contexts potentially as detrimental to their development and health as physical toxins.”

To investigate whether exposure to community violence is associated with an increased risk for childhood asthma, the Michelle Sternthal (Harvard School of Public Health, Boston, Massachusetts, USA) and team studied data on 2071 children, aged up to 9 years at enrollment, participating in the Project on Human Development in Chicago Neighborhoods (PHDCN).

Details on asthma diagnosis, exposure to violence (at home and in the community), race/ethnicity, maternal asthma, socioeconomic status, maternal breastfeeding, and neighborhood-level factors, such as concentrated disadvantage, collective efficacy, and social disorder were collected from questionnaires completed by the children’s primary caregivers in 1994–1997, 1997–1999, and 2000–2001.

Overall, 19% of the children had diagnosed asthma.

The researchers found that 43.0% of children with high and 35.2% of those with medium levels of exposure to community violence had asthma, compared with 21.8% of those with low levels of exposure.

After adjustment for potential confounding factors, including exposure to violence at home, the researchers found that exposure to medium and high levels of community violence were significantly associated with the development of childhood asthma, at odds ratios of 1.60 and 1.56, respectively, compared with exposure to relatively low levels of community violence.

However, the researchers also note that the increased risk for asthma among African-American children remained even after including exposure to community violence in the risk model, but was attenuated after accounting for collective efficacy.

Sternthal and team conclude: “Our findings underscore the potential role of community violence in explaining urban asthma risk in the US.

“From a policy perspective, our findings suggest that public health interventions outside of the biomedical model (eg, neighborhood safety programs) may be advantageous in reducing the asthma burden in disadvantaged populations.”

They add: “Research to more fully elucidate the excess asthma burden among African-American children, and the potential role of collective efficacy in reducing that burden, is also warranted.” MedWire Link:

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

Literature

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