Community violence and asthma morbidity: the Inner-City Asthma Study.
OBJECTIVE
We examined the association between exposure to violence and asthma among urban children.


METHODS
We obtained reports from caretakers (n = 851) of violence, negative life events, unwanted memories (rumination), caretaker-perceived stress, and caretaker behaviors (keeping children indoors, smoking, and medication adherence). Outcomes included caretaker-reported wheezing, sleep disruption, interference with play because of asthma, and effects on the caretaker (nights caretaker lost sleep because of child's asthma).


RESULTS
Increased exposure to violence predicted higher number of symptom days (P =.0008) and more nights that caretakers lost sleep (P =.02) in a graded fashion after control for socioeconomic status, housing deterioration, and negative life events. Control for stress and behaviors partially attenuated this gradient, although these variables had little effect on the association between the highest level of exposure to morbidity, which suggests there are other mechanisms.


CONCLUSIONS
Mechanisms linking violence and asthma morbidity need to be further explored.
Wright
Rosalind J
RJ
Beth Israel Deaconess Medical Center, Pulmonary and Critical Care Division, and the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. rosalind.wright@channing.harvard.edu
Mitchell
Herman
H
Visness
Cynthia M
CM
Cohen
Sheldon
S
Stout
James
J
Evans
Richard
R
Gold
Diane R
DR
D001130:Arizona / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D001294:Attitude to Health; D001900:Boston / Q000453:epidemiology; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D009017:Morbidity; D009519:New York City / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D011159:Population Surveillance; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data; D014861:Washington / Q000453:epidemiology