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Witnessing a Violent Death and Smoking, Alcohol Consumption, and Marijuana Use among Adolescents

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Abstract

Witnessing violence has been linked to maladaptive coping behaviors such as smoking, alcohol consumption, and marijuana use. However, more research is required to identify mechanisms in which witnessing violence leads to these behaviors. The objectives of this investigation were to examine the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents, to identify whether exhibiting depressive symptoms was a mediator within this relationship, and to determine if those who had adult support in school were less likely to engage in risky health behaviors. Data were collected from a sample of 1,878 urban students, from 18 public high schools participating in the 2008 Boston Youth Survey. In 2012, we used multilevel log-binomial regression models and propensity score matching to estimate the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use. Analyses indicated that girls who witnessed a violent death were more likely to use marijuana (relative risk (RR) = 1.09, 95 % confidence interval (CI) = 1.02, 1.17), and tended towards a higher likelihood to smoke (RR = 1.06, 95 % CI = 1.00, 1.13) and consume alcohol (RR = 1.07, 95 % CI = 0.97, 1.18). Among boys, those who witnessed a violent death were significantly more likely to smoke (RR = 1.20, 95 % CI = 1.11, 1.29), consume alcohol (RR = 1.30, 95 % CI = 1.17, 1.45) and use marijuana (RR = 1.33, 95 % CI = 1.21, 1.46). When exhibiting depressive symptoms was included, estimates were not attenuated. However, among girls who witnessed a violent death, having an adult at school for support was protective against alcohol consumption. When we used propensity score matching, findings were consistent with the main analyses among boys only. This study adds insight into how witnessing violence can lead to adoption of adverse health behaviors.

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Abbreviations

SES:

Socioeconomic Status

References

  1. Satcher D. Violence as a public health issue. Bull N Y Acad Med. 1995; 72(1): 46–56.

    CAS  PubMed Central  PubMed  Google Scholar 

  2. Powell EC, Sheehan KM, Christoffel KK. Firearm violence among youth: public health strategies for prevention. Ann Emerg Med. 1996; 28(2): 204–212.

    Article  CAS  PubMed  Google Scholar 

  3. Finkelhor D, Ormrod R, Turner H, Hamby SL. The victimization of children and youth: a comprehensive, national survey. Child Maltreat. 2005; 10(1): 5–25.

    Article  PubMed  Google Scholar 

  4. Morenoff JD, Sampson RJ, Raudenbush SW. Neighborhood inequality, collective efficacy, and the spatial dynamics of urban violence. Criminology. 2006; 39(3): 517–558.

    Article  Google Scholar 

  5. Massey DS. Getting away with murder: segregation and violent crime in urban America. Univ Pennsylvania Law Rev. 1995; 143(5): 1203.

    Article  Google Scholar 

  6. Clark C, Ryan L, Kawachi I, Canner MJ, Berkman L, Wright RJ. Witnessing community violence in residential neighborhoods: a mental health hazard for urban women. J Urban Health. 2008; 85(1): 22–38.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Dowdell EB. Urban seventh grade students: a report of health risk behaviors and exposure to violence. J Sch Nurs. 2012; 28(2): 130–137.

    Article  PubMed  Google Scholar 

  8. DuRant RH, Kahn J, Beckford PH, Woods ER. The association of weapon carrying and fighting on school property and other health risk and problem behaviors among high school students. Arch Pediatr Adolesc Med. 1997; 151(4): 360–366.

    Article  CAS  PubMed  Google Scholar 

  9. Orpinas PK, Basen-Engquist K, Grunbaum JA, Parcel GS. The co-morbidity of violence-related behaviors with health-risk behaviors in a population of high school students. J Adolesc Health. 1995; 16(3): 216–225.

    Article  CAS  PubMed  Google Scholar 

  10. Zinzow HM, Ruggiero KJ, Hanson RF, Smith DW, Saunders BE, Kilpatrick DG. Witnessed community and parental violence in relation to substance use and delinquency in a national sample of adolescents. J Trauma Stress. 2009; 22(6): 525–533.

    PubMed Central  PubMed  Google Scholar 

  11. Copeland-Linder N, Lambert SF, Chen YF, Ialongo NS. Contextual stress and health risk behaviors among African American adolescents. J Youth Adolesc. 2011; 40(2): 158–173.

    Article  PubMed  Google Scholar 

  12. Brady SS. Lifetime community violence exposure and health risk behavior among young adults in college. J Adolesc Health. 2006; 39(4): 610–613.

    Article  PubMed  Google Scholar 

  13. Kuntsche E, Muller S. Why do young people start drinking? Motives for first-time alcohol consumption and links to risky drinking in early adolescence. Eur Addict Res. 2012; 18(1): 34–39.

    Article  PubMed  Google Scholar 

  14. Kuntsche E, Knibbe R, Gmel G, Engels R. ‘I drink spirits to get drunk and block out my problems…’ beverage preference, drinking motives and alcohol use in adolescence. Alcohol Alcohol. 2006; 41(5): 566–573.

    Article  PubMed  Google Scholar 

  15. Hooshmand S, Willoughby T, Good M. Does the direction of effects in the association between depressive symptoms and health-risk behaviors differ by behavior? A longitudinal study across the high school years. J Adolesc Health. 2012; 50(2): 140–147.

    Article  PubMed  Google Scholar 

  16. Measelle JR, Stice E, Hogansen JM. Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents. J Abnorm Psychol. 2006; 115(3): 524–538.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Wills TA, Sandy JM, Yaeger AM. Stress and smoking in adolescence: a test of directional hypotheses. Health Psychol. 2002; 21(2): 122–130.

    Article  PubMed  Google Scholar 

  18. Peirce RS, Frone MR, Russell M, Cooper ML, Mudar P. A longitudinal model of social contact, social support, depression, and alcohol use. Health Psychol. 2000; 19(1): 28–38.

    Article  CAS  PubMed  Google Scholar 

  19. Hanson MD, Chen E. Socioeconomic status and health behaviors in adolescence: a review of the literature. J Behav Med. 2007; 30(3): 263–285.

    Article  PubMed  Google Scholar 

  20. Wilkinson R, Marmot M. Social determinants of health: the solid facts. 2nd ed. Denmark: World Health Organization; 2003.

    Google Scholar 

  21. Bjerk D. Thieves, thugs, and neighborhood poverty. J Urban Econ. 2010; 68: 231–246.

    Article  Google Scholar 

  22. Fauth RC. The impacts of neighborhood poverty deconcentration efforts on low-income children’s and adolescents’ well-being. Child Youth Environ. 2004; 14(1): 1–55.

    Google Scholar 

  23. Centers for Disease Control and Prevention. Violence-related firearm deaths among residents of metropolitan areas and cities—United States, 2006–2007. MMWR Morb Mortal Wkly Rep. 2011; 60(18): 573–578.

    Google Scholar 

  24. Wardle J, Jarvis MJ, Steggles N, et al. Socioeconomic disparities in cancer-risk behaviors in adolescence: baseline results from the Health and Behaviour in Teenagers Study (HABITS). Prev Med. 2003; 36(6): 721–730.

    Article  CAS  PubMed  Google Scholar 

  25. Cerda M, Diez-Roux AV, Tchetgen ET, Gordon-Larsen P, Kiefe C. The relationship between neighborhood poverty and alcohol use: estimation by marginal structural models. Epidemiology. 2010; 21(4): 482–489.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Wilson N, Syme SL, Boyce WT, Battistich VA, Selvin S. Adolescent alcohol, tobacco, and marijuana use: the influence of neighborhood disorder and hope. Am J Health Promot. 2005; 20(1): 11–19.

    Article  PubMed  Google Scholar 

  27. Galea S, Ahern J, Tracy M, Vlahov D. Neighborhood income and income distribution and the use of cigarettes, alcohol, and marijuana. Am J Prev Med. 2007; 32(6 Suppl): S195–S202.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Shihadeh ES, Shrum W. Serious crime in urban neighborhoods: is there a race effect? Sociological Spectrum: Mid-South Sociological Assoc. 2004; 24(4): 507–533.

    Article  Google Scholar 

  29. Xue Y, Zimmerman MA, Caldwell CH. Neighborhood residence and cigarette smoking among urban youths: the protective role of prosocial activities. Am J Public Health. 2007; 97(10): 1865–1872.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Chuang YC, Ennett ST, Bauman KE, Foshee VA. Neighborhood influences on adolescent cigarette and alcohol use: mediating effects through parent and peer behaviors. J Health Soc Behav. 2005; 46(2): 187–204.

    Article  PubMed  Google Scholar 

  31. Buka SL, Stichick TL, Birdthistle I, Earls FJ. Youth exposure to violence: prevalence, risks, and consequences. Am J Orthopsychiatry. 2001; 71(3): 298–310.

    Article  CAS  PubMed  Google Scholar 

  32. Selner-O’Hagan MB, Kindlon DJ, Buka SL, Raudenbush SW, Earls FJ. Assessing exposure to violence in urban youth. J Child Psychol Psychiatry. 1998; 39(2): 215–224.

    Article  PubMed  Google Scholar 

  33. Giaconia RM, Reinherz HZ, Silverman AB, Pakiz B, Frost AK, Cohen E. Traumas and posttraumatic stress disorder in a community population of older adolescents. J Am Acad Child Adolesc Psychiatry. 1995; 34(10): 1369–1380.

    Article  CAS  PubMed  Google Scholar 

  34. Rothman EF, Johnson RM, Azrael D, Hall DM, Weinberg J. Perpetration of physical assault against dating partners, peers, and siblings among a locally representative sample of high school students in Boston, Massachusetts. Arch Pediatr Adolesc Med. 2010; 164(12): 1118–1124.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Azrael D, Johnson RM, Molnar BE, et al. Creating a youth violence data system for Boston, Massachusetts. Aust N Z J Criminol. 2009; 42(3): 406–421.

    Article  Google Scholar 

  36. Hemenway D, Barber CW, Gallagher SS, Azrael DR. Creating a national violent death reporting system: a successful beginning. Am J Prev Med. 2009; 37(1): 68–71.

    Article  PubMed  Google Scholar 

  37. Brennan RT, Molnar BE, Earls F. Refining the measurement of exposure to violence (ETV) in urban youth. J Community Psychol. 2007; 35(5): 603–618.

    Article  Google Scholar 

  38. Dunn EC, Johnson RM, Green JG. The Modified Depression Scale (MDS): a brief, no-cost assessment tool to estimate the level of depressive symptoms in students and schools. School Ment Health. 2012; 4(1): 34–45.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51(6): 1173–1182.

    Article  CAS  PubMed  Google Scholar 

  40. D’Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998; 17(19): 2265–2281.

    Article  PubMed  Google Scholar 

  41. Austin PC. A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2008; 27(12): 2037–2049.

    Article  PubMed  Google Scholar 

  42. Cisler JM, Begle AM, Amstadter AB, et al. Exposure to interpersonal violence and risk for PTSD, depression, delinquency, and binge drinking among adolescents: data from the NSA-R. J Trauma Stress. 2012; 25(1): 33–40.

    Article  PubMed  Google Scholar 

  43. Wilson DK, Kliewer W, Bayer L, et al. The influence of gender and emotional versus instrumental support on cardiovascular reactivity in African-American adolescents. Ann Behav Med. 1999; 21(3): 235–243.

    Article  CAS  PubMed  Google Scholar 

  44. Shumaker SA, Hill DR. Gender differences in social support and physical health. Health Psychol. 1991; 10(2): 102–111.

    Article  CAS  PubMed  Google Scholar 

  45. Belle D. Children’s social networks and social supports. New York: Wiley; 1989.

    Google Scholar 

  46. Kliewer W, Lepore SJ, Broquet A, Zuba L. Developmental and gender differences in anonymous support-seeking: analysis of data from a community help line for children. Am J Community Psychol. 1990; 18(2): 333–339.

    Article  CAS  PubMed  Google Scholar 

  47. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989; 56(2): 267–283.

    Article  CAS  PubMed  Google Scholar 

  48. Lepore SJ, Allen KA, Evans GW. Social support lowers cardiovascular reactivity to an acute stressor. Psychosom Med. 1993; 55(6): 518–524.

    CAS  PubMed  Google Scholar 

  49. Hannon L. Extremely poor neighborhoods and homicide. Soc Sci Q. 2005; 86(s1): 1418–1434.

    Article  Google Scholar 

  50. Kaufman JS, Maclehose RF, Kaufman SA. Further critique of the analytic strategy of adjusting for covariates to identify biologic mediation. Epidemiol Perspect Innov. 2004; 1(1): 4. Oct 8.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Cole SR, Hernan MA. Fallibility in estimating direct effects. Int J Epidemiol. 2002; 31(1): 163–165.

    Article  PubMed  Google Scholar 

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Acknowledgments

The Boston Youth Survey (BYS) was conducted in collaboration with the Boston Public Health Commission (Barbara Ferrer, Director), Boston’s Office of Human Services (Larry Mayes, Chief), Boston Public Schools (Carol Johnson, Superintendent), and the Office of The Honorable Mayor Thomas M. Menino. The survey would not have been possible without the participation of the faculty, staff, administrators, and students of Boston Public Schools. This work was supported by a grant from the Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) (U49CE00740) to the Harvard Youth Violence Prevention Center (David Hemenway, Principal Investigator). Roman Pabayo is a Canadian Institutes of Health Research postdoctoral fellowship recipient.

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Roman Pabayo & Ichiro Kawachi

  2. Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave., M/S 310 INV, Boston, MA, 02115, USA

    Beth E. Molnar

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  1. Roman Pabayo
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Correspondence to Roman Pabayo.

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Pabayo, R., Molnar, B.E. & Kawachi, I. Witnessing a Violent Death and Smoking, Alcohol Consumption, and Marijuana Use among Adolescents. J Urban Health 91, 335–354 (2014). https://doi.org/10.1007/s11524-013-9828-5

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