Advertisement

Journal of Community Health

, Volume 33, Issue 6, pp 384–388 | Cite as

The Effect of Violence on Asthma: Are Our Children Facing a Double-edged Sword?

  • Jennifer WalkerEmail author
  • Cassia Lewis-Land
  • Joan Kub
  • Mona Tsoukleris
  • Arlene Butz
Original Paper

Abstract

Low income, urban children with asthma are experiencing community violence that may contribute to asthma morbidity. The objective of this study was to examine the relationship between caregiver report of feeling unsafe, seeing community violence or child seeing community violence and asthma morbidity and health care utilization. Two hundred thirty-one caregivers of children with asthma enrolled in an asthma,education, intervention reported perceptions of safety and violence exposure in six months and frequency of child asthma symptoms, emergency department (ED), primary care (PCP) visits and hospitalizations over 12 months. Children were primarily male (93%), black (61%), and reported income <$30,000 (56%). Violence exposure was high: feeling unsafe (25%), seeing violence themselves (22%), child saw violence (14%). If caregivers or children saw violence, there were significantly more nighttime symptoms than those who were not exposed (caregiver: yes violence = 6.72 ± 9.19, no violence = 4.23 ± 6.98, P = 0.03; child: yes violence = 7.09 ± 7.15, no violence = 4.37 ± 9.49, P = 0.05). Children who saw violence were less likely to see their PCP. Families exposed to community violence report more asthma symptoms, but are less likely to seek care for asthma. Health care providers and asthma educators should evaluate potential violence exposure with asthma patients and tailor care and education to include violence prevention and avoidance.

Keywords

Community violence Asthma Inner-city African Americans 

Notes

Acknowledgments

Funding provided by National Institute of Nursing Research, NIH. Grant number: NR008544.

References

  1. 1.
    National Center for Health Statistics. (updated 2007 June 04; cited 2007 Aug 10). Asthma prevalence health care use and mortality, United States 2003–05. Atlanta, GA: Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ashtma03-05/asthma03-05.htm.
  2. 2.
    National Center for Injury Prevention and Control. (updated 2007 Apr 19; cited 2007 Aug 10). Youth violence fact sheet. Atlanta, GA: Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/ncipc/factsheets/yvfacts.htm.
  3. 3.
    Ceballo, R., Dahl, T. A., Aretakis, M. T., & Ramirez, C. (2001). Inner-city children’s exposure to community violence: How much do parents know? Journal of Marriage and the Family, 63, 927–940.CrossRefGoogle Scholar
  4. 4.
    Wright, R. J., & Steinbach, S. F. (2001). Violence: An unrecognized environmental exposure that may contribute to greater asthma morbidity in high risk inner-city populations. Environmental Health Perspectives, 109, 1085–1089.PubMedCrossRefGoogle Scholar
  5. 5.
    Veenema, T. G. (2001). Children’s exposure to community violence. Journal of Nursing Scholarship, 33, 167–173.PubMedCrossRefGoogle Scholar
  6. 6.
    Swahn, M. H., & Bossarte, R. M. (2006). The associations between victimization, feeling unsafe, and asthma episodes among US high-school students. American Journal of Public Health, 96, 802–804.PubMedCrossRefGoogle Scholar
  7. 7.
    Berz, J., Carter, A. S., Wagmiller, R. L., Horwitz, S. M., Murdock, K., & Briggs-Gowan, M. (2007). Prevalence and correlates of early onset asthma and wheezing in a healthy cohort of 2-to 3- year olds. Journal of Pediatric Psychology, 32, 154–166.PubMedCrossRefGoogle Scholar
  8. 8.
    National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program (NAEPP). (2007). Draft full report of the expert panel: Guidelines for the diagnosis and management of asthma. EPR-3.Google Scholar
  9. 9.
    Clark, N. M., Gong, M., & Kaciroti, N. (2001). A model of self-regulation for control of chronic disease. Health Education and Behavior, 28, 769–782.PubMedCrossRefGoogle Scholar
  10. 10.
    SAS Institute. (2000). SAS/STAT user’s guide. [CD Rom] (8.0th ed.). Cary NC: SAS Institute, Inc.Google Scholar
  11. 11.
    Stata Corporation. (2001). Stata statistical software (7.0th ed.). College Station, TX: Stata Corporation.Google Scholar
  12. 12.
    Smith, S. R., Wakefield, D. B., & Cloutier, M. M. (2007). Relationship between pediatric primary provider visits and acute asthma ED visits. Pediatric Pulmonology, 42, 1041–1047.PubMedCrossRefGoogle Scholar
  13. 13.
    Zorc, J., Scarfone, R., Li, Y., et al. (2003). Scheduled follow-up after a pediatric emergency department visit for asthma: Randomized trial. Pediatrics, 111, 495–502.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Jennifer Walker
    • 1
    Email author
  • Cassia Lewis-Land
    • 1
  • Joan Kub
    • 2
  • Mona Tsoukleris
    • 3
  • Arlene Butz
    • 1
  1. 1.Department of Pediatrics, School of MedicineJohns Hopkins UniversityBaltimoreUSA
  2. 2.Johns Hopkins School of NursingBaltimoreUSA
  3. 3.University of Maryland School of PharmacyBaltimoreUSA

Personalised recommendations