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RESEARCH AND PRACTICE |
Rosalind J. Wright is with the 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, Mass. Herman Mitchell and Cynthia M. Visness are with Rho Inc, Federal Systems Division, Chapel Hill, NC. Sheldon Cohen is with the Department of Psychology, Carnegie Mellon University, Pittsburgh, Pa. James Stout is with the Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash. Richard Evans is with the Department of Pediatrics and Medicine, Northwestern University Medical School, Chicago, Ill. Diane R. Gold is with the Channing Laboratory, Dept of Medicine, Brigham and Women’s Hospital, Harvard Medical School.
Correspondence: Requests for reprints should be sent to Rosalind J. Wright, MD, MPH, Channing Laboratory, 181 Longwood Ave, Boston, MA 02115 (e-mail: rosalind.wright{at}channing.harvard.edu).
Objectives. 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.
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