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Violence May Increase Risk of Childhood Asthma

Children in urban communities marked by violence and crime may be twice as likely to develop asthma as kids in lower-crime areas, new research suggests.

Dr. Rosalind Wright, MD, MPH, of the Beth Deaconess Medical Society and an epidemiologist at Harvard, presented the results of her study at the 96th International Conference of the American Thoracic Society in Toronto on May 9.

Her team studied the link between chronic social stress, including crime, violence, poverty and substandard housing, and the risk of asthma in 549 inner-city children. Measures were based on the incidence of respiratory symptom reporting (such as wheezing), use of bronchodilators and physician diagnosis.

Previous population-based studies have shown that as many as 18 percent of children in urban U.S. regions have asthma compared to non-urban areas where the rates of childhood asthma are between eight and 12 percent.

Using the Boston police database, researchers defined markers of social "disadvantage" as local violent crime rates and the percentage of vacant, boarded-up housing.

"The study shows a relationship between chronic disease and social factors," says Dr. Wright. "We hope it will lead to intervention strategies to decrease the health and social costs associated with asthma.

"For marginalized groups, inequities in the health system cause feelings of powerlessness, stress and frustration. Overburdened by social stressors, people can't effectively manage their condition." Dr. Wright says that crime, violence and trauma have long-term chronic implications for conditions such as asthma.

Dr. Wright's study provides additional support for her similar study two years ago. At that time, she found that children exposed to neighborhood violence were twice as likely to use bronchodilators for wheezing and almost three times as likely to be diagnosed with asthma, compared to children living in non-violent communities.

Stress, including social stress, affects the immune system and compromises its ability to fight infections, including respiratory infections. Because they do not develop an 'immunity' against asthma, Dr. Wright explains, repeated exposure to social stressors makes children more susceptible to allergens and infections.

Dr. Wright says that further studies should examine the compound effects of social stress and allergens, or the physical variables that may be present in inner-city homes including dust mites, cockroach allergens and cigarette smoke.