Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep;126(3):552-7.
doi: 10.1016/j.jaci.2010.07.014.

Exposure to community violence is associated with asthma hospitalizations and emergency department visits

Andrea J Apter  1 , Laura A Garcia, Rhonda C Boyd, Xingmei Wang, Daniel K Bogen, Thomas Ten Have
Affiliations

Exposure to community violence is associated with asthma hospitalizations and emergency department visits

Andrea J Apter et al. J Allergy Clin Immunol. 2010 Sep.

Abstract

Background: Exposure to community violence (ECV) has been associated with asthma morbidity of children living in inner-city neighborhoods.

Objective: To examine with prospective longitudinal data whether ECV is independently associated with asthma-related health outcomes in adults.

Methods: Adults with moderate-severe asthma, recruited from clinics serving inner-city neighborhoods, completed questionnaires covering sociodemographics, asthma severity, and ECV and were followed for 26 weeks. Longitudinal models were used to assess unadjusted and adjusted associations of subsequent asthma outcomes (emergency department [ED] visits, hospitalizations, FEV(1), quality of life).

Results: A total of 397 adults, 47 +/- 14 years old, 73% women, 70% African American, 7% Latino, mean FEV(1) 66% +/- 19%, 133 with hospitalizations and 222 with ED visits for asthma in the year before entry, were evaluated. Ninety-one reported ECV. Controlling for age, sex, race/ethnicity, and household income, those exposed to violence had 2.27 (95% CI, 1.32-3.90) times more asthma-related ED visits per month and 2.49 (95% CI, 1.11-5.60) times more asthma-related hospitalizations per month over the 26-week study period compared with those unexposed. Violence-exposed participants also had 1.71 (95% CI, 1.14-2.56) times more overall ED visits per month and 1.72 (95% CI, 0.95-3.11) times more overall hospitalizations per month from any cause. Asthma-related quality of life was lower in the violence-exposed participants (-0.40; 95% CI, -0.77 to -0.025; P = .04). Effect modification by depressive symptoms was only statistically significant for the ECV association with overall ED visits and quality-of-life outcomes (P < .01).

Conclusion: In adults, ECV is associated with increased asthma hospitalizations and emergency care for asthma or any condition and with asthma-related quality of life.

PubMed Disclaimer

References

    1. Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, et al. National surveillance for asthma--United States, 1980-2004. MMWR Surveill Summ. 2007;56:1–54. - PubMed
    1. Clougherty JE, Levy JI, Kubzansky LD, Ryan PB, Suglia SF, Canner MJ, et al. Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology. Environ Health Perspect. 2007;115:1140–6. - PMC - PubMed
    1. Wright RJ, Mitchell H, Visness CM, Cohen S, Stout J, Evans R, et al. Community violence and asthma morbidity: the inner-city asthma study. Am J Public Health. 2004;94:625–32. - PMC - PubMed
    1. Chen E, Fisher EB, Bacharier LB, Strunk RC. Socioeconomic status, stress, and immune markers in adolescents with asthma. Psychosom Med. 2003;65:984–92. - PubMed
    1. Gee GC, Payne-Sturges DC. Environmental health disparities: a framework integrating psychosocial and environmental concepts. Environ Health Perspect. 2004;112:1645–53. - PMC - PubMed

Publication types