Citation

Sternthal MJ, Jun HJ, Earls F, Wright RJ. Eur. Respir. J. 2010; 36(6): 1400-1409.

Affiliation

Harvard School of Public Health, Boston, MA.

Copyright

(Copyright © 2010, European Respiratory Society)

DOI

10.1183/09031936.00003010

PMID

20413538

Abstract

We examined the association between community violence exposure and childhood asthma risk in a multilevel, multi-method longitudinal study controlling for individual- and neighborhood-level confounders and pathway variables.Analyses included 2071 children aged 0-9 at enrollment from the Project on Human Development in Chicago Neighborhoods (PHDCN). Multilevel logistic regression models estimated the likelihood of asthma, controlling for individual-level (child's age, gender, race/ethnicity; maternal asthma, socioeconomic status, and family violence in the home) and neighborhood-level confounders (concentrated disadvantage, collective efficacy, social disorder), and pathway variables (maternal smoking, breastfeeding).In adjusted analyses, medium (OR 1.60; 95% CI 1.17, 2.19) and high levels (OR 1.56; 95% CI 1.12, 2.18) of community violence were associated with increased asthma risk, relative to low levels. The increased asthma risk remained for African Americans when models included community violence and all other individual-level covariates but attenuated to borderline non-significance when further adjusting for collective efficacy.Community violence is associated with asthma risk when controlling for individual- and neighborhood-level confounders. Neither community violence nor the other individual-level factors fully accounted for the excess asthma burden among African Americans. These data suggest that public health interventions outside of the biomedical model may be needed to reduce asthma in disadvantaged populations.

Language: en