Citation

Matthay EC, Rudolph KE, Goin DE, Farkas K, Skeem JL, Ahern J. Epidemiology 2019; 30(2): e5-e7.

Affiliation

Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, ellicott.matthay@ucsf.edu Violence Prevention Research Program, Department of Emergency Medicine, University of California at Davis School of Medicine, Sacramento, CA Division of Epidemiology, School of Public Health, University of California, Berkeley, CA School of Social Welfare, University of California, Berkeley, CA, Goldman School of Public Policy, University of California, Berkeley, CA Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/EDE.0000000000000949

PMID

30720589

Abstract

Self-harm is a leading cause of morbidity and mortality in the United States,1 and rates are increasing for reasons that are not well understood. Social environments are recognized to be associated with self-harm,2 but research to identify features of the social environment that matter most is limited.

Community violence is one potentially modifiable feature of the social environment that may influence self-harm. However, few studies have examined the association of community violence with self-harm3–10 and, to our knowledge, no research has examined short-term, within-community variation in violence, as opposed to chronic or overall levels of violence.
Within-community variation in violence is directly relevant to the stress-diathesis model of self-harm which posits that incidents of self-harm reflect the confluence of long-term predisposition to self-harm (e.g., due to genetic vulnerability) with exposure to stressful life events that trigger brief periods of elevated risk.11 Thus, increases in community violence (e.g., having neighbors who were recently shot) may trigger self-harm in a vulnerable individual.

Methodologically, chronic community violence is strongly associated with other self-harm risk factors such as economic opportunity, making the effects of these factors difficult or impossible to disentangle ...

Language: en