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Violence Exposure, A Chronic Psychosocial Stressor, and Childhood Lung Function

From the Department of Epidemiology (S.F.S., F.L., D.W.D.), Department of Environmental Health (S.F.S., F.L., D.W.D.), Department of Biostatistics (L.R.), and Department of Society (R.J.W.), Human Development and Health, Harvard School of Public Health, Boston, Massachusetts; and Channing Laboratory (R.J.W.), Brigham & Women’s Hospital, Boston, Massachusetts.

Address correspondence and reprint requests to Shakira Franco Suglia, Harvard School of Public Health, Department of Environmental Health, Landmark 415W, 401 Park Drive, Boston, MA 02215. E-mail: sfranco{at}hsph.harvard.edu

Objective: Chronic psychosocial stressors, including violence, and neuropsychological and behavioral development in children as well as physiologic alterations that may lead to broader health effects.

Methods: We studied the relationship between violence and childhood lung function in a prospective birth cohort of 313 urban children (age range = 6–7 years). Mothers reported on their child’s lifetime exposure to community violence (ETV) and interparental conflict in the home (Conflict Tactics Scale (CTS)) within 1 year of the lung function assessment.

Results: In linear regression analyses, adjusting for maternal education, child’s age, race, birthweight, tobacco smoke exposure, and medical history, girls in the highest CTS verbal aggression tertile had a 5.5% (95% confidence interval (CI) = –9.6, –1.5) decrease in percent predicted forced expiratory volume (FEV₁) and a 5.4% (95% CI = –9.7, –1.1) decrease in forced vital capacity (FVC) compared with girls in the lowest tertile. The CTS verbal aggression subscale was associated with lung function among boys in the same direction, albeit this was not statistically significant. Boys in the highest ETV tertile had a 3.4% (95% CI = –8.0, 1.1) lower FEV₁ and 5.3% lower FVC (95% CI = –10.2, –0.4) compared with boys in the lowest tertile. The ETV score was not a significant predictor of girls’ lung function.

Conclusions: Interparental conflict, specifically verbal aggression, and ETV were associated with decreased childhood lung function independent of socioeconomic status, tobacco smoke exposure, birthweight, and respiratory illness history. Gender differences were noted based on the type of violence exposure, which may warrant further exploration.

Key Words: lung function • violence exposure • children

Abbreviations: ETV = exposure to violence; CTS = Conflict Tactic Scale; FEV₁ = forced expiratory volume; FVC = forced vital capacity; FEF_25%–75% = forced mid-expiratory flow rate; UTS = in utero tobacco smoke; SHS = second hand smoke.

This article has been cited by other articles:

				S. F. Suglia, M. B. Enlow, A. Kullowatz, and R. J. Wright Maternal Intimate Partner Violence and Increased Asthma Incidence in Children: Buffering Effects of Supportive Caregiving Arch Pediatr Adolesc Med, March 1, 2009; 163(3): 244 - 250. [Abstract] [Full Text] [PDF]