Researchers at the University of Pennsylvania School of Medicine have found that patients with asthma who are exposed to violence in their community are at an increased risk for an asthma-related hospitalization and emergency room visits. The findings, to be published in The Journal of Allergy & Clinical Immunology, adds to research showing a link between exposure to community violence and increased symptoms in pediatric patients. The new research, however, adds to this finding with a longitudinal study showing a connection in the adult population—and more than symptoms: actual emergency department (ED) visits and hospitalizations.

The prospective cohort study tracked 397 adults living in an inner city community with moderate to severe asthma for 6 months as part of a large study of asthma management. Participants were interviewed to determine sociodemographics, asthma status, asthma-specific quality of life, depressive symptoms, social support, and exposure to community violence. To define exposure to community violence, patients were asked, “in the past 6 months did you witness any violence in your neighborhood.” If they responded “yes,” they were asked to indicate the types of violence they had witnessed. They were then seen monthly, and reports of hospitalization and ED visits were obtained as part of data collected at these visits.

The study found that exposure to violence was quite common in the study group—affecting almost one quarter of the group. Those previously exposed to violence had nearly twice the rate of subsequent hospitalization or ED visits for asthma compared to asthmatics who had not experienced violence exposure. Asthma-related quality of life was also found to be lower in the violence-exposed group. Younger adults were more likely to be exposed to violence and more likely to have an ED visit in general.

The researchers said it is difficult to determine exactly how exposure to violence affects health. One possibility for individuals with asthma is that exposure to violence is a marker for other exposures, such as outdoor pollution, inadequate housing, or limited access to pharmacies that contribute to the development of the disease, exacerbate symptoms, and interfere with successful treatment and management of their condition. Another possibility, and not mutually exclusive according to the researchers, is that the psychological stress of living in a community with concentrated disadvantage directly affects the health of people with asthma. Such stress is known to have an affect on overall health.

The study’s authors contend that the findings highlight the importance of neighborhood factors on overall health and the need for physicians to consider the environment in which the patient lives in order to recommend the most effective treatments.

Source: University of Pennsylvania School of Medicine