Community Violence as Psychosocial Stressor: The Case of Childhood Asthma in Boston

Childhood asthma is a critical public health problem of urban centers in the United States and other industrialized nations. Population-based and laboratory research studies indicate that psychosocial stress differentially affects asthma expression. Witnessing or experiencing community violence is a psychosocial stressor that results in long-term biological changes that may in turn contribute to asthma morbidity. This is a review of the literature that examines the exposure to violence as a psychosocial stressor that is independently associated with asthma morbidity even after adjustment for income, housing, and other adverse life events. In addition to acting as a physiological trigger for the disease, community violence can also impact health behaviors and exposure to other unknown environmental risk factors. This connection leads the authors to suggest that reducing violence and the amelioration of its impact has implications beyond public health. The City of Boston in Massachusetts serves as the context to contextualize a series of recommendations that may ameliorate and/or prevent asthma incidence and prevalence. The reduction of poverty, unemployment, substandard housing, and high crime/violence rates can have significant health implications for children asthma and a decline on asthma hospitalization.