�Children wHO are physically or sexually abused ar more than twice as likely to have asthma attack as their peers, according to a recent study of urban children in Puerto Rico. In fact, physical and sexual maltreat was second only to maternal asthma in all the risk factors tried and true, including paternal asthma and indicators of socioeconomic position.
"To our knowledge, this is the first news report of a direct association between childhood abuse and asthma and asthma-related outcomes," wrote Robyn T. Cohen, M.D., M.P.H., lead source of the paper of the Channing Laboratory of Brigham and Women's Hospital in Boston.
The article was published in the first issue for September of the American Journal of Respiratory and Critical Care Medicine, a issue of the American Thoracic Society.
"We wanted to explore whether exposure to stress and violence is associated with an increased risk of asthma in urban children living in Puerto Rico," said star investigator, Juan C. Celed�n, M.D., Dr.P.H. "We already know that there is a high prevalence of asthma in Puerto Rican children, and many studies have coupled stress and exposure to violence to health problems in puerility, including asthma attack."
The researchers interviewed 1,353 parent-child pairs in between 2001 and 2003, and re-interviewed nearly 90 percent of the same pairs iI years after their initial interviews. They used validated questionnaires to elicit information about accent and furiousness in the children's lives (whenever possible, without the parent present), and secondhand doctor-diagnosed bronchial asthma, allergic coryza, use of prescription medication for bronchial asthma and dr. visits for asthma and/or allergic rhinitis within the previous yr to appraise the children's asthma/allergy status.
"Children with a history of maltreat had higher frequencies of all outcomes of interest than those without a history of abuse," wrote Dr. Cohen. "After adjusting for relevant covariates, history of abuse was associated with an approximate doubling of the odds of current bronchial asthma, healthcare use for asthma, and supersensitive rhinitis." For example, whereas 15 (20 percent) of the 75 children with a history of abuse had current asthma, 128 (11.5 percent) of 1,117 children without history of abuse had current bronchial asthma.
The study did not, however, find a connection between neighborhood violence and asthma, as other studies have done in the past. The researchers hint that the discrepancy may be the result of the fact that "it is non simply the exposure to a particular stressor merely the physiologic response to that stressor that predicts physical health outcomes."
Individual responses to stressors such as community violence will vary, and according to some information, Puerto Rican culture itself may have protective features. "Latino culture places an emphasis on certain values and social supports that may buffer the effects of poorness and residential district violence experienced by children in Puerto Rico," aforesaid Dr. Cohen. Direct physical or sexual abuse, however, could cause a dissect of those buffering systems.
The investigators postulate that abuse may alter the
