Saturday, April 19, 2014
Inquirer Daily News

Violence, stress and children's health

Multiple studies show that when children witness or - even worse - are personally assaulted, there are long-term consequences for their health and behavior.

Violence, stress and children's health

Children caught up in violence have much higher chances of: poor school achievement, early sexual activity, depression, or participating in violence themselves. (AP Photo)<br />
Children caught up in violence have much higher chances of: poor school achievement, early sexual activity, depression, or participating in violence themselves. (AP Photo)

by Gary A. Emmett, M.D.

Multiple studies show that when children witness or - even worse - are personally assaulted, there are long-term consequences for their health and behavior. Children caught up in the web of violence have much higher chances of:

  • Poor school achievement
  • Early sexual activity
  • Depression
  • Participating in violence themselves. 

A recent New England Journal of Medicine study looked at the experiences of more than 5,000 fifth graders in three different urban areas - Birmingham, Ala., Houston and Los Angeles.  It focused on health disparities between African-American, Latino and white children. One finding was the chances that a child witnessed the threat of injury, or saw actual injury caused by a gun, were four times higher in African-American children than in white children. When the researchers took socio-economic status into account, African-American kids were still twice as likely as white or Latino kids to have witnessed violence even when they lived in similar neighborhoods and had similar incomes.

Health disparities are rampant in our society. Asthma hospitalization is five times more frequent in black children than in white children.  Violence - mostly gunshot wounds - is the number one killer of adolescent black males, but much less frequent in white adolescent males (who mainly die in car accidents). Research is beginning to show that many physical disorders have their origins in our everyday, disparate experiences.

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Two areas where these disparities affect our kids:

Living in harm’s way. Being vulnerable to assault or to watching others assaulted decreases natural compounds that protect the body, such as innate steroids that protect against infection. Getting guns off the street will protect our children in many ways especially in preventing future trauma to their system. Teens exposed to violence continue to have higher stress levels several  years later, says one new Penn State study. This can weaken immunity and increase their risk for heart disease and diabetes. Seeing violence in real life is a torment that interrupts kids’ sleep for multiple years as well, says another recent study, from Case Western Reserve University.

Living with extra stress day in, day out. An emerging field of research is looking at health disparities that stem from “the biology of adversity." Findings were, that the wear and tear of day-to-day experiences and stresses - like living with overt or perceived racism or being in a neighborhood without great schools and transportation - wreaks havoc regarding physical health in the long-run. It may play a role in higher risk for heart-disease deaths and for high blood pressure among some African-Americans. In one 2007 study, researchers found that adversity early in life was associated with higher levels of heart-threatening inflammation and certain blood clot-inducing compounds in African Americans. Opportunity counts, too. In another study of 7,000 women health professionals, those with the highest levels of education were 26 percent less likely, to develop high blood pressure compared to those with less education.

Great reasons to get guns off the streets, improve our schools and our cities - for the health of our children and everyone.

Garry A. Emmett, M.D., F.A.A.P., has been a primary care pediatrician in South Philadelphia and Center City since 1979. He is currently an attending pediatrician at Nemours Pediatrics, Philadelphia and director of hospital pediatrics at Thomas Jefferson University Hospital

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