Asthma And Domestic Violence Linked
May 7, 2007
The link between environmental exposures and asthma has been clearly described,
but a new study from researchers at the Harvard School of Public Health (HSPH)
finds a strong association between domestic violence and asthma. The study, in
the upcoming June issue of the International Journal of Epidemiology,
raises questions about the role of stress in the development of this common
respiratory condition.
"Classic environmental triggers for asthma have been carefully studied, but
there is less information on the role of stress in asthma episodes," says
lead researcher S.V. Subramanian, Assistant Professor in the Department of
Society, Human Development and Health at HSPH. "The risk posed by domestic
violence - and perhaps other psychosocial factors - could be as high as some
well known environmental risk factors such as smoking."
The authors performed their research using a large nationally representative
database of 92,000 households in India, where domestic violence is highly
prevalent. Each respondent was surveyed in a face-to-face interview in one of 18
Indian languages. Respondents were asked if anyone in the household suffered
from asthma, and were also asked about a personal history of experiencing or
witnessing domestic violence. Researchers also accounted for many other factors
that have been associated with asthma, including exposure to tobacco smoke and
level of education and income.
The study found that women who had experienced domestic violence in the past
year had a 37 percent increased risk of asthma. For women who had not
experienced domestic violence themselves but lived in a household where a woman
had been beaten in the past year, there was a 21 percent increased risk of
asthma than for women who did not live in such households. In addition, living
in a household where a woman experienced domestic violence also increased the
risk of reported asthma in children and adult men.
While the authors caution that the study cannot prove a causal link between
domestic violence and asthma, there are several possible mechanisms to explain
such a strong relationship between the two. Exposure to violence, and other
major psychosocial stressors, is known to affect the immune system and
inflammation, which have a role in asthma development. In addition, those
exposed to violence may adopt certain 'coping' behaviors that predispose them to
asthma, such as cigarette smoking.
This study is the first to examine the relationship between violence and asthma
in India, where domestic violence is at relatively high levels, and where the
World Health Organization estimates 15-20 million asthmatics live. Subramanian
adds, "Our study suggests a new method for identifying stress-induced
episodes and also reveals another terrible health risk of domestic
violence."
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Other authors on the study were HSPH graduate students Leland
Ackerson and Malavika Subramanyam; and Rosalind Wright, HMS assistant professor
of medicine at Brigham and Women's Hospital.
Harvard School of Public Health is dedicated to advancing the public's health
through learning, discovery, and communication. More than 300 faculty members
are engaged in teaching and training the 900-plus student body in a broad
spectrum of disciplines crucial to the health and well being of individuals and
populations around the world. Programs and projects range from the molecular
biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to
violence prevention; from maternal and children's health to quality of care
measurement; from health care management to international health and human
rights. For more information on the school visit: http://www.hsph.harvard.edu/
Contact: Robin Herman
Harvard School of Public
Health
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