Children who live in violent neighborhoods experience more physical and mental health issues than the rest of the population, according to a study published Monday in Health Affairs.
While previous research has shown a connection between violent environments and health issues among children, this latest study demonstrated an association between living in neighborhoods that produce violence or the threat of violence and a greater incidence of health issues ranging from daily difficulties to chronic, developmental and behavioral issues.
It comes as violence—specifically gun violence—as a public health issue has gained a growing profile and increased support from medical providers.
Along with the broader array of outcomes, the study sample is both recent and large enough to be nationally representative, making it among the most comprehensive studies of its kind to date, according to lead author Dylan Jackson, Ph.D., an assistant professor of criminal justice at the University of Texas at San Antonio.
The study also attempted to quantify the contribution of other social conditions often connected with violent communities, such as the physical deterioration of buildings or low availability of social resources within a neighborhood.
“I thought that perhaps the violence effects would be more attenuated or diminished once you account for the social processes in the neighborhood and the physical disorder,”Jackson told FierceHealthcare. Instead, it turns out that violence and the threat of violence correlated much more strongly to the health risks targeted in the study.
“I was surprised that the results were this robust for violence because those things are so interconnected,” he said.
The general consensus among researchers has been that the chronic stress under which children in violent neighborhoods live affects their physical and mental development. Left unchecked, those issues generate a social and public health cost. As value-based care puts a greater emphasis on population health, hospitals and other healthcare providers have increasingly begun to approach violence as a public health issue and have become more assertive about the role they intend to play in attempting to stem the tide.
Getting healthcare advocates involved is important because many previous efforts in violent communities have focused more on physical decay and deterioration, he said.
“When you’re thinking about promoting the health of kids, you’ve got to think about reducing violence and enhancing public safety above and beyond just investing more generally in the neighborhood,” he says.
Jackson points to violence-prevention initiatives such as the Nurse-Family Partnership, which sends nurses to visit parents in at-risk areas and provides parenting programs and expanded early childhood education.
At some level, however, he believes joint initiatives that combine the efforts of law enforcement and public health advocates will be a key factor in producing lasting change and improving the health of at-risk children and adolescents.
“Violence prevention is a very narrow endeavor right now—it’s important, but people don’t think about how it’s connected to every other facet, like well-being and health,” Jackson said.
“They’re definitely not thinking about how early health issues among kids—mental health, physical health—can actually have downstream effects on their own involvement in delinquency and the criminal justice system,” he adds. “It’s all connected and often people don’t want to see the ways that it is. They just kind of say, ‘Hey, well, law enforcement and courts and corrections, you deal with all this violence stuff and enforcing the law, and we’ll deal over here with population health.’ But it doesn’t work that way in reality.”