Exposure to neighborhood violence associated with unmet medical needs and increased child care utilization

A new collaborative study between Boston Medical Center, Brigham and Women's Hospital, Boston Children's Hospital, Hennepin Healthcare Research Institute at the University of Pennsylvania, and Children's Hospital of Philadelphia finds that children's exposure to neighborhood violence was found to be associated with lower medical needs and increased use of emergency care.Published in American Journal of Preventive Medicine This study also provides evidence to improve access to care in communities affected by violence, based on nationally representative data on violence exposure and access to care measures from the National Health Interview Survey. This study shows that interventions based on these findings are necessary to alleviate long-term physical pain. Mental health effects on children.

Millions of children in the United States are exposed to violence in their homes and communities. Research shows that children exposed to violence have worse academic performance in childhood, increased rates of substance use disorders in adolescence, and higher rates of anxiety, depression, and post-traumatic stress disorder in adulthood. has been shown to increase the risk of developing chronic diseases throughout life. It is alive. Exposure to violence also exacerbates child health inequalities, especially in marginalized communities that are disproportionately exposed to violence due to intergenerational systemic racism.

This research examines exposure to violence at the population level, both as a direct driver of health inequalities and as a result of underlying causes such as racism, poverty, and other structural risk conditions. Helpful. Researchers found that even after controlling for the influence of other important factors such as family income and insurance status, children exposed to neighborhood violence are more likely to have unmet physical and mental health care. We found that patients face increased needs, cost-related barriers, decreased access to prescription drugs, and increased emergency care. Emergency department use decreased and access to preventive care, mental health care, and medications decreased.

The study also identified an association between exposure to neighborhood violence and mental health symptoms, including increased rates of depression and anxiety, which was consistent with previous studies. Researchers also found that children exposed to violence had higher rates of delayed or abandoned mental health care, even though they experienced more mental health symptoms. Previous research has shown how early access to care can reduce the mental health effects of exposure to violence. Improving access to high-quality, affordable mental health care services remains critical in communities affected by neighborhood violence.

Researchers identify opportunities for action through embedded environmental reforms such as greening and cleaning neighborhoods, poverty alleviation interventions such as expanding the child tax credit, insurance coverage protections such as Medicaid retention, and hospital-based violence prevention. We are calling for your attention to the program.

Our findings highlight the serious impact of limited access to care in communities affected by violence. We also identify specific opportunities for evidence-based clinician, health system, and policy actions that can reduce the incidence of neighborhood violence and reduce its health consequences. ”

Dr. Rohan Kazanchi, MPH, Lead author, Resident in the Harvard Internal Medicine and Pediatrics Residency Program at Brigham and Women's Hospital, Boston Children's Hospital, and Boston Medical Center.

“To improve the health outcomes of the millions of children in the United States affected by neighborhood violence, we must invest in their families and communities,” said lead author and Philadelphia said Aditi Vasan, MD, MSHP, a pediatrician and assistant professor at Children's Hospital. in Pediatrics, Perelman School of Medicine, University of Pennsylvania. “Our findings support upstream policy interventions, such as expanding the Child Tax Credit, which provide essential financial support to families in low-income communities affected by violence and increased access to quality health care. “It highlights the need for both downstream health system interventions focused on improving trauma-informed care for these children and their families.”