HSPH researchers have identified a new risk factor for asthma that seems to be as important as other well-known environmental threats. Domestic violence was associated with an increased risk for the respiratory disorder based on a survey performed in a nationally representative sample of more than 90,000 households in India. The risk posed by domestic violence prevailed even after other well-established asthma risks were held constant. The findings appeared online Feb. 28 in the International Journal of Epidemiology.
Some studies suggest that psychosocial stressors might explain the higher prevalence of asthma among lower socioeconomic groups. S.V. Subramanian, HSPH assistant professor of society, human development, and health; HSPH graduate students Leland Ackerson and Malavika Subramanyam; and Rosalind Wright, HMS assistant professor of medicine at Brigham and Women’s Hospital, used domestic violence as a marker of psychosocial stress and analyzed its relationship with asthma risk from data collected as part of the Indian National Family Health Survey from 1998 to 1999.
Women who were abused within the previous year had a 37 percent increase in their asthma risk. Abuse that occurred over a year before the survey was also linked to greater risk, indicating enduring adverse consequences of domestic violence.
“The magnitude of the risk is right up there with other well-known, well-established risk factors,” said Subramanian, referring, in part, to smoking cigarettes, which the survey found to increase asthma risk by 54 percent. The researchers held other asthma risk factors constant so their risk calculations would reflect an independent association between asthma and domestic violence.
The increased prevalence of asthma among family members exposed to domestic violence was not restricted to victims. All occupants of a household where abuse had occurred within the past year had a 19 percent increased risk. “If you live in a household with a woman being abused, everyone is at risk for asthma,” Subramanian said.
The researchers also estimated the way age alters asthma risk due to domestic violence. They found that children under 5 years old—a critical mark for asthma onset, Subramanian said—had a particularly strong association between asthma and domestic violence, with about a 20 percent increased risk.
Links between asthma and violence have also been identified in the United States and Australia. The field of research linking psychosocial stress and asthma holds some promise for explaining why asthma rates have been increasing in recent years, Subramanian said.
