The influence of social and political violence on the risk of pregnancy complications.

Abstract

BACKGROUND. Events in Chile provided an opportunity to evaluate health effects associated with exposure to high levels of social and political violence. METHODS. Neighborhoods in Santiago, Chile, were mapped for occurrences of sociopolitical violence during 1985-86, such as bomb threats, military presence, undercover surveillance, and political demonstrations. Six health centers providing prenatal care were then chosen at random: three from "high-violence" and three from "low-violence" neighborhoods. The 161 healthy, pregnant women due to deliver between August 1 and September 7, 1986, who attended these health centers were interviewed twice about their living conditions. Pregnancy complications and labor/delivery information were subsequently obtained from clinic and hospital records. RESULTS. Women living in the high-violence neighborhoods were significantly more likely to experience pregnancy complications than women living in lower violence neighborhoods (OR = 5.0; 95% CI = 1.9-12.6; p less than 0.01). Residence in a high-violence neighborhood was the strongest risk factor observed; results persisted after controlling for several sets of potential confounders. CONCLUSION. Living in areas of high social and political violence increased the risk of pregnancy complications among otherwise healthy women.

Iron Deficiency Associated with Higher Blood Lead in Children Living in Contaminated Environments

“…Inner-city populations that experience high rates of exposure to violence are also characterized by high levels of poverty, hopelessness, lack of opportunity, and unemployment (i.e., chronic ongoing stressors). Living in a violent environment is Grounds Rounds in Environmental Medicine • Wright and Steinbach associated with a chronic pervasive atmosphere of fear and the perceived threat of violence (19,20). Children and families living with community violence are likely to view their world and their lives as being out of their control.…”

“…Controlled animal studies consistently demonstrate higher lead levels in iron-deficient animals than in iron-replete controls (18)(19)(20)(21)(22)(23). The mechanism for enhanced absorption is likely to be substitution of Fe +2 with Pb +2 and increased active transport into the body (19,22,24,25).…”

Armed conflict and birth weight: Evidence from the al-Aqsa Intifada

“…There is also evidence that fatalities in the later stages of pregnancy are negatively related to anemia. See Zapata et al (1992) for more on the relationship between prenatal exposure to violence and pregnancy complications. 17 Table 5 does not include children who were reported to weigh 2500 g at birth in the low-birth-weight category.…”

The Social Environment and Health: A Discussion of the Epidemiologic Literature

“…Two studies reported associations between urban violence and poor pregnancy outcomes (15,127). In Santiago, Chile, Zapata and colleagues assigned ratings for sociopolitical violence, such as bomb threats, military presence, undercover surveillance, and political demonstrations (127).…”

“…In Santiago, Chile, Zapata and colleagues assigned ratings for sociopolitical violence, such as bomb threats, military presence, undercover surveillance, and political demonstrations (127). Collins & David (15) used police department violent-crime statistics to measure urban violence in Chicago's low-income census tracts.…”