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Erschienen in: Journal of General Internal Medicine 11/2018

03.08.2018 | Original Research

Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago

Erschienen in: Journal of General Internal Medicine | Ausgabe 11/2018

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Abstract

Background

Community violence is an important social determinant of health in many high-poverty, urban communities.

Objective

The purpose of this study was to explore and characterize self-described experiences of community violence among adults with chronic health conditions.

Design

Qualitative study design was implemented in 2017 using in-depth, semi-structured focus groups and interviews; data were collected from two clinical sites located in geographic epicenters of high violent crime in Chicago.

Participants

Adult patients, ages 35 years and older, who had at least one chronic condition.

Approach

Data were analyzed using grounded theory and the constant comparison method.

Key Results

The overall sample (N = 51) was predominantly female (67%) and black non-Hispanic (75%); a large proportion had hypertension (65%), arthritis (55%), obesity (53%), and/or diabetes (45%). The majority reported that a close friend or family member was seriously injured or killed due to community violence (71%); a similar proportion had never discussed their experiences of community violence with a healthcare provider (73%). Several major themes emerged: (1) perceived risk of being targeted, (2) chronic stress and worry, (3) hypervigilance, (4) social breakdown, (5) chronic isolation, (6) constrained choice (loss of freedom), (7) limited access to material resources, and (8) inadequate healthcare responses.

Conclusions

Patients often struggled to balance the challenges imposed by community violence with the demands of living with and managing their chronic conditions. Emergent themes may inform practical targets for addressing community violence as a social determinant of health in vulnerable populations.
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Literatur
1.
Zurück zum Zitat Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System. 2015. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System. 2015.
2.
Zurück zum Zitat Voisin DR. The public health implications of violence exposures: violence and immunological factors among perinatally HIV-infected youth. J Adolesc Health. 2016;59:3–4.PubMedCrossRef Voisin DR. The public health implications of violence exposures: violence and immunological factors among perinatally HIV-infected youth. J Adolesc Health. 2016;59:3–4.PubMedCrossRef
3.
Zurück zum Zitat Voisin DR, Neilands TB. Community violence and health risk factors among adolescents on Chicago’s southside: does gender matter? J Adolesc Health. 2010;46:600–2.PubMedPubMedCentralCrossRef Voisin DR, Neilands TB. Community violence and health risk factors among adolescents on Chicago’s southside: does gender matter? J Adolesc Health. 2010;46:600–2.PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat Reese C, Pederson T, Avila S, Joseph K, Nagy K, Dennis A, Wiley D, Starr F, Bokhari F. Screening for traumatic stress among survivors of urban trauma. J Trauma Acute Care Surg. 2012;73:462–7; discussion 467-8.PubMedCrossRef Reese C, Pederson T, Avila S, Joseph K, Nagy K, Dennis A, Wiley D, Starr F, Bokhari F. Screening for traumatic stress among survivors of urban trauma. J Trauma Acute Care Surg. 2012;73:462–7; discussion 467-8.PubMedCrossRef
5.
Zurück zum Zitat Lovasi GS, Hutson MA, Guerra M, Neckerman KM. Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009;31:7–20.PubMedCrossRef Lovasi GS, Hutson MA, Guerra M, Neckerman KM. Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009;31:7–20.PubMedCrossRef
6.
Zurück zum Zitat Fish JS, Ettner S, Ang A, Brown AF. Association of perceived neighborhood safety with [corrected] body mass index. Am J Public Health. 2010;100:2296–303.PubMedPubMedCentralCrossRef Fish JS, Ettner S, Ang A, Brown AF. Association of perceived neighborhood safety with [corrected] body mass index. Am J Public Health. 2010;100:2296–303.PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Yu E, Lippert AM. Neighborhood crime rate, weight-related behaviors, and obesity: a systematic review of the literature. Sociol Compass. 2016;10:187–207.CrossRef Yu E, Lippert AM. Neighborhood crime rate, weight-related behaviors, and obesity: a systematic review of the literature. Sociol Compass. 2016;10:187–207.CrossRef
8.
Zurück zum Zitat Doyle S, Kelly-Schwartz A, Schlossberg M, Stockard J. Active community environments and health: the relationship of walkable and safe communities to individual health. J Am Plan Assoc. 2006;72:19–31.CrossRef Doyle S, Kelly-Schwartz A, Schlossberg M, Stockard J. Active community environments and health: the relationship of walkable and safe communities to individual health. J Am Plan Assoc. 2006;72:19–31.CrossRef
9.
Zurück zum Zitat Sundquist K, Theobald H, Yang M, Li X, Johansson SE, Sundquist J. Neighborhood violent crime and unemployment increase the risk of coronary heart disease: a multilevel study in an urban setting. Soc Sci Med. 2006;62:2061–71.PubMedCrossRef Sundquist K, Theobald H, Yang M, Li X, Johansson SE, Sundquist J. Neighborhood violent crime and unemployment increase the risk of coronary heart disease: a multilevel study in an urban setting. Soc Sci Med. 2006;62:2061–71.PubMedCrossRef
10.
Zurück zum Zitat Foster S, Giles-Corti B. The built environment, neighborhood crime and constrained physical activity: an exploration of inconsistent findings. Prev Med. 2008;47:241–51.PubMedCrossRef Foster S, Giles-Corti B. The built environment, neighborhood crime and constrained physical activity: an exploration of inconsistent findings. Prev Med. 2008;47:241–51.PubMedCrossRef
11.
Zurück zum Zitat Billimek J, Sorkin DH. Self-reported neighborhood safety and nonadherence to treatment regimens among patients with type 2 diabetes. J Gen Intern Med. 2012;27:292–6.PubMedCrossRef Billimek J, Sorkin DH. Self-reported neighborhood safety and nonadherence to treatment regimens among patients with type 2 diabetes. J Gen Intern Med. 2012;27:292–6.PubMedCrossRef
12.
Zurück zum Zitat McEwen B, Lasley EN. Allostatic load: when protection gives way to damage. Adv Mind-Body Med. 2003;19:28–33.PubMed McEwen B, Lasley EN. Allostatic load: when protection gives way to damage. Adv Mind-Body Med. 2003;19:28–33.PubMed
13.
Zurück zum Zitat Astell-Burt T, Feng X, Kolt GS, Jalaludin B. Does rising crime lead to increasing distress? Longitudinal analysis of a natural experiment with dynamic objective neighbourhood measures. Soc Sci Med. 2015;138:68–73.PubMedCrossRef Astell-Burt T, Feng X, Kolt GS, Jalaludin B. Does rising crime lead to increasing distress? Longitudinal analysis of a natural experiment with dynamic objective neighbourhood measures. Soc Sci Med. 2015;138:68–73.PubMedCrossRef
14.
Zurück zum Zitat Lorenc T, Clayton S, Neary D, Whitehead M, Petticrew M, Thomson H, Cummins S, Sowden A, Renton A. Crime, fear of crime, environment, and mental health and wellbeing: mapping review of theories and causal pathways. Health Place. 2012;18:757–65.PubMedCrossRef Lorenc T, Clayton S, Neary D, Whitehead M, Petticrew M, Thomson H, Cummins S, Sowden A, Renton A. Crime, fear of crime, environment, and mental health and wellbeing: mapping review of theories and causal pathways. Health Place. 2012;18:757–65.PubMedCrossRef
15.
Zurück zum Zitat Bogar S, Beyer KM. Green space, violence, and crime: a systematic review. Trauma Violence Abuse. 2016;17:160–71.PubMedCrossRef Bogar S, Beyer KM. Green space, violence, and crime: a systematic review. Trauma Violence Abuse. 2016;17:160–71.PubMedCrossRef
16.
Zurück zum Zitat Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science (New York, NY). 1997;277:918–24.CrossRef Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science (New York, NY). 1997;277:918–24.CrossRef
17.
Zurück zum Zitat Ruijsbroek A, Droomers M, Groenewegen PP, Hardyns W, Stronks K. Social safety, self-rated general health and physical activity: changes in area crime, area safety feelings and the role of social cohesion. Health Place. 2015;31:39–45.PubMedCrossRef Ruijsbroek A, Droomers M, Groenewegen PP, Hardyns W, Stronks K. Social safety, self-rated general health and physical activity: changes in area crime, area safety feelings and the role of social cohesion. Health Place. 2015;31:39–45.PubMedCrossRef
18.
Zurück zum Zitat Mmari K, Lantos H, Brahmbhatt H, Delany-Moretlwe S, Lou C, Acharya R, Sangowawa A. How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment. BMC Public Health. 2014;14:349.PubMedPubMedCentralCrossRef Mmari K, Lantos H, Brahmbhatt H, Delany-Moretlwe S, Lou C, Acharya R, Sangowawa A. How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment. BMC Public Health. 2014;14:349.PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat U.S. Department of Veterans Affairs National Center for PTSD. Brief Trauma Questionnaire (BTQ). U.S. Department of Veterans Affairs National Center for PTSD. Brief Trauma Questionnaire (BTQ).
20.
Zurück zum Zitat Payne TJ, Wyatt SB, Mosley TH, Dubbert PM, Guiterrez-Mohammed ML, Calvin RL, Taylor HA Jr, Williams DR. Sociocultural methods in the Jackson Heart Study: conceptual and descriptive overview. Ethn Dis. 2005;15:S6–38-48.PubMed Payne TJ, Wyatt SB, Mosley TH, Dubbert PM, Guiterrez-Mohammed ML, Calvin RL, Taylor HA Jr, Williams DR. Sociocultural methods in the Jackson Heart Study: conceptual and descriptive overview. Ethn Dis. 2005;15:S6–38-48.PubMed
21.
Zurück zum Zitat Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Questionnaire. 2012. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Questionnaire. 2012.
22.
Zurück zum Zitat Lindau ST. South Side Population Health Study. 2013;10. Lindau ST. South Side Population Health Study. 2013;10.
23.
Zurück zum Zitat Kimble M, Boxwala M, Bean W, Maletsky K, Halper J, Spollen K, Fleming K. The impact of hypervigilance: evidence for a forward feedback loop. J Anxiety Disord. 2014;28:241–5.PubMedCrossRef Kimble M, Boxwala M, Bean W, Maletsky K, Halper J, Spollen K, Fleming K. The impact of hypervigilance: evidence for a forward feedback loop. J Anxiety Disord. 2014;28:241–5.PubMedCrossRef
24.
Zurück zum Zitat Klinenberg E. Heat Wave: A Social Autopsy of Disaster in Chicago. Chicago, IL: University of Chicago Press; 2002.CrossRef Klinenberg E. Heat Wave: A Social Autopsy of Disaster in Chicago. Chicago, IL: University of Chicago Press; 2002.CrossRef
25.
26.
Zurück zum Zitat Pantell M, Rehkopf D, Jutte D, Syme SL, Balmes J, Adler N. Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Am J Public Health. 2013;103:2056–62.PubMedPubMedCentralCrossRef Pantell M, Rehkopf D, Jutte D, Syme SL, Balmes J, Adler N. Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Am J Public Health. 2013;103:2056–62.PubMedPubMedCentralCrossRef
27.
Zurück zum Zitat Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36:1–10.PubMedCrossRef Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36:1–10.PubMedCrossRef
28.
Zurück zum Zitat Tung EL, Peek ME. Linking community resources in diabetes care: a role for technology? Curr Diab Rep. 2015;15:45.PubMedCrossRef Tung EL, Peek ME. Linking community resources in diabetes care: a role for technology? Curr Diab Rep. 2015;15:45.PubMedCrossRef
29.
Zurück zum Zitat Bauchner H, Rivara FP, Bonow RO, Bressler NM, Disis ML, Heckers S, Josephson SA, Kibbe MR, Piccirillo JF, Redberg RF, Rhee JS, Robinson JK. Death by gun violence—a public health crisis. JAMA Intern Med. 2017. Bauchner H, Rivara FP, Bonow RO, Bressler NM, Disis ML, Heckers S, Josephson SA, Kibbe MR, Piccirillo JF, Redberg RF, Rhee JS, Robinson JK. Death by gun violence—a public health crisis. JAMA Intern Med. 2017.
30.
Zurück zum Zitat Fox S, Duggan M, Rainie L, Purcell K. The diagnosis difference: a portrait of the 45% of U.S. adults living with chronic health conditions. 2013;94. Fox S, Duggan M, Rainie L, Purcell K. The diagnosis difference: a portrait of the 45% of U.S. adults living with chronic health conditions. 2013;94.
Metadaten
Titel
Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago
Publikationsdatum
03.08.2018
Erschienen in
Journal of General Internal Medicine / Ausgabe 11/2018
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-018-4607-3

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