Subramanian S V, Ackerson Leland K, Subramanyam Malavika A, Wright Rosalind J
Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Int J Epidemiol. 2007 Jun;36(3):569-79. doi: 10.1093/ije/dym007. Epub 2007 Feb 28.
Little is known on the influence of stressful psychosocial circumstances in predicting asthma. We examine the link between asthma prevalence and domestic violence (DV) in a nationally representative sample of adults and children in India.
Analyses were based on the 1998-99 cross-sectional nationally representative Indian National Family Health Survey administered in 92 486 households. Individual-level prevalence of asthma was the primary outcome for this study. Exposure to DV was based on women's self-report of DV.
In adjusted models, women who experienced DV either recently or in the past were at greater risk of being asthmatic [odds ratio (OR) range 1.26-1.37], compared with those who did not report any abuse. In households where women reported to have experienced DV, asthma risk was higher for all individuals in those households (OR range 1.15-1.19). The association between household DV and individual risk for asthma was also observed in gender-stratified analysis, and also in age-stratified analysis, with strong association observed in age groups of under-five, 5-14, 15-24 and 25-44 years.
We find a consistent association between being exposed to, and having experienced, DV and asthma prevalence. Stress-induced mechanisms, partially captured through violence and social circumstances, may be a critical explanatory link in furthering our understanding of the social disparities in asthma.
关于压力性社会心理环境对哮喘预测的影响，我们所知甚少。我们在印度全国具有代表性的成年人和儿童样本中，研究哮喘患病率与家庭暴力（DV）之间的联系。
分析基于1998 - 1999年对92486户家庭进行的全国代表性印度全国家庭健康调查的横断面数据。本研究的主要结果是个体层面的哮喘患病率。家庭暴力暴露基于女性对家庭暴力的自我报告。
在调整模型中，近期或过去遭受过家庭暴力的女性患哮喘的风险更高[比值比（OR）范围为1.26 - 1.37]，相比那些未报告任何虐待情况的女性。在女性报告遭受过家庭暴力的家庭中，这些家庭中所有个体患哮喘的风险更高（OR范围为1.15 - 1.19）。在按性别分层分析以及按年龄分层分析中，也观察到家庭家庭暴力与个体患哮喘风险之间的关联，在5岁以下、5 - 14岁、15 - 24岁和25 - 44岁年龄组中观察到强烈关联。
我们发现遭受家庭暴力以及经历过家庭暴力与哮喘患病率之间存在一致的关联。通过暴力和社会环境部分体现的压力诱导机制，可能是进一步加深我们对哮喘社会差异理解的关键解释性联系。
