Residing in a violence-prone community brings with it a 20-25 percent greater risk for adverse pregnancy outcomes than living in a less violent community. That is the conclusion of a recently published study led by Felix A. Okah, a pediatrician at the School of Medicine at the University of Missouri-Kansas City.
For years, researchers have known that babies born to poor mothers are more likely to wind up needing care in a neonatal intensive care unit (NICU). Babies who are premature, or small for their gestational ages, are more likely to come from poor – often more violent – communities. Poor health behaviors often associated with community violence, like using tobacco, alcohol or drugs during pregnancy, are known to play a part in these unfortunate outcomes.
But when Okah and a team of researchers from the UMKC School of Pharmacy and the Kansas City Health Department recently looked at whether living in a violent community by itself – excluding for poor health behaviors – played a part, Okah didn’t expect the findings.
The database analysis that looked at birth certificates in the state of Missouri determined that even if mothers in violent communities didn’t smoke, drink or take drugs, they’re still more likely to have an unsuccessful pregnancy.
The take-away from the research published in August in The Southern Medical Journal, Okah said, is that community violence needs to be looked at as a standalone problem in the realm of public health. Reducing violence, the research concludes, could have “a significant impact” on general health, unhealthy behaviors, and pregnancy outcomes.
“The city can begin to see violence prevention programs – including law enforcement – as tools for not just reducing violence, but as tools for improving the health of the community,” Okah said.
At the very least, he said, the research should give city and health officials a better idea of the steps they need to take so that NICUs aren’t so disproportionately filled with babies from poor communities. Not only do public health campaigns need to teach pregnant women about the dangers of poor health choices, cities need to reduce community violence.
The problem goes beyond the infants themselves into the very fabric of the community. Babies born prematurely or small for their gestational ages are more likely to have health problems – particularly behavioral health problems like attention deficit disorder, learning difficulties and school behavioral problems.
“We’re looking at a potential vicious cycle, where children who are born at risk…are mostly growing up in the same area, and eventually producing children who are going to have the same problems,” Okah said.
Okah said that he and his fellow researchers – Adebayo Oshodi, M.D., of the School of Medicine; Yifei Liu, Ph.D., of the School of Pharmacy; and Jinwen Cai, M.D., of the Kansas City Health Department – know that their study may have raised more questions than it answered. But he hopes it will inspire officials to look at community violence in a different light.