RESEARCH AND PRACTICE

Objectives. We examined the association between exposure to violence and asthma among urban children. Methods. We obtained reports from caretakers (n=851) of violence, negative life events, unwanted memories (rumination), caretaker-perceived stress, and caretaker behaviors (keeping children indoors, smoking, and medication adherence). Outcomes included care-taker-reported wheezing, sleep disruption, interference with play because of asthma, and effects on the caretaker (nights caretaker lost sleep because of child’s asthma). Results. Increased exposure to violence predicted higher number of symptom days (P=.0008) and more nights that caretakers lost sleep (P=.02) in a graded fashion after control for socioeconomic status, housing deterioration, and negative life events. Control for stress and behaviors partially attenuated this gradient, although these var-iables had little effect on the association between the highest level of exposure to mor-bidity, which suggests there are other mechanisms. Conclusions. Mechanisms linking violence and asthma morbidity need to be further ex-plored. (Am J Public Health. 2004;94:625–632