Violence exposure and traumatic stress symptoms as additional predictors of health problems in high-risk children.

OBJECTIVE To test the hypotheses that both violence and traumatic stress symptoms are associated with negative health status among poor preschool children. STUDY DESIGN This cross-sectional analysis of a Head Start preschool age cohort (n = 160) studied health outcomes parallel to those assessed in the 2001 National Health Interview Survey of child health (asthma, allergy, attention deficit hyperactivity disorder, global appraisal) as well as two stress-related somatic complaints, gastrointestinal problems and headache. Risk factors include sociodemographics, mothers' health factors, extent of exposure to violence and maltreatment, and mother- and teacher-reported traumatic stress symptoms. RESULTS Compared with poor children in the National Health Interview Survey and their Head Start peers, children exposed to violence and those with high levels of traumatic stress had significantly worse outcomes, in a dose-response relation. Being abused, exposed to domestic violence, and having a mother using substances were associated with a higher number of health problems. The hierarchical model established the mother's own poor physical health and the child's level of traumatic stress as the strongest predictors of poor child health. CONCLUSIONS These two risk factors are amenable to intervention by health care providers who treat children.