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The Effect of Local Violence on Children's Attention and Impulse Control

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Objectives: We examined whether the burden of violence in a child's community environment alters the child's behavior and functioning in the classroom setting. Methods: To identify the effects of local violence, we exploited variation in the timing of local homicides, based on data from the Chicago Police Department, relative to the timing of interview assessments conducted as part of a randomized controlled trial conducted with preschoolers in Head Start programs from 2004-2006, the Chicago School Readiness Project. We compared children's scores when exposed to recent local violence with scores when no recent violence had occurred to identify causal effects. Results: When children were assessed within a week of a homicide that occurred near their home, they exhibited lower levels of attention and impulse control and lower preacademic skills. The analysis showed strong positive effects of local violence on parental distress, providing suggestive evidence that parental responses may be a likely pathway by which local violence affects young children. Conclusions: Exposure to homicide generates acute psychological distress among caregivers and impairs children's self-regulatory behavior and cognitive functioning.
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The Effect of Local Violence on Children’s Attention and
Impulse Control
Patrick T. Sharkey, PhD, Nicole Tirado-Strayer, BA, Andrew V. Papachristos, PhD, and C. Cybele Raver, PhD
As one of the leading causes of death among
young people, interpersonal violence is an
urgent public health problem.
1,2
Violence has
a disproportionate impact on children, it is
highly concentrated in space, and a great deal
of evidence suggests that the effects of violence
extend beyond the direct victims of assaults
or homicides. Direct and indirect exposure to
violence is associated with negative health
consequences and psychobiological symptoms
of distress, such as posttraumatic stress disor-
der, depression, and difculty concentrating.
3---6
Furthermore, the threat or the experience of
violence during childhood can induce high
levels of stress, which manifests itself in chil-
drens compromised cognitive functioning, as
well as in their academic performance, emo-
tional responses, and social interactions.
7---13
We considered how the burden of violence
in a childs community can alter the childs
behavior and functioning in the classroom
setting. We specically focused on violence
exposure among young children facing socio-
economic disadvantage. Research over the past
2 decades has highlighted stark poverty-related
disparities in childrens school readiness as
early as kindergarten entry and has under-
scored poor childrens much higher likelihood
of exposure to a wide range of stressful life
events, including neighborhood violence.
14---17
Yet exposure to violence remains a relatively
unexplored pathway through which poor
childrens opportunities for learning may be
compromised. In examining this pathway, we
hypothesized that exposure to extreme com-
munity violence, in the form of local homicides,
would have an acute impact on childrens
ability to regulate behavior, maintain attention,
and control impulses in the classroom setting. If
local violence affects behavior and perfor-
mance in the classroom, the results would
provide evidence for an additional mechanism
by which the problem of community violence
extends into key domains of social life, with
consequences that have the potential to alter
educational trajectories and a range of sub-
sequent health and social outcomes.
18---20
However, identifying the causal impact of
community violence on childrens behavioral
and cognitive functioning is difcult because
families do not randomly select into violent (or
nonviolent) environments.
7,21,22
Associations
between community violence and childrens
outcomes may be a result of unobserved
characteristics of families that lead some fam-
ilies to be at higher risk for having to move into
(or not being able to move out of) violent
community settings.
19, 23
Those same unobserved
parental characteristics may also place childrens
likelihood of school success in jeopardy.
To address this problem, we departed from
the traditional approach to identifying the
impact of community violence on children,
which involves making comparisons among
children living within different communities.
Instead, we exploited variation in the timing of
local violencein this case, homiciderelative
to the timing of assessments conducted as
part of a randomized controlled trial, the
Chicago School Readiness Project (CSRP).
24,25
The CSRP was designed to assess the effects
of a classroom intervention geared toward
improving self-regulation and cognitive skills
among a sample of students in Head Start
classrooms in Chicago. Using data from the
CSRP merged with data on homicides across
Chicago, we hypothesized that exposure to re-
cent homicides occurring within close geo-
graphic proximity to childrens homes affects
childrens ability to maintain focus, control im-
pulses, and perform well on tests of preacademic
cognitive skills.
METHODS
Data came from 2 sources: the CSRP and
police records from the Chicago Police De-
partment. The CSRP is a multicomponent,
classroom-based preschool intervention
study.
24,25
Using a clustered randomized con-
trolled trial design, the CSRP measured child
school readiness in 18 Head Start sites in the
Fall and Spring of the preschool year. A total of
Objectives. We examined whether the burden of violence in a child’s com-
munity environment alters the child’s behavior and functioning in the classroom
setting.
Methods. To identify the effects of local violence, we exploited variation in the
timing of local homicides, based on data from the Chicago Police Department,
relative to the timing of interview assessments conducted as part of a random-
ized controlled trial conducted with preschoolers in Head Start programs from
2004–2006, the Chicago School Readiness Project. We compared children’s
scores when exposed to recent local violence with scores when no recent
violence had occurred to identify causal effects.
Results. When children were assessed within a week of a homicide that
occurred near their home, they exhibited lower levels of attention and impulse
control and lower preacademic skills. The analysis showed strong positive
effects of local violence on parental distress, providing suggestive evidence that
parental responses may be a likely pathway by which local violence affects
young children.
Conclusions. Exposure to homicide generates acute psychological distress
among caregivers and impairs children’s self-regulatory behavior and cognitive
functioning. (Am J Public Health. 2012;102:2287–2293. doi:10.2105/AJPH.2012.
300789)
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496 children participated in the CSRP with
cohort 1 participating in 2004---2005 and
cohort 2 participating in 2005---2006. Chil-
dren were 49.24 months in age, on average
(SD = 7.48). Families were predominantly low
income with a mean income-to-needs ratio of
0.70 (SD = 0.58). Additional demographic
characteristics of these children and their fam-
ilies are presented in Table 1.
Measures
Ouroutcomesofinterestmeasuredmultiple
dimensions of childrens self-regulation and pre-
academic skills (brief descriptions are provided
here, and more detailed descriptions of all out-
come measures are available as a supplement to
the online version of this article at http://www.
ajph.org). Childrens self-regulatory behavior was
based on the Preschool Self-Regulation Assess-
ment (PSRA),
26
which was used in the CSRP to
capture childrens strengths and difculties in
behavioral self-regulation along (1) global
dimensions of attention and impulse control as
well as (2) component dimensions of executive
functioning and effortful control. Procedurally,
the PSRA rst obtains a direct assessment of
childrens executive functioning and effortful
control, where the assessor records live-coded
latencies or performance levels for a range of
lab-based tasks that have been adapted for eld
administration.
27
Childrensperformanceon2
executive functioning tasks and 4 effortful con-
trol tasks were standardized and then averaged
into 2 composites. After the tasks were admin-
istered, the 28-item PSRA Assessor Report was
completed.
26
Providing a global picture of
childrens emotions, attention, and impulsivity
throughout the assessor---child interaction, items
were coded by using a Likert scale ranging from
0 to 3, with some items reverse-coded to
minimize automatic responding.
Preacademic skills were measured with as-
sessments of vocabulary and early math skills.
A shortened version of The Peabody Picture
Vocabulary Test (a= 0.78) with 24 items was
administered to the child by the assessor
(PPVT-III).
27---29
A parallel Spanish-language
version of the PPVT, entitled the Test de
Vocabulario en Imagenes Peabody
30
was ad-
ministered to Spanish-procient and bilingual
children. The Early Math Skills (a= 0.82)
portion of the cognitive assessment consists of19
items and covers basic addition and subtrac-
tion.
28
This set of measures has been used
extensively in national surveys of Head Start---
enrolled 4-year-old childrens school readiness
and has demonstrated high levels of internal,
criterion, and predictive validity for low-income,
ethnic minority children.
31
Lastly, parentsmental health was measured
with the K6, a 6-question scale of psychological
distress developed for the US National Health
Interview Survey.
32
Parents were interviewed by
a group of masters level assessors in the fall of
their childs preschool year. Items were coded
0 to 4 and a mean score was calculated ranging
from 0 to 4 (a=0.78).
We derived our measure of exposure to
violence from incident-level records of all
homicides that occurred in the city of Chicago
during the CSRP data collection period. To
assess the exposure of CSRP study youths to
a homicide occurring in their community, we
geocoded all homicides to precise geographic
coordinates. Then we determined whether
a homicide occurred within a specied geo-
graphic distance of the childs home within the
week before the assessment.
Analytic Strategy
The analytic strategies utilized in this paper
exploited variation in exposure to local vio-
lence among individual children or among
children living within the same geographic area
who were assessed at different times. We de-
ned a child as exposedto a local homicide
if a homicide occurred within a given geo-
graphic radius of the childs home within
a week of the CSRP assessment. Children who
were assessed more than 7 days after the
homicide but before 14 days were excluded
from the analysis to avoid any potential con-
tamination of the treatmentprevious research
has found that the acute effects of local homi-
cides on older adolescents appear to fade after
a week to 10 days.
12
To assess the importance
of proximity in analyzing the effects of
TABLE 1—Descriptive Statistics of 414 Preschool Children in Chicago School
Readiness Project Trials, 2004–2006
Fall Measurement, % or Mean (SD) Spring Measurement, Mean (SD)
Child
Executive functioning 0.01 (0.83) 0.07 (0.81)
Effortful control 0.02 (0.67) 0.04 (0.65)
Attention 2.11 (0.78) 2.35 (0.68)
Impulse control 2.36 (0.68) 2.42 (0.63)
PPVT English 0.44 (0.16) 0.57 (0.18)
PPVT Spanish 0.45 (0.17) 0.49 (0.16)
Early math skill English 0.41 (0.19) 0.54 (0.20)
Early math skill Spanish 0.33 (0.18) 0.48 (0.22)
Boy 49
African American race/ethnicity 66
Hispanic race/ethnicity 26
Treatment 51
Age, mo 50.36 (6.72)
Caregiver
Income-to-needs ratio 0.70 (0.60)
Completed < 12th grade 25
High-school diploma or GED 37
Some college 26
bachelor’s degree 8
Living with partner 41
Mental health problem 0.70 (0.74)
Note. GED = general equivalency diploma; PPVT = The Peabody Picture Vocabulary Test.
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community violence, we used multiple deni-
tions of exposure, beginning with a geographic
radius of 2500 feet surrounding the homicide,
followed by a smaller radius of 2000 feet, 1500
feet, and, nally, 1000 feet. The number of
children exposed to a local homicide within
2500 feet was 74 (17.87%), within 2000 feet
was 40 (9.66%), within 1500 feet was 19
(4.59%), and within 1000 feet was 7 (1.69%).
We generated 2 sets of estimates to model
the effects of exposure to violence on the set of
outcome variables. We labeled the rst esti-
mates child xed effectsestimates, and these
rely on variation in exposure to local homicides
among individual children. We regressed the
dependent variable, measuring a given domain
of self-regulation (or cognitive skills), on an
indicator for a recent homicide within a speci-
ed radius of the childs home, with xed
effects for each child, along with controls for
the month and year at which the assessment
occurred, as in equation 1:
ð1ÞYi¼aþbðHomicideÞiþgðChildÞi
þdðYearÞiþgðMonthÞiþei;
where Yiis child is score on the measure of
self-regulation, Homicide is an indicator taking
on a value of unity if the childs assessment
was conducted within a week following
a homicide within the specied radius, and b
represents the effect of a local and recent
homicide on the childs score on the given
measure of self-regulation. Child represents
a set of indicators for each child in the sample;
Year and Month represent calendar year and
month of year indicators. The inclusion of child
xed effects means that the estimator relies on
variation in exposure to local homicides among
individual children across the 2 assessments.
We generated separate estimates using the
different geographic radii to dene exposure.
We labeled a second set of estimates homi-
cide zone xed effects,which rely on varia-
tion in the relative timing of homicides and
self-regulation assessments among all children
living within a specied radius of each specic
homicide. As an example, consider a homicide
that occurs within 1000 feet of the homes of 8
children in the sample. Two of these children are
assessed within the week following the homi-
cide, whereas 3 of the remaining children are
assessed several weeks earlier and the other 3
are assessed a month later. To identify the acute
effect of the homicide on self-regulation, this
method compares the scores of the 2 children
who were assessed in the week following the
homicide with the scores of the other 6
children, all of whom were exposed to the
same homicide but were assessed at different
times. The same comparison is made for
every homicide to which at least 1 sample
member is exposed within a week before the
assessment.
In these models we regressed the childs
score on a given measure of self-regulation on
an indicator for exposure to a recent homicide
within a given radius of the childs home and
within a week before the assessment, with xed
effects for every child living within the homi-
cide zone,meaning the radius of specied
length surrounding each homicide. The zone
xed effects specication is the same as in
equation 1, except instead of child xed effects
we included a set of dummy variables indicat-
ing whether the child lived within the specied
radius of the homicide.
Unlike the child xed effects specication,
there is some variation in observable charac-
teristics of children living nearby each local
homicide. Thus, although the method relies
on the assumption that there is no systematic
heterogeneity among students living within
thesamezoneofahomicidewhowere
assessed at different times, we included con-
trols for observable characteristics to increase
precision in the estimate. Control variables in
this specication included measures of race/
ethnicity, gender, and age of the student,
caregiver educational attainment, income rel-
ative to needs, whether the caregiver was
married or lived with a domestic partner, and
an indicator for membership in the experi-
mental group, which we included to control
for effects of the experimental treatment pro-
vided through the CSRP. Individual children
can appear in the data multiple times if they
were exposed to multiple homicides close to
the hometo adjust standard errors for pos-
sible clustering of error terms within individ-
uals, results from the zone xed effects
specications used the Huber---White sand-
wich estimator.
The 2 sets of estimates are presented to
assess how stable the results were across
different analytic approaches. The main
difference between the 2 approaches lies in the
composition of the control groups. In each case,
the treatment group was composed of students
who were exposed to a homicide near the
home within a week of the assessment. The
control group for the child xed effects esti-
mates was the students themselves; we com-
pared student scores from the assessment
occurring after a local homicide with the
students scores from the assessment occurring
at a time when no recent homicides had taken
place. The control group for the zone xed
effectsestimates was composed of other chil-
dren living in similar proximity to a homicide
but assessed at a different time. The core
assumption was that the relative timing of
homicides and assessments was exogenous
among students living within the specied
radius of the homicide, allowing for the iden-
tication of the causal effect of exposure to the
homicide on student self-regulation.
RESULTS
Figure 1 shows results from child xed
effects estimates of homicide effects on self-
regulation (as with all results, tables with full
regression coefcients are available as a sup-
plement to the online version of this article at
http://www.ajph.org). Results from child xed
effects models show that local homicides
had strong effects on studentsattention and
impulse control, and had no effects on chil-
drens scores on tasks of executive function
or effortful control. When we used the child
xed effects approach, results showed that
exposure to a homicide within 2500 feet of the
home lowered attention by 0.25 points (SD=
0.33) and impulse control by 0.23 points (SD =
0.35), whereas exposure to a homicide within
1000 feet lowered attention by 0.63 points
(SD = 0.83) and impulse control by 0.45 points
(SD = 0.68). We also conducted falsication
tests to assess whether there was an effect of
exposure to homicides that occurred in the
week after the assessment. All results were null
and estimated effectshovered around zero.
We found similar results when we used
homicide zone xed effects (see materials
available as a supplement to the online version
of this article at http://www.ajph.org). We
conducted additional analyses to assess how
long the effect of local violence appears to
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persist. Results from these analyses were con-
sistent with a linear relationship between the
number of days since a local homicide and
childrens scores on the assessments of atten-
tion and impulse control, but one that fades out
roughly 10 to 14 days after the incident of
violence. More detail on the additional models
that led to this conclusion is available from the
authors on request
Homicide Effects on Children’s
Vocabulary and Math Scores
We used the same sequence of analyses to
estimate homicide effects on preacademic
cognitive skills. The results from child xed
effects estimates for PPVT scores and Early
Math Skills scores are shown in the main text
in Figure 2, and in the second set of rows in
Table C (available as a supplement to the
online version of this article at http://www.
ajph.org). Estimates using homicide zone xed
effects also can be found in the supplementary
materials.
When we used the child xed effects ap-
proach, we found that the effects of homicides
occurring within 2500 feet and 2000 feet on
PPVT scores were negative but nonsignicant,
whereas the effects of homicides occurring
within a radius of 1500 and 1000 feet from
the childs home were statistically signicant.
Exposure to a homicide within 1500 feet
reduced PPVT scores by 1.47 points (SD =
0.33), and exposure to a homicide within 1000
feet of the home by 3.53 points (SD =0.80).
Effects on math scores were negative but
nonsignicant. When we used the homicide
zone xed effects approach, the magnitude of
the effect on PPVT scores of homicides within
1500 and 1000 feet of the childshomewas
quite similar to what was found in the child
xed effect estimates. However, only the
effect of homicides occurring within 1000
feet of the childs address was statistically
signicant.
Mediation Analysis
To assess whether the effects of homicides
on vocabulary scores were mediated by im-
paired attention, we conducted an additional
set of analyses that estimated the effects of local
homicides on PPVT scores while controlling for
the measure of attention. This analysis was
limited to students who were given the PPVT
assessments and the self-regulation assess-
ments on the same day, which was almost the
entire sample. Results (shown in Figures C and
D, available as supplements to the online
version of this article at http://www.ajph.org)
provide mixed support for the hypothesis that
attention partially mediates the relationship
between exposure to local violence and PPVT
scores.
Results from child xed effects specications
showed that, without adjustment for attention,
exposure to a homicide within 1500 feet of the
childs address reduced PPVT scores by 1.30
points, a marginally signicant effect (Figure C,
available as a supplement to the online version of
this article at http://www.ajph.org). After we
adjusted for attention, the effect size was 0.51
points and was not signicant. Without adjust-
ment for attention, exposure to a homicide within
1000 feet of the childs address reduced PPVT
scores by 3.53 points, a highly signicant effect.
After we adjusted for attention, the negative
effect of exposure to local homicide was 2.09
points and was not signicant. Results when we
used homicide zone xedeffects,whichare
showninFigureD(availableasasupplementto
the online version of this article at http://www.
ajph.org), provide less evidence of mediation. In
these estimates, only exposure to homicide
within 1000 feet of the childsresidencehad
asignicant negative effectthe effect size was
smaller when we controlled for attention, but
was still quite large and statistically signicant.
Overall, our results provided only partial
support for the hypothesis that impaired at-
tention mediates the relationship between local
violence and performance on cognitive
–1.2
–1.0
–0.8
–0.6
–0.4
–0.2
0.0
0.2
0.4
0.6
0.8
1.0
Dependent Variable
Eect Size
2500 Feet 2000 Feet 1500 Fee t 1000 Feet
Executive functioning Eortful control Attention Impulse control
Note. Estimates represent effects of homicides occurring within distances of 2500 feet, 2000 feet, 1500 feet, and 1000 feet of child’s residential address.
FIGURE 1—Estimates of homicide effects on 4 dimensions of self-regulation, attention, and impulse control using child fixed effects
specifications, among Chicago preschoolers in the Chicago School Readiness Project Trials, 2004–2006.
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assessments. Although the effects of local
homicides were weaker in models that con-
trolled for childrens attention, in most
models there remained a direct effect of local
violence on PPVT scores that was not
explained by attention.
Homicide Effects on Parents’ Mental
Health Symptoms
Anal set of analyses assessed the direct
effects of local homicides on parentsself-
reported mental health. Parentsmental health
was assessed once, and on a different date
than childrens assessments. As a conse-
quence, it was not possible to estimate parent
xed effects specications (which require
multiple assessments) or to assess whether
parental mental health mediated the relation-
ship between homicide exposure and chil-
drens self-regulation or cognition. Instead, we
used the homicide zone xed effects speci-
cation to estimate the effects of local homi-
cides on parentssummed scores from the K6
instrument, providing only suggestive evi-
dence as to whether parental mental health
may be a mechanism linking local violence
with childrensoutcomes.
Estimates were based on a Poisson regres-
sion with homicide zone xed effects and full
results can be found in the supplemental
materials (Figure E, available as a supplement
to the online version of this article at http://
www.ajph.org). To summarize, the results in-
dicated that local homicides substantially in-
creased parentsmental health symptoms.
Exposure to a homicide within 2500 feet of
the home address increased mental health
symptoms by 43%, a highly signicant effect.
The magnitude of the effect grew larger for
homicides closer to the home. Exposure to
a homicide within 1500 feet of the home
address increased mental health symptoms by
69%. There were too few parents exposed to
homicides within 1000 feet of the home resi-
dence to generate stable estimates of homicides
within this distance.
Although these results suggest strong homi-
cide effects on parentsmental health, the
results should be interpreted with caution
because of limitations of the analysis. The most
important limitation was that items from the K6
scale of mental health refer to mental health
symptoms in the 30 days before to the in-
terview, whereas the treatment under study
was the effect of exposure to a local homicide
within the week before the interview. Because
of this discrepancy in reference periods, an
implicit assumption of this analysis is that
respondents weighted more heavily their
mental health symptoms in the period imme-
diately preceding the interview, as opposed to
symptoms experienced several weeks earlier.
In an additional analysis we relaxed this as-
sumption and estimated the effect of homicides
occurring in the 30 days before the interview
date. The effect sizes from this specication
were generally smaller in magnitude, but the
effects remained positive and statistically sig-
nicant, with the exception of the analysis
estimating the effect of homicides occurring
within 1500 feet.
DISCUSSION
This study provides evidence that local ho-
micides have strong impacts on preschoolers
attention and impulse control and on their
performance on vocabulary assessments. Re-
sults thus highlight the way that a major public
health problem, interpersonal violence, can have
consequences that spread throughout a commu-
nity and affect the behavior of children living
within the vicinity in which a violent incident
occurs. These ndings, in highlighting the grave
negative consequences of exposure to higher
versus lower levels of violence, suggest that lack
of safety represents a primary (but certainly not
the only) form of social inequality for families
and children in our sample, with high costs to
the formation of human capital for the eco-
nomically and racially stratied urban commu-
nities in which they reside.
Limitations
One limitation of the analysis is that it is
not equipped to identify the long-term impacts
of local violence on childrens development of
self-regulation or cognitive skills. The primary
reason for this is that the method relies on
variation in the timing of exposure to local
homicides among individual children or among
children living within the same environment.
This approach does not allow for the identi-
cation of permanent or long-term impacts of
local violence, but it does allow us to make
more convincing estimates of the acute impacts
of local violence than is possible when one uses
standard analytical approaches that rely on
variation among individuals living in different
communities. The core assumption of the
methods is that the relative timing of homicides
and assessments is exogenous among individ-
ual students or among students living within
the specied radius of the homicide, allowing
for the identication of the causal effect of the
–7.0
–6.0
–5.0
–4.0
–3.0
–2.0
–1.0
0.0
1.0
2
Dependent Variable
Eect Size
PPVT score Math skills score
2500 Feet 2000 Feet 1500 Feet 1000 Feet
Note. Estimates represent effects of homicides occurring within distances of 2500 feet, 2000 feet, 1500 feet, and 1000 feet
of child’s residential address
FIGURE 2—Estimates of homicide effects on The Peabody Picture Vocabulary Test
(vocabulary) scores and Math Skills Scores using child fixed effects specifications among
Chicago preschoolers in the Chicago School Readiness Project Trials, 2004–2006.
RESEARCH AND PRACTICE
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homicide on student self-regulation and cogni-
tive function.
Although the methods are conservative be-
cause they only allow for inferences about
the acute impacts of violence, the results
suggest that the costs of violence, even if
episodic, are high. Children living in the area
where a homicide took place exhibited sub-
stantial behavioral and cognitive consequences,
indicating that community violence, one of the
most severe public health problems in urban
areas, has major educational consequences.
Previous research has demonstrated the aca-
demic costs of homicides on adolescents,
12,32
but our results indicate that the consequences
of community violence may be present even
for the youngest learners in schools and Head
Start programs.
A logical and important question that follows
from these ndings is one of mechanisms. How
might homicides in close proximity to chil-
drens homes have such negative consequences
for their attention, impulsivity, and early cog-
nitive skills? The analyses provide preliminary
support for parental psychological distress as
a potential mediating process through which
exposure to violence might affect young chil-
drens self-regulatory and cognitive outcomes.
Such mediation is aligned with emerging nd-
ings from developmental science in the con-
texts of poverty and public policy that suggest
that childrens neurocognitive and neuroen-
docrine functioning may be directly as well as
indirectly affected by environmental hazards
such as loud and unpredictable ambient
noise, crowding, and residential instability.
33
The chaotic environmental conditions and
the perceptual, allostatic, emotional, and
neuroendocrine sequelae that accompany the
occurrence of a local homicide are unknown.
The next empirical step will be to better
understand and test these multiple direct and
indirect potential pathways of inuence link-
ing exposure to local violence and early
learning.
Conclusions
Whereas most research on exposure to
violence focuses attention on those who wit-
ness an incident of violence directly, the nd-
ings presented here suggest that violence has
a wider impact that is felt by children across
a community. These ndings signal the need
for renewed attention to the ways in which
children carry the burden of community vio-
lence with them into the school setting, with the
potential to disrupt individual learning and
classroom climate. More broadly, our ndings
highlight ways that public health policy for
neighborhoods and cities goes hand-in-hand
with educational policyreducing violent
crime is a potentially important means of re-
ducing educational disparities between low-
income children and their more economically
advantaged counterparts who may be housed
and schooled in safer communities. j
About the Authors
Patrick T. Sharkey is with the Department of Sociology,
New York University, New York, NY. Nicole Tirado-Strayer
is with the School of Education, Stanford University,
Stanford, CA. Andrew V. Papachristos is with the De-
partment of Sociology, Yale University, New Haven, CT.
C. Cybele Raver is with Steinhardt School of Education,
New York University.
Correspondence should be sent to Patrick T. Sharkey,
295 Lafayette St, Room 4102, New York, NY 10012
(e-mail: patrick.sharkey@nyu.edu). Reprints can be ordered
at http://www.ajph.org by clicking the Reprintslink.
This article was accepted March 6, 2012.
Contributors
P. T. Sharkey took the lead on the desig n and analysis of
the data, writing of the article, and approval of the nal
version. N. Tirado-Strayer substantially contributed to
the analysis, writing, and preparation of the article. A. V.
Papachristos and C. C. Raver substantially contributed to
the analysis and writing of the article.
Acknowledgments
The Chicago School Readiness Project was supported by the
Eunice Kennedy Shriver National Institute of Child Health
and Human Development (award R01HD046160). The
research described in the article was funded also by the
William T. Grant Foundation.
Note. The content is solely the responsibility of the
authors and does not necessarily represent the ofcial
views of the Eunice Kennedy Shriver National Institute
of Child Health and Human Development or the National
Institutes of Health. The Chicago School Readiness Pro-
ject is not associated with The Chicago School, which
is a trademark of The Chicago School of Professional
Psychology.
Human Participant Protection
This research was reviewed and approved by in-
stitutional review boards at New York University, the
University of Chicago, and the District of Chicago
Public Schools.
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... As noted in our introduction, a growing body of research has found that the occurrence of a violent incident near a child's home is associated with subsequent school and behavioral problems, as well as acute mental health-related emergency department utilization [21][22][23][24][25]28]. There is additional evidence to suggest a graded dose-response relationship between community violence exposure and adverse outcomes, including increasing levels of posttraumatic stress symptoms and delinquent behaviors [43]. ...
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