WIP 80 - The Role of Neighborhood in the Development of Toxic Stress and Resilience in New Orleans Children and Adolescents

Poster Number: WIP 80
Publication Number: WIP 80.875

Background: Trauma is associated with adverse childhood experiences including exposure to violence while resilience is associated with positive childhood experiences including community interaction. Exposure to trauma in childhood increases the development of post-traumatic stress disorder (PTSD) secondary to the toxic stress response. About one third of children and adolescents in the United States experience PTSD while, in New Orleans, the risk is 3 to 4 times higher. Alternatively, New Orleans has a high rating of childhood opportunity index including proximity to parks and playgrounds. There is significant overlap between the risk factors that are associated with high utilization of the pediatric emergency department (PED) and trauma. For example, 30 percent of children develop PTSD after injury.

Objective: The objective of this study is to observe how primary location predicts toxic stress based on PTSS in relation to both positive and negative neighborhood level factors including childhood opportunity index, violent crime rate, and stop and frisk rate.

Design/Methods: In the current study we examine the extent of PTSS reported in a convenience sample of patients ages 7 to 18 years that speak either English or Spanish and the relation to neighborhood. Research assistants collect primary address with zip code then administer the UCLA Brief Screen to measure PTSS to patients. Addresses will be geocoded and linked by Census tract number to data on violent crime and stop and frisk rates obtained from the New Orleans Police Department and childhood opportunity index from Diversity Data Kids. Data will be analyzed with a generalized linear mixed model to account for clustering by neighborhood. This study was IRB approved with full written consent and assent obtained. Data collection began in August and will complete in February. Current sample size is 33 patients. Data analysis will complete in March.