It's hard to think of a baby being violent or destructive, but the seeds of violence may be planted before a child is born, according to research at the University of Pennsylvania School of Nursing. Attention to health factors as early as the prenatal stage could prevent violence in later life, reports Penn Nursing Assistant Professor Jianghong Liu, PhD, RN, in the journal Aggression and Violent Behavior.
Recent research demonstrates a biological basis of crime, says Dr. Liu. "'Biological' does not mean only genetic factors," she explains, "but also health factors, such as nutritional deficiency and lead exposure, which influence biological processes."
Dr. Liu's study emphasizes the prenatal, perinatal, and postnatal periods, which are critical times for both a child's neuro-development and for environmental modifications.
Evidence shows that the risk factors for delinquency and crime begin early in life and that the brain undergoes the most critical development in children in the first 36 months, highlighting the importance of early intervention.
Among the early health risk factors Dr. Liu identifies are prenatal and postnatal nutrition, lead exposure, tobacco use during pregnancy, maternal depression and stress, birth complications, traumatic brain injury, and child abuse. Dr. Liu's research indicates that identifying early health risk factors is an important first step in preventing childhood aggression and teenage delinquency, which have been shown to lead to violence in adulthood, a major problem in society.
"Violence affects everyone in society and the cost of violence also has an indirect impact on our lives," says Dr. Liu. Data from the Centers for Disease Control show that within the American population ages 10 to 34, homicides rank within the top three leading causes of death. The U.S. healthcare system incurs $176 billion a year in costs from gunshot and stabbing wounds alone.
Despite decades of research into social and biological risk factors for antisocial and aggressive behavior in children, very little is known about the effects of early childhood health factors on these outcomes.
"As a society we should invest in better health care for early life -- as early as a growing fetus -- in order to minimize their health risk factors for violence," says Dr. Liu. "It is never too early to intervene in the development of violent tendencies."
In this capacity, nurses can have a central role in prenatal care, says Dr. Liu. "When a woman visits the hospital during her pregnancy, her physical symptoms are often the main focus. Very little time is spent talking extensively with expectant parents about things like avoiding toxic exposure and screening for exposure to lead and tobacco, which have been shown to lead to both birth complications and behavior problems in later life," she explains.
"Nurses can take an active role in not only caring for the victims of violence, but also in the prevention of violence," she says. "In primary care and community health settings, nurses are in an excellent position to provide education to parents about proper prenatal care and early childhood care, such as good nutrition and how to minimize exposure to environmental toxins."
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