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South CarolinaRural Health Research Center
Prevalence of Violent Disagreements in US Families: Residence, Race/Ethnicity, and
Parental Stress
Charity G. Moore, PhDUniversity of North Carolina
Janice C. Probst, PhDMark Tompkins, PhD
Steven Cuffe, MDAmy B. Martin, DrPH
University of South Carolina
Rural Health Research Center
South Carolina
NSCH and violence
Looking for an “asthma in children” data set
Discovered questions on disagreements in household
National data, large sample (>100,000)
Study purpose: National estimates and estimates for rural minorities
Rural Health Research Center
South Carolina
Factors of interest
Residence (Rural) and Race/Ethnicity Poverty Shortage of health care providers Lack of health insurance Fewer economic resources
(see Rural Health Response to Domestic Violence: Policy and Practice Issues: http://ruralhealth.hrsa.gov/pub/domviol.htm )
Rural Health Research Center
South Carolina
Rural disadvantage (2003 NSCH data)
25 21 17 17
3130
28 21
0
10
20
30
40
50
60
70
80
90
100
Smallrural
MediumRural
Largerural
Urban
<100% FPL 100-199% FPL
48 43 37 34
0
10
20
30
40
50
60
70
80
90
100
Smallrural
MediumRural
Largerural
Urban
46 42 36 32
0
10
20
30
40
50
60
70
80
90
100
Smallrural
MediumRural
Largerural
Urban
Parental education <= HS
Poverty Public or no health insurance
Parental educ ≤ HS
Rural Health Research Center
South Carolina
Factors of interest
Residence Race/Ethnicity Parental Stress
Rural Health Research Center
South Carolina
Defining key variables: violence
“When you have a serious disagreement… do you…. (1) …discuss … calmly; (2) …argue heatedly or shout; (3) …end up hitting or throwing things.”
Three levels of disagreement: Violent: ANY occurrence of hitting or throwing Heated: Argue or shout “sometimes,” “usually,” or
“always” Calm: All others
Rural Health Research Center
South Carolina
Definitions, continued
Residence: County level Rural-Urban Continuum Codes 4 levels: urban, large rural, med rural, small rural
Race/ethnicity: White, Black, Hispanic and Other Parental Stress:
Child was hard to care for Child bothered parent Felt angry with him/her Split at the 75th percentile
Rural Health Research Center
South Carolina
Nationally, 1 in 10 children experience violent disagreements (10.3%)
Rural Health Research Center
South Carolina
Residence
8 11
29 31 31 32
9100
20
40
60
80
100
SmallRural
MediumRural
LargeRural
Urban
%
Hit/Throw Heated
p=0.0001
Rural Health Research Center
South Carolina
Race/Ethnicity
9 12
32 3037
32
15110
20
40
60
80
100
Hispanic White Black Other
%
Hit/Throw Heated
p<0.0001
Rural Health Research Center
South Carolina
Parental Stress
18
29
40
80
20
40
60
80
100
Low/Mod Stress High Stress
%
Hit/Throw Heated
p<0.0001
Rural Health Research Center
South Carolina
Examining parental stress
2329 33
28
01020304050
60708090
100
White Black Hispanic Other
Minority parents slightly more likely to report high stress (%)
24 23 23 26
0
10
20
30
40
50
60
70
80
90
100
Sm rural Med rural Lg rural Urban
No difference across residence
Rural Health Research Center
South Carolina
Violent disagreements: Final Results
Hit, throw Argue, shout
OR 95% CI OR 95% CI
Residence (reference: urban)
Rural 0.86 0.77 0.95 0.98 0.92 1.05
Race/Ethnicity (reference: white)
Hispanic 1.03 0.87 1.21 1.07 0.95 1.20
African-American 1.73 1.51 1.98 1.41 1.29 1.54
Other 1.38 1.14 1.67 1.17 1.04 1.33
Parenting stress (reference: low)
High Stress 3.17 2.91 3.47 1.99 1.87 2.12
Included in the model but not shown: Child attributes including age, gender, health status, and health insurance; Parental characteristics including relationship to child, highest education in household, employment, parental health, perceived neighborhood support; and Family characteristics including poverty level, family structure, number of children, family mobility, primary language, and region.
Rural Health Research Center
South Carolina
Conclusions
Violent and heated disagreement are not rare in US homes with children
No large differences across residence
Minority children are particularly at risk
Parenting stress may provide a clue for intervention
Rural Health Research Center
South Carolina
Questions or Comments?
Charity G. Moore: [email protected]
Janice C. Probst: [email protected]
