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In September 2018, I wrote about the adverse physical effects of psychological stress and made the point that psychological stress had a strong, dose-dependent association with heart attacks and strokes in men and women, possibly via an increased inflammatory state. Recent information has expanded that association to include violence in youngsters and workplace bullying.
Violence can take many forms, including racism, incarceration, economic deprivation, policing, individual decision making, and access to guns. Even spanking children as a disciplinary measure can be a form of violence. These factors create a post-traumatic stress disorder among exposed individuals.
Childhood exposure to community violence may manifest in cardiovascular disease later in life. Studies in Mississippi and Sweden have found an increase in cardiovascular disease in both men and women from neighborhoods where community violent crime or unemployment increase. Violence stresses the brain and modulates nerves that control heart and brain function. The body adapts to various stressors over time in ways that can be harmful, and result in abnormal metabolic changes, diabetes, or coronary artery disease.
Depending on the level of violence, brain structure and function can change. Adults who reported violence in childhood have also been found to have increased inflammation. By the time children reach adulthood, violence is statistically linked with cardiovascular disease, with a threefold greater risk of cardiovascular disease for every seven adverse childhood events.
While difficult work conditions, including job strain and excessive hours, have long been linked to an increased risk of cardiovascular disease, the impact of bullying on heart disease has only been studied recently. Bullies were colleagues, supervisors or subordinates, rather than clients or other individuals outside the workplace.
People who are bullied or exposed to violence on the job appear to be more likely to develop cardiovascular disease than individuals not exposed to these challenges at work.
Researchers examined survey data from more than 79,000 employed men and women 19 to 65 years old without a history of heart disease. About 9 percent reported being bullied and 13 percent said they had been exposed to violence on the job in the last year.
Those bullied on the job were 59 percent more likely to be diagnosed with heart disease or hospitalized for heart attacks or strokes in subsequent years than those who were not bullied, while workers exposed to violence had a 25 percent higher likelihood of developing heart disease or hospitalization for related events. The associations showed a dose–response pattern for workplace bullying and to a lesser extent also for workplace violence. The authors concluded that bullying and violence are common at work, and those exposed to these stresses are at greater risk of developing cardiovascular disease in the future.
Violence in youngsters and bullying in the workplace likely do not occur in isolation but are part of a continuum of risk behavior beginning at a young age and continuing into adulthood. If the associations demonstrated are actually causal, that is, violence and bullying directly cause cardiovascular disease, then interventions to resolve interpersonal problems beginning with children and continuing as lifelong endeavors would be expected to prevent a sizable number of cardiovascular events from occurring in the future.
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