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Sonu S, Mann K, Potter J, Rush P, Stillerman A. Toward Integration of Trauma, Resilience, and Equity Theory and Practice: A Narrative Review and Call for Consilience. Perm J 2024; 28:151-168. [PMID: 38206776 PMCID: PMC10940235 DOI: 10.7812/tpp/23.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Investigating the roots of health and illness has inspired unprecedented growth in research on trauma and adversity across academic and scientific disciplines. Can this science achieve its potential? How? Much of this research remains siloed and fragmented, limiting integrative approaches to translating science into a unified paradigm. From age-old traditions to the health, social, and basic sciences, this established and rapidly growing body of work has overwhelmingly found that experiences, both positive and negative, profoundly influence life course health. Such convergence across disciplines highlights the complex, intersectional nature and impact of experiences and reveals consilience: agreement of findings across diverse fields. This narrative review explored 400 sources to curate a representative sample of 98 tracing the evolution of trauma theory and practice from the 19th century to the present. It emphasizes research from 1970 to 2022, with a specific focus on adverse childhood experiences, everyday discrimination, sexual and gender minority stress, acculturative stress, and positive childhood experiences. This research reveals how experiences are a cause, catalyst, and key ingredient of health or of illness, disability, and disparities. The review also proposes steps toward a unified paradigm and showcases innovative integrated models and applications. These examples provide a more comprehensive and nuanced understanding and lead to more effective solutions. Recognition of consilience can connect multidimensional insights on trauma, resilience, and equity to spark further cross-sector innovations toward health, prevention, and justice. Realizing the promise of consilience will require a new era of radical intentionality, ongoing dialogue, and interdisciplinary collaboration to achieve necessary system transformation.
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Affiliation(s)
- Stan Sonu
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Patricia Rush
- The Center for Collaborative Study of Trauma, Health Equity, and Neurobiology, Chicago, IL, USA
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Mrug S, Barker-Kamps M, Goering M, Patki A, Tiwari HK. Neighborhood Disadvantage and Parenting in Early Adolescence Predict Epigenetic Aging and Mortality Risk in Adulthood. J Youth Adolesc 2024; 53:258-272. [PMID: 37715862 DOI: 10.1007/s10964-023-01863-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
Youth who grow up in disadvantaged neighborhoods experience poorer health later in life, but little is known about the biological mechanisms underlying these effects and socioenvironmental factors that may protect youth from the biological embedding of neighborhood adversity. This study tests whether supportive and consistent parenting buffers associations between neighborhood disadvantage in early adolescence and epigenetic aging in adulthood. A community sample from Birmingham, Alabama, USA (N = 343; 57% female; 81% Black, 19% White) was assessed in early adolescence (T1; ages 11 and 13) and adulthood (T2; age 27). At T1, neighborhood poverty was derived from census data and neighborhood disorder was reported by caregivers. Both youth and parents reported on parental discipline and nurturance. At T2, methylation of salivary DNA was used to derive a mortality risk index and Hannum, Horvath, PhenoAge, and GrimAge epigenetic age estimators. Regression analyses revealed that neighborhood disadvantage was associated with accelerated epigenetic aging and/or mortality risk only when combined with high levels of harsh and inconsistent discipline and low child-reported parental nurturance. These findings identify epigenetic aging and mortality risk as relevant mechanisms through which neighborhood adversity experienced in adolescence may affect later health; they also point to the importance of supportive and consistent parenting for reducing the biological embedding of neighborhood adversity in early adolescence.
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Affiliation(s)
- Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA.
| | - Malcolm Barker-Kamps
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Marlon Goering
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Amit Patki
- Department of Biostatistics, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Hemant K Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294, USA
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Hartwell M, Hendrix-Dicken A, Terry R, Schiffmacher S, Conway L, Croff JM. Trends and forecasted rates of adverse childhood experiences among adults in the United States: an analysis of the Behavioral Risk Factor Surveillance System. J Osteopath Med 2023; 123:357-363. [PMID: 36947857 DOI: 10.1515/jom-2022-0221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023]
Abstract
CONTEXT Many studies have shown increases in negative social aspects in the United States that may increase the likelihood of a child experiencing adversity. These rising trends include household dysfunction, poor mental health and substance use, crime rates, and incarceration. Additionally, the pathway of adverse childhood experiences (ACEs) may also perpetuate intergenerational trauma. OBJECTIVES Given these increased trends, our objective was to determine the mean ACEs reported among adults by year of birth to assess trends of ACEs over time. METHODS To assess ACEs trends in the United States, we utilized data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey. We summed individuals' reported ACEs and then calculated the mean ACE score within age cohorts (in 1-year increments) by year of birth. We utilized an auto-regressive integrated moving average (ARIMA) model to forecast mean ACEs through 2030. RESULTS Respondents to the ACEs module (n=116,378) represented 63,076,717 adults in the United States, with an average age cohort of 1715 individuals. The mean reported ACEs among individuals 80 years or older (born in or before 1940) was 0.79, while the highest mean ACEs (2.74) were reported among the cohort born in 1998-an average increase of 0.022 ACEs per year. The ARIMA model forecasted that individuals born in 2018 will, on average, surpass a cumulative of three ACEs. CONCLUSIONS Given the connection of ACEs to poor health outcomes and quality of life, this trend is alarming and provides evidence for the necessity of child maltreatment prevention. Multigenerational trauma-informed care and education are warranted for individuals with ACEs and may even prevent the cycle from recurring.
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Affiliation(s)
- Micah Hartwell
- Department of Psychiatry and Behavioural Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA
| | - Amy Hendrix-Dicken
- Department of Paediatrics, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
| | - Rachel Terry
- Oklahoma State University College of Osteopathic Medicine, Office of Medical Student Research, Tulsa, OK, USA
| | - Sadie Schiffmacher
- Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA
| | - Lauren Conway
- Department of Paediatrics, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
| | - Julie M Croff
- Oklahoma State University Centre for Health Sciences, National Centre for Wellness and Recovery, Tulsa, OK, USA
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Kaufman J, Khan M, Shepard Payne J, Mancini J, Summers White Y. Transgenerational Inheritance and Systemic Racism in America. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2023. [DOI: 10.1176/appi.prcp.20220043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Affiliation(s)
- Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Maria Khan
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Jennifer Shepard Payne
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Julia Mancini
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Yvonne Summers White
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
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Busso DS, Pool AC, Kendall-Taylor N, Ginsburg KR. Reframing Adolescent Development: Identifying Communications Challenges and Opportunities. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:1328-1340. [PMID: 34747536 DOI: 10.1111/jora.12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Understanding Americans' deeply held and widely shared assumptions about adolescents and their development can reveal key opportunities and challenges for developmental science communicators. Twenty-nine in-depth interviews were conducted with adolescents and adults about adolescence. We analyzed the cultural models the public use to make meaning about what adolescence is, what development involves, what adolescents need, and how adolescents can be supported. The analysis revealed several cultural models that may impede public engagement around youth issues. These dominant ways of thinking include a strong focus on the vulnerability of adolescence and a narrow understanding of how environments affect adolescent development. The findings have important implications for communicators seeking to expand and deepen public thinking about adolescence.
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Affiliation(s)
| | | | | | - Kenneth R Ginsburg
- Children's Hospital of Philadelphia
- Perelman School of Medicine, University of Pennsylvania
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Mrug S, Barker-Kamps M, Orihuela CA, Patki A, Tiwari HK. Childhood Neighborhood Disadvantage, Parenting, and Adult Health. Am J Prev Med 2022; 63:S28-S36. [PMID: 35725138 PMCID: PMC9219037 DOI: 10.1016/j.amepre.2022.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/04/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Growing up in disadvantaged neighborhoods is associated with poor adult health indicators. Consistent and supportive parenting plays a key role in life-long health, but it is not known whether positive parenting can mitigate the relationship between neighborhood adversity and poor health. This study examines parenting as a moderator of the links between childhood neighborhood characteristics and adult health indicators. METHODS A sample of 305 individuals (61% female; 82% African American, 18% Caucasian) were assessed in childhood (T1; age 11 years; 2003‒2004) and adulthood (T2; age 27 years; 2018‒2021). At T1, neighborhood poverty was derived from census data; neighborhood disorder was reported by parents. Children reported on parental harsh discipline, inconsistent discipline, and parental nurturance. At T2, health outcomes included BMI, serum cortisol and C-reactive protein (CRP), and salivary DNA methylation index related to CRP. Regression models predicted T2 health outcomes from T1 neighborhood and parenting variables and their interactions, adjusting for clustering and confounders. Data were analyzed in 2021. RESULTS Neighborhood poverty was associated with lower cortisol, whereas neighborhood disorder was linked with CRP‒related DNA methylation. Multiple interactions between neighborhood and parenting variables emerged, indicating that adverse neighborhood conditions were only related to poor adult health when combined with inconsistent discipline and low parental nurturance. By contrast, warm and supportive parenting, consistent discipline, and to a lesser extent harsh discipline buffered children from poor health outcomes associated with neighborhood disadvantage. CONCLUSIONS Interventions enhancing consistent and nurturing parenting may help to reduce the long-term associations of neighborhood disadvantage with poor health.
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Affiliation(s)
- Sylvie Mrug
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, Alabama.
| | - Malcolm Barker-Kamps
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Catheryn A Orihuela
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Amit Patki
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Hemant K Tiwari
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
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Suglia SF, Appleton AA, Bleil ME, Campo RA, Dube SR, Fagundes CP, Heard-Garris NJ, Johnson SB, Slopen N, Stoney CM, Watamura SE. Timing, duration, and differential susceptibility to early life adversities and cardiovascular disease risk across the lifespan: Implications for future research. Prev Med 2021; 153:106736. [PMID: 34293381 PMCID: PMC8595689 DOI: 10.1016/j.ypmed.2021.106736] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Early life adversities (ELA), include experiences such as child maltreatment, household dysfunction, bullying, exposure to crime, discrimination, bias, and victimization, and are recognized as social determinants of cardiovascular disease (CVD). Strong evidence shows exposure to ELA directly impacts cardiometabolic risk in adulthood and emerging evidence suggests there may be continuity in ELA's prediction of cardiometabolic risk over the life course. Extant research has primarily relied on a cumulative risk framework to evaluate the relationship between ELA and CVD. In this framework, risk is considered a function of the number of risk factors or adversities that an individual was exposed to across developmental periods. The cumulative risk exposure approach treats developmental periods and types of risk as equivalent and interchangeable. Moreover, cumulative risk models do not lend themselves to investigating the chronicity of adverse exposures or consider individual variation in susceptibility, differential contexts, or adaptive resilience processes, which may modify the impact of ELA on CVD risk. To date, however, alternative models have received comparatively little consideration. Overall, this paper will highlight existing gaps and offer recommendations to address these gaps that would extend our knowledge of the relationship between ELA and CVD development. We focus specifically on the roles of: 1) susceptibility and resilience, 2) timing and developmental context; and 3) variation in risk exposure. We propose to expand current conceptual models to incorporate these factors to better guide research that examines ELA and CVD risk across the life course.
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Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Emory University, Atlanta, GA, United States of America.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Albany, NY, United States of America
| | - Maria E Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States of America
| | - Rebecca A Campo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Shanta R Dube
- Public Health Program, Levine College of Health Sciences, Wingate University, Wingate, NC, United States of America
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - Nia J Heard-Garris
- Division of Advanced General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Catherine M Stoney
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Sarah E Watamura
- Department of Psychology, University of Denver, Denver, CO, United States of America
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Loucks EB, Rosenkranz MA, Creswell JD. Harnessing Life's Slings and Arrows: The Science and Opportunities for Mindfulness Meditation During a Global Pandemic and Beyond. Psychosom Med 2021; 83:497-502. [PMID: 34117158 PMCID: PMC8740951 DOI: 10.1097/psy.0000000000000961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
ABSTRACT We are at a difficult time in history with societal increases in stress, loneliness, and psychopathology, along with high rates of obesity, sedentary lifestyles, and chronic pain. Mindfulness interventions offer promise to address these societal issues. However, in order to make best use of the opportunities revealed by our current challenges, we must: (1) tackle these issues head-on with inclusive, innovative, and creative experimental designs and interventions, and (2) collectively adhere to rigorous, high quality methods so as to provide an evidence-based integration of mindfulness interventions into mainstream medicine and public health.We find there are several areas for which important advances are happening, including sampling socially diverse populations, examining mechanisms of action, pain management, and health behaviors. Furthermore, rigorous methods, including measurement, causal inference from control groups, delivery and scalability of mindfulness interventions, and effect modifiers to determine who mindfulness programs work best for are also gaining traction. This special issue on Mindfulness: Biobehavioral Mechanisms and Health Outcomes attends to many of these issues, several of which are highlighted in this editorial perspective.
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Affiliation(s)
- Eric B Loucks
- From the Department of Epidemiology, Brown University School of Public Health (Loucks); Mindfulness Center at Brown University (Loucks); Department of Psychiatry, University of Wisconsin-Madison (Rosenkranz); Center for Healthy Minds, University of Wisconsin-Madison (Rosenkranz); and Department of Psychology, Carnegie Mellon University (Creswell)
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Bleil ME, Spieker SJ, Booth-LaForce C. Targeting Parenting Quality to Reduce Early Life Adversity Impacts on Lifespan Cardiometabolic Risk. Front Psychol 2021; 12:678946. [PMID: 34149571 PMCID: PMC8211431 DOI: 10.3389/fpsyg.2021.678946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence that early life adversity (ELA) exposures confer risk for cardiometabolic disease over the lifespan motivated this narrative review to examine parenting quality as a potential intervention target to reduce ELA exposures or mitigate their impact as a way of reducing or preventing cardiometabolic disease. We describe findings from the limited number of family-based intervention studies in ELA-exposed children that have tested parenting impacts on cardiometabolic health outcomes. We then describe the implications of this work and make recommendations for future research that will move this field forward.
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Affiliation(s)
- Maria E. Bleil
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
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10
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Boyce WT, Levitt P, Martinez FD, McEwen BS, Shonkoff JP. Genes, Environments, and Time: The Biology of Adversity and Resilience. Pediatrics 2021; 147:peds.2020-1651. [PMID: 33495368 DOI: 10.1542/peds.2020-1651] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 11/24/2022] Open
Abstract
Exposures to adverse environments, both psychosocial and physicochemical, are prevalent and consequential across a broad range of childhood populations. Such adversity, especially early in life, conveys measurable risk to learning and behavior and to the foundations of both mental and physical health. Using an interactive gene-environment-time (GET) framework, we survey the independent and interactive roles of genetic variation, environmental context, and developmental timing in light of advances in the biology of adversity and resilience, as well as new discoveries in biomedical research. Drawing on this rich evidence base, we identify 4 core concepts that provide a powerful catalyst for fresh thinking about primary health care for young children: (1) all biological systems are inextricably integrated, continuously "reading" and adapting to the environment and "talking back" to the brain and each other through highly regulated channels of cross-system communication; (2) adverse environmental exposures induce alterations in developmental trajectories that can lead to persistent disruptions of organ function and structure; (3) children vary in their sensitivity to context, and this variation is influenced by interactions among genetic factors, family and community environments, and developmental timing; and (4) critical or sensitive periods provide unmatched windows of opportunity for both positive and negative influences on multiple biological systems. These rapidly moving frontiers of investigation provide a powerful framework for new, science-informed thinking about health promotion and disease prevention in the early childhood period.
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Affiliation(s)
- W Thomas Boyce
- Departments of Pediatrics and Psychiatry, University of California, San Francisco, San Francisco, California
| | - Pat Levitt
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California.,Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, The University of Arizona, Tucson, Arizona
| | - Bruce S McEwen
- The Rockefeller University, New York, New York.,Deceased
| | - Jack P Shonkoff
- Center on the Developing Child and .,Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts.,Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health and.,Harvard Medical School and Boston Children's Hospital, Harvard University, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts; and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
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11
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Giano Z, Camplain RL, Camplain C, Pro G, Haberstroh S, Baldwin JA, Wheeler DL, Hubach RD. Adverse Childhood Events in American Indian/Alaska Native Populations. Am J Prev Med 2021; 60:213-221. [PMID: 33223364 PMCID: PMC8098634 DOI: 10.1016/j.amepre.2020.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Adverse childhood experiences are linked to deleterious outcomes in adulthood. Certain populations have been shown to be more vulnerable to adversity in childhood than others. Despite these findings, research in this area lacks an empirical investigation that examines adverse childhood experiences among American Indian and Alaska Native populations using large, nationally representative data. As such, the authors have compiled what they believe is the largest empirical investigation of adverse childhood experiences among American Indian and Alaska Native individuals to date. METHODS Data were collected from the Behavioral Risk Factor Surveillance System from 34 states (2009-2017), whereby all individuals self-report as American Indian and Alaska Native (N=3,894). Adverse childhood experience scores were calculated and further stratified by sex, age, household income, education, employment status, sexual orientation, Census region, and state. In addition, frequencies and prevalence of each adverse childhood experience domain (stratified by the same categories) were calculated. Analysis was conducted in 2019. RESULTS The average adverse childhood experience score among American Indians and Alaska Natives was 2.32, higher than those of individuals identifying as White (1.53), Black (1.66), and Hispanic (1.63). Female participants had a higher average adverse childhood experience score than male participants (2.52 vs 2.12). Generally, younger individuals and those with lower incomes reported higher adverse childhood experience scores, whereas those with higher educational attainment reported lower scores. CONCLUSIONS Compared with the few studies among American Indian and Alaska Native populations that have used either smaller samples or nontraditional adverse childhood experience data (i.e., asking parents about their children's experiences), these results present overall higher adverse childhood experience averages than previously published studies. Nevertheless, aligning with other research on adverse childhood experiences, female individuals, younger adults, and sexual minorities reported higher adverse childhood experiences scores than other categories in their respective demographics.
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Affiliation(s)
- Zachary Giano
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma.
| | - Ricky L Camplain
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona
| | - Carolyn Camplain
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona
| | - George Pro
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Shane Haberstroh
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona
| | - Julie A Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona
| | - Denna L Wheeler
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Randolph D Hubach
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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12
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Shonkoff JP, Slopen N, Williams DR. Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health. Annu Rev Public Health 2021; 42:115-134. [PMID: 33497247 DOI: 10.1146/annurev-publhealth-090419-101940] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Inequalities in health outcomes impose substantial human and economic costs on all societies-and the relation between early adversity and lifelong well-being presents a rich scientific framework for fresh thinking about health promotion and disease prevention broadly, augmented by a deeper focus on how racism influences disparities more specifically. This review begins with an overview of advances in the biology of adversity and resilience through an early childhood lens, followed by an overview of the unique effects of racism on health and a selective review of findings from related intervention research. This article presents a framework for addressing multiple dimensions of the public health challenge-including institutional/structural racism, cultural racism, and interpersonal discrimination-and concludes with the compelling need to protect the developing brain and other biological systems from the physiological disruptions of toxic stress that can undermine the building blocks of optimal health and development in the early childhood period.
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Affiliation(s)
- Jack P Shonkoff
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts 02138, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; , , .,Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts 02138, USA.,Harvard Medical School, Harvard University, Boston, Massachusetts 02115, USA
| | - Natalie Slopen
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts 02138, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; , ,
| | - David R Williams
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts 02138, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; , , .,Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
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13
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Bleil ME, Spieker SJ, Gregorich SE, Thomas AS, Hiatt RA, Appelhans BM, Roisman GI, Booth-LaForce C. Early Life Adversity and Pubertal Timing: Implications for Cardiometabolic Health. J Pediatr Psychol 2021; 46:36-48. [PMID: 33120426 PMCID: PMC7819716 DOI: 10.1093/jpepsy/jsaa082] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/24/2020] [Accepted: 08/22/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To identify early life adversity (ELA) risk factors for earlier pubertal timing, itself a risk factor for poor cardiometabolic health, and to determine whether such ELA-related risk may be mediated by pre-pubertal body mass index (BMI). METHODS Subjects included 426 female participants in a prospective birth cohort study, the NICHD Study of Early Child Care and Youth Development. Survival analysis models were fit to examine ELA exposures, representing childhood socioeconomic status (SES), maternal sensitivity, mother-child attachment, and negative life events, along with child health indicators and covariates, in relation to pubertal timing outcomes, including age at menarche and ages at Tanner stage II for breast and pubic hair development. RESULTS Higher childhood SES emerged as an independent predictor of older age at menarche, showing each one standard deviation increase in childhood SES corresponded to a 1.3% increase in age at menarche (factor change = 1.013; 1.003-1.022; p < .01), but did not predict breast or pubic hair development (ps > .05). In mediation analyses, indirect (mediated) effects of mother-child attachment on the pubertal timing outcomes, via pre-pubertal BMI, were all statistically significant (ps < .05). CONCLUSIONS Higher childhood SES predicted directly, and secure (vs. insecure) mother-child attachment predicted indirectly (via pre-pubertal BMI), later pubertal timing, suggesting these factors may protect girls from earlier pubertal development. By extension, clinical implications are that intervention strategies designed to lessen ELA- and pre-pubertal obesity-related risk may be effective in remediating life course pathways linking ELA, accelerated pubertal development, and cardiometabolic risk.
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Affiliation(s)
- Maria E Bleil
- Child, Family, & Population Health Nursing, University of Washington
| | - Susan J Spieker
- Child, Family, & Population Health Nursing, University of Washington
| | | | - Alexis S Thomas
- Child, Family, & Population Health Nursing, University of Washington
| | - Robert A Hiatt
- Department of Epidemiology & Biostatistics, University of California San Francisco
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Ehrlich KB. How does the social world shape health across the lifespan? Insights and new directions. ACTA ACUST UNITED AC 2021; 75:1231-1241. [PMID: 33382288 DOI: 10.1037/amp0000757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Decades of research highlight the connections between stressful life experiences-particularly those experienced in childhood-and physical health across the lifespan. In recent years, studies at the intersection of social and biomedical science have provided intriguing insights into the biological mechanisms that might explain how chronic and acute stressors give rise to health problems, sometimes decades later in life. To date, efforts to understand these connections have relied on a handful of study designs, and these studies have revealed important observations about how stressful experiences are thought to shape health. At the same time, these study designs have some drawbacks that limit the conclusions that can be drawn about the role of the social world for health. This article provides an overview of research on social determinants of health and includes a discussion of conceptual and methodological directions for the field to consider. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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15
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Ittoop T, Jeffrey K, Cheng CI, Reddy S. The Relationship Between Adverse Childhood Experiences and Diabetes in Central Michigan Adults. Endocr Pract 2020; 26:1425-1434. [PMID: 33471734 DOI: 10.4158/ep-2020-0239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/18/2020] [Indexed: 09/16/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) predispose individuals to poor health outcomes as adults. Although a dose-response relationship between the number of ACEs and certain chronic illnesses has been shown, the impact of ACEs on diabetes is not thoroughly understood. We investigated the prevalence of ACEs in patients with diabetes and the potential relationship to the severity of diabetes. METHODS Patients with diabetes (both type 1 and type 2) or obesity were surveyed from the Endocrinology & Diabetes Center at McLaren Central Michigan in Mount Pleasant, Michigan. A validated, standard ACE questionnaire was administered to quantify the number of adverse childhood events that patients have experienced. A retrospective chart analysis was then conducted, addressing the relationship of ACEs with the severity of disease in the diabetes group and the obesity group. The number of ACEs was correlated with disease comorbidities, complications, and measurable quantities, such as body mass index (BMI) and hemoglobin A1c (HbA1c). RESULTS ACE scores in both diabetes and obesity groups were shown to have a greater prevalence compared to the general ACE average in Michigan. ACE scores also positively correlated to BMI and HbA1c in the diabetes group. Those with higher ACE scores in the diabetes group were also more likely to have depression and anxiety. CONCLUSION ACE screening may lead to a greater understanding of the severity of and progression of diabetes. Ultimately, these results could provide support to potential interventional studies leading to the altered management of diabetes in patients with ACEs, or preventative intervention to children with ACEs. ABBREVIATIONS ACE = adverse childhood experiences; BMI = body mass index; HbA1c = hemoglobin A1c; T1DM = type 1 diabetes mellitus; T2DM = type 2 diabetes mellitus.
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Affiliation(s)
- Thomas Ittoop
- From (1)Central Michigan University, College of Medicine, Mount Pleasant, Michigan
| | - Kimberly Jeffrey
- McLaren Central Michigan, Endocrinology, Mount Pleasant, Michigan, and
| | - Chin-I Cheng
- Central Michigan University, Department of Statistics, Actuarial and Data Science, Mount Pleasant, Michigan
| | - Sethu Reddy
- From (1)Central Michigan University, College of Medicine, Mount Pleasant, Michigan,; McLaren Central Michigan, Endocrinology, Mount Pleasant, Michigan, and.
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16
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Novilla LK, Broadbent E, Glade R, Crandall A. Supporting and Engaging Families: An Examination of Publicly-Funded Health Promotion Programs in the Intermountain West, USA. Front Public Health 2020; 8:573003. [PMID: 33178662 PMCID: PMC7593609 DOI: 10.3389/fpubh.2020.573003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/28/2020] [Indexed: 11/24/2022] Open
Abstract
Public health programming efforts have traditionally focused on either an individualistic or population approach, neglecting the family as a setting for or partner in health promotion efforts. Due to the multi-faceted influence of families on individual health, family-focused, and family-friendly public health interventions are important to making lasting changes for individual and community health. The purpose of this study was to examine the degree to which health promotion programs in a state in the US Intermountain West involve and support families across four family impact principles: family engagement, family stability, family responsibility, and family diversity. A survey was completed by 67 health promotion administrators and practitioners from 12 out of 13 county health departments with additional responses from public health practitioners at the State Health Department. The results of the survey indicated that health promotion efforts were best at supporting family responsibility and a diverse group of families but were weaker in family engagement and family stability. Applying a more family-centered and family-focused approach to health promotion efforts can be achieved by employing interdisciplinary efforts and by taking advantage of tools like the Public Health Family Impact Checklist to intentionally engage and support families in programs and interventions.
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Affiliation(s)
| | - Eliza Broadbent
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Rozalyn Glade
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - AliceAnn Crandall
- Department of Public Health, Brigham Young University, Provo, UT, United States
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17
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Giano Z, Wheeler DL, Hubach RD. The frequencies and disparities of adverse childhood experiences in the U.S. BMC Public Health 2020; 20:1327. [PMID: 32907569 PMCID: PMC7488299 DOI: 10.1186/s12889-020-09411-z] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adversity experienced during childhood manifests deleteriously across the lifespan. This study provides updated frequency estimates of ACEs using the most comprehensive and geographically diverse sample to date. METHODS ACEs data were collected via BRFSS (Behavioral Risk Factor Surveillance System). Data from a total of 211,376 adults across 34 states were analyzed. The ACEs survey is comprised of 8 domains: physical/emotional/sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation/divorce. Frequencies were calculated for each domain and summed to derive mean ACE scores. Findings were weighted and stratified by demographic variables. Group differences were assessed by post-estimation F-tests. RESULTS Most individuals experienced at least one ACE (57.8%) with 21.5% experiencing 3+ ACEs. F-tests showed females had significantly higher ACEs than males (1.64 to 1.46). Multiracial individuals had a significantly higher ACEs (2.39) than all other races/ethnicities, while White individuals had significantly lower mean ACE scores (1.53) than Black (1.66) or Hispanic (1.63) individuals. The 25-to-34 age group had a significantly higher mean ACE score than any other group (1.98). Generally, those with higher income/educational attainment had lower mean ACE scores than those with lower income/educational attainment. Sexual minority individuals had higher ACEs than straight individuals, with significantly higher ACEs in bisexual individuals (3.01). CONCLUSION Findings highlight that childhood adversity is common across sociodemographic, yet higher in certain categories. Identifying at-risk populations for higher ACEs is essential to improving the health outcomes and attainment across the lifespan.
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Affiliation(s)
- Zachary Giano
- Center for Rural Health, Oklahoma State University--Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA.
| | - Denna L Wheeler
- Center for Rural Health, Oklahoma State University--Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
| | - Randolph D Hubach
- Center for Rural Health, Oklahoma State University--Center for Health Sciences, 1111 W 17th Street, Tulsa, OK, 74107, USA
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Assari S, Boyce S, Bazargan M, Caldwell CH. Race, Socioeconomic Status, and Sex Hormones among Male and Female American Adolescents. REPRODUCTIVE MEDICINE 2020; 1:108-121. [PMID: 32832919 DOI: 10.3390/reprodmed1020008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although early sexual initiation and childbearing are major barriers against the upward social mobility of American adolescents, particularly those who belong to a low socioeconomic status (SES) and racial minorities such as Blacks, less is known on how SES and race correlate with adolescents' sex hormones. An understanding of the associations between race and SES with adolescents' sex hormones may help better understand why racial, and SES gaps exist in sexual risk behaviors and teen pregnancies. To extend the existing knowledge on social patterning of adolescents' sex hormones, in the current study, we studied social patterning of sex hormones in a national sample of male and female American adolescents, with a particular interest in the role of race and SES. For this cross-sectional study, data came from the baseline data (wave 1) of the Adolescent Brain Cognitive Development (ABCD) study, a national longitudinal prospective study of American adolescents. This analysis included 717 male and 576 female non-Hispanic White or Black adolescents ages 9-10. The dependent variables were sex hormones (testosterone for males and estradiol for females). Independent variables were age, race, family marital status, parental education, and financial difficulties. For data analysis, linear regression models were used. Age, race, parental education, and financial difficulties were associated with estradiol in female and testosterone levels in male adolescents. Associations were not identical for males and females, but the patterns were mainly similar. Low SES explained why race is associated with higher estradiol in female adolescents. Marital status of the family did not correlate with any of the sex hormones. Being Black and low SES were associated with a higher level of sex hormones in male and female adolescents. This information may help us understand the social patterning of sexual initiation and childbearing. Addressing racial and economic inequalities in early puberty, sexual initiation, and childbearing is an essential part of closing the racial and economic gaps in the US.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles Drew University, Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Cleopatra H Caldwell
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
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19
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Abstract
The investigation of hormones, brain function and behavior over the past 50 years has played a major role in elucidating how the brain and body communicate reciprocally via hormones and other mediators and how this impacts brain and body health both positively and negatively. This is illustrated here for the hippocampus, a uniquely sensitive and vulnerable brain region, study of which as a hormone target has provided a gateway into the rest of the brain. Hormone actions on the brain and hormones generated within the brain are now recognized to include not only steroid hormones but also metabolic hormones and chemical signals from bone and muscle. Moreover, steroid hormones, and some metabolic hormones, and their receptors, are generated by the brain for specific functions that synergize with effects of those circulating hormones. Hormone actions in hippocampus have revealed its capacity, and that of other brain regions, for adaptive plasticity, loss of which needs external intervention in, for example, mood disorders. Early life experiences as well as in utero and transgenerational effects are now appreciated for their lasting effects at the level of gene expression affecting the capacity for adaptive plasticity. Moreover sex differences are recognized as affecting the whole brain via both genetic and epigenetic mechanisms. The demonstrated plasticity of a healthy brain gives hope that interventions throughout the life course can ameliorate negative effects by reactivating that plasticity and the underlying epigenetic activity to produce compensatory changes in the brain with more positive consequences for the body.
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Affiliation(s)
- Bruce S McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University, 1230 York Avenue, New York, NY 10065, United States of America.
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20
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Miller TR, Waehrer GM, Oh DL, Purewal Boparai S, Ohlsson Walker S, Silverio Marques S, Burke Harris N. Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences. PLoS One 2020; 15:e0228019. [PMID: 31990957 PMCID: PMC6986705 DOI: 10.1371/journal.pone.0228019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/06/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To estimate the adult health burden and costs in California during 2013 associated with adults' prior Adverse Childhood Experiences (ACEs). METHODS We analyzed five ACEs-linked conditions (asthma, arthritis, COPD, depression, and cardiovascular disease) and three health risk factors (lifetime smoking, heavy drinking, and obesity). We estimated ACEs-associated fractions of disease risk for people aged 18+ for these conditions by ACEs exposure using inputs from a companion study of California Behavioral Risk Factor Surveillance System data for 2008-2009, 2011, and 2013. We combined these estimates with published estimates of personal healthcare spending and Disability-Adjusted-Life-Years (DALYs) in the United States by condition during 2013. DALYs captured both the years of healthy life lost to disability and the years of life lost to deaths during 2013. We applied a published estimate of cost per DALY. RESULTS Among adults in California, 61% reported ACEs. Those ACEs were associated with $10.5 billion in excess personal healthcare spending during 2013, and 434,000 DALYs valued at approximately $102 billion dollars. During 2013, the estimated health burden per exposed adult included $589 in personal healthcare expenses and 0.0224 DALYs valued at $5,769. CONCLUSIONS Estimates of the costs of childhood adversity are far greater than previously understood and provide a fiscal rationale for prevention efforts.
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Affiliation(s)
- Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland, United States of America
- School of Public Health, Curtin University, Perth, Australia
| | - Geetha M. Waehrer
- Pacific Institute for Research and Evaluation, Calverton, Maryland, United States of America
| | - Debora L. Oh
- University of California, San Francisco, California, United States of America
| | | | - Sheila Ohlsson Walker
- Children’s National Medical Center, George Washington University, Washington, DC, United States of America
| | | | - Nadine Burke Harris
- Center for Youth Wellness, San Francisco, California, United States of America
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21
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Farrell AK, Stanton SCE. Toward a Mechanistic Understanding of Links Between Close Relationships and Physical Health. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2019. [DOI: 10.1177/0963721419855657] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Although researchers have made great strides in identifying links between close relationship processes and physical health, we know less about the psychological and behavioral mechanisms underlying these links. As we move toward considering relationships as a public health issue, understanding mechanistic pathways in relationships–health links is crucial for designing efficient and effective interventions. In this review, we outline criteria for establishing a construct as a relationships–health mechanism. We then discuss how best to test potential mechanisms of relationships–health links and identify some promising mechanism candidates on the basis of initial evidence (emotion, attachment, sleep, and substance abuse). We conclude by recommending key directions for future research.
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22
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Reiss D, Nielsen L, Godfrey K, McEwen B, Power C, Seeman T, Suomi S. Midlife reversibility of early-established biobehavioral risk factors: A research agenda. Dev Psychol 2019; 55:2203-2218. [PMID: 31368762 DOI: 10.1037/dev0000780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epidemiological evidence links exposure to early life adversities-such as childhood maltreatment-with impaired health and well-being in adulthood. Since these effects are usually unrecognized or untreated in childhood, preventive and remediating interventions in adults are needed. Our focus on adulthood prompted three major questions. First, does our increased understanding of mechanisms accounting for the long-term effects of early life adversities help delineate underlying dimensions that underscore key similarities and differences among these adversities? Second, can adults accurately report on adversities they experienced in childhood? Third, can we identify malleable risk processes in adulthood that might be targets for preventive intervention? Supported by the National Institute on Aging, the U.K. Economic and Social and the Biotechnology and Biological Sciences Research Councils, a network of researchers in human and animal development addressed these questions through meetings and literature review. A small number of dimensions may adequately distinguish among a range of co-occurring childhood adversities. Widely used adult ascertainments of childhood adversity are poorly related to prospective ascertainment. Strategies for preventive interventions should be aimed both at adults who were actually exposed to adversity as well as those who recall adversity, but the targeted risk processes may be different. Now is an opportune time to support research on adult interventions based on unfolding research on critical periods of sensitivity to adversity in fetal and child development, on improved understanding of risk mechanisms that may persist across the life span, and on new insights on enhancing neuroplasticity in adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Lisbeth Nielsen
- Division of Social and Behavioral Research, National Institute on Aging
| | - Keith Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - Bruce McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University
| | - Christine Power
- Great Ormond Street Institute of Child Health, University College London
| | - Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles
| | - Stephen Suomi
- Laboratory of Comparative Ethology, Eunice Kennedy Shriver National Institute of Child Health and Human Development
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23
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The hippocampus underlies the association between self-esteem and physical health. Sci Rep 2018; 8:17141. [PMID: 30459409 PMCID: PMC6244287 DOI: 10.1038/s41598-018-34793-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/12/2018] [Indexed: 01/01/2023] Open
Abstract
Self-esteem refers to the extent to which we feel positive or negative about ourselves, and reflects an individual's subjective evaluation of personal worth and attitudes about the self. As one kind of positive psychosocial resources, high self-esteem has been found to buffer the effects of stress on physical health. However, little is known about the possible neural basis underlying the association between physical health and self-esteem. In the present study, we investigated whether the hippocampus served as a neuroanatomical basis for the association between self-esteem and physical health in a large population of healthy young adults. We examined self-esteem and self-reported physical health with the Rosenberg Self Esteem Scale (RSES) and the Chinese Constitution Questionnaire (CCQ) respectively, and gray matter volume of the hippocampus was measured using magnetic resonance imaging. As expected, we found that individuals with higher levels of self-esteem had better self-reported physical health. Importantly, the mediation analysis showed that the gray matter volume of the hippocampus mediated the link between self-esteem and physical health, suggesting its critical role in the neural circuitry through which self-esteem is related to physical health.
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24
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Purewal Boparai SK, Au V, Koita K, Oh DL, Briner S, Burke Harris N, Bucci M. Ameliorating the biological impacts of childhood adversity: A review of intervention programs. CHILD ABUSE & NEGLECT 2018; 81:82-105. [PMID: 29727766 DOI: 10.1016/j.chiabu.2018.04.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/03/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
Childhood adversity negatively impacts the biological development of children and has been linked to poor health outcomes across the life course. The purpose of this literature review is to explore and evaluate the effectiveness of interventions that have addressed an array of biological markers and physical health outcomes in children and adolescents affected by adversity. PubMed, CINAHL, PsychInfo, Sociological Abstracts databases and additional sources (Cochrane, WHO, NIH trial registries) were searched for English language studies published between January 2007 and September 2017. Articles with a childhood adversity exposure, biological health outcome, and evaluation of intervention using a randomized controlled trial study design were selected. The resulting 40 intervention studies addressed cortisol outcomes (n = 20) and a range of neurological, epigenetic, immune, and other outcomes (n = 22). Across institutional, foster care, and community settings, intervention programs demonstrated success overall for improving or normalizing morning and diurnal cortisol levels, and ameliorating the impacts of adversity on brain development, epigenetic regulation, and additional outcomes in children. Factors such as earlier timing of intervention, high quality and nurturant parenting traits, and greater intervention engagement played a role in intervention success. This study underlines progress and promise in addressing the health impacts of adversity in children. Ongoing research efforts should collect baseline data, improve retention, replicate studies in additional samples and settings, and evaluate additional variables, resilience factors, mediators, and long-term implications of results. Clinicians should integrate lessons from the intervention sciences for preventing and treating the health effects of adversity in children and adolescents.
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Affiliation(s)
- Sukhdip K Purewal Boparai
- Center for Youth Wellness, 3450 Third Street, Building 2, Suite 201, San Francisco, CA 94124, USA; Human Impact Partners, 304 12th Street, Suite 2B, Oakland, CA 94607, USA.
| | | | - Kadiatou Koita
- Center for Youth Wellness, 3450 Third Street, Building 2, Suite 201, San Francisco, CA 94124, USA.
| | - Debora Lee Oh
- Center for Youth Wellness, 3450 Third Street, Building 2, Suite 201, San Francisco, CA 94124, USA.
| | - Susan Briner
- Center for Youth Wellness, 3450 Third Street, Building 2, Suite 201, San Francisco, CA 94124, USA.
| | - Nadine Burke Harris
- Center for Youth Wellness, 3450 Third Street, Building 2, Suite 201, San Francisco, CA 94124, USA.
| | - Monica Bucci
- Center for Youth Wellness, 3450 Third Street, Building 2, Suite 201, San Francisco, CA 94124, USA.
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25
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Kuhlman KR, Robles TF, Bower JE, Carroll JE. Screening for childhood adversity: the what and when of identifying individuals at risk for lifespan health disparities. J Behav Med 2018; 41:516-527. [PMID: 29603040 DOI: 10.1007/s10865-018-9921-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/24/2018] [Indexed: 12/30/2022]
Abstract
Existing research on childhood adversity and health risk across the lifespan lacks specificity regarding which types of exposures to assess and when. The purpose of this study was to contribute to an empirically-supported framework to guide practitioners interested in identifying youth who may be at greatest risk for a lifelong trajectory of health disparities. We also sought to identify the point in childhood at which screening for adversity exposure would capture the largest group of at risk individuals for triage to prevention and intervention services. Participants (n = 4036) collected as part of the Midlife in the United States study reported their medical status and history including physical (cardiovascular disease, hypertension, obesity, diabetes, cancer) and mental health (depression, substance use problems, sleep problems). Participants indicated whether they were exposed to 7 adversities at any point in childhood and their age of exposure to 19 additional lifetime adversities before the age of 18. Parent drug abuse, dropping out or failing out of school, being fired from a job, and sexual assault during childhood exhibited the largest effect sizes on health in adulthood, which were comparable to the effects of childhood maltreatment. Childhood adversity screening in early adolescence may identify the largest proportion of youth at risk for negative health trajectories. The results of this descriptive analysis provide an empirical framework to guide screening for childhood adversity in pediatric populations. We discuss the implications of these observations in the context of prevention science and practice.
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Affiliation(s)
- Kate Ryan Kuhlman
- Department of Psychology and Social Behavior, School of Social Ecology, University of California Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697-7085, USA. .,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.
| | - Theodore F Robles
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.,Department of Psychology, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Judith E Carroll
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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