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Shoaff JR, Hahn J, Calafat AM, Korrick SA. Adolescent endocrine disrupting chemical exposure and academic achievement. ENVIRONMENTAL RESEARCH 2023; 234:116493. [PMID: 37390949 DOI: 10.1016/j.envres.2023.116493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/30/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Epidemiologic studies support associations of exposure to endocrine disrupting chemicals (EDCs), such as some phthalates, phenols, and parabens with a wide range of cognitive and behavioral traits. While many of these traits are associated with academic achievement, the relationship of EDC exposure specifically with academic achievement in adolescence has not yet been studied. OBJECTIVE We assessed the association of urinary biomarker concentrations of EDCs with academic achievement in adolescents as well as the potential for psychosocial factors to modify associations. METHODS We quantified urinary concentrations of select EDCs in 205 adolescent participants from the New Bedford Cohort (NBC), a prospective birth cohort of children born to mothers residing near the New Bedford Harbor Superfund site in Massachusetts, and estimated associations between EDCs and adolescent academic achievement assessed with the Wide Range Achievement Test (WRAT). Measures of socioeconomic status and the home environment were used to estimate psychosocial stress. RESULTS Urinary concentrations of antiandrogenic phthalates were inversely associated with Math Computation scores. For example, each doubling of the concentration of antiandrogenic phthalate metabolites in urine was associated with a 1.94 point decrease (95% CI: 3.84, -0.05) in Math Computation scores, indicating poorer performance. For the most part, associations were stronger in adolescents with more, as compared to less, social disadvantage, but most of these differences did not achieve statistical significance. CONCLUSION Our findings support the potential for adolescents' exposure to antiandrogenic phthalates to correlate with poorer academic achievement in math, particularly among participants with greater psychosocial stress.
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Affiliation(s)
- Jessica R Shoaff
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jill Hahn
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan A Korrick
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Denstel KD, Beyl RA, Danos DM, Kepper MM, Staiano AE, Theall KT, Tseng TS, Broyles ST. An examination of the relationships between the neighborhood social environment, adiposity, and cardiometabolic disease risk in adolescence: a cross-sectional study. BMC Public Health 2023; 23:1692. [PMID: 37658323 PMCID: PMC10472712 DOI: 10.1186/s12889-023-16580-0] [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: 04/17/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years. METHODS This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey five-year block group estimates, 2012-2016. Multilevel linear regression models were used to examine whether neighborhood concentrated disadvantage index and perceived neighborhood disorder were associated with body mass index, waist circumference, body fat, adipose tissue, blood pressure, and lipids. We performed multilevel logistic regression to determine the odds of elevated adiposity and cardiometabolic disease risk for adolescents living in neighborhoods with varying levels of neighborhood concentrated disadvantage and disorder. RESULTS Adolescents living in neighborhoods with higher disadvantage or disorder had greater waist circumference and total percent body fat compared to those in less disadvantaged and disordered neighborhoods (p for trend < 0.05). Neighborhood disadvantage was also positively associated with percentage of the 95th Body Mass Index percentile and visceral abdominal adipose tissue mass while greater perceived neighborhood disorder was related to higher trunk fat mass and diastolic blood pressure (p for trend < 0.05). Living in the most disadvantaged was associated with greater odds of obesity (OR: 2.9, 95% CI:1.3, 6.5) and being in the top tertile of body fat mass (OR: 3.0, 95% CI: 1.4, 6.6). Similar results were found with neighborhood disorder for odds of obesity (OR: 2.1, 95% CI:1.1, 4.2) and top tertile of body fat mass (OR: 2.1, 95% CI:1.04, 4.1). CONCLUSIONS Neighborhood social environment measures of chronic stress exposure were associated with excess adiposity during adolescence, and relationships were most consistently identified among adolescents living in the most disadvantaged and disordered neighborhoods. Future studies should account for the influences of the neighborhood environment to stimulate equitable improvements in adolescent health. CLINICAL TRIALS REGISTRATION: # NCT02784509.
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Affiliation(s)
- Kara D Denstel
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, Baton Rouge, LA, 70808, USA
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, Baton Rouge, LA, 70808, USA
| | - Denise M Danos
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Maura M Kepper
- Prevention Research Center, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, USA
| | - Amanda E Staiano
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, Baton Rouge, LA, 70808, USA
| | - Katherine T Theall
- Department of Epidemiology and Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Tung-Sung Tseng
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Stephanie T Broyles
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, Baton Rouge, LA, 70808, USA.
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Rokoff LB, Coull BA, Bosquet Enlow M, Korrick SA. Associations of Prenatal Chemical and Nonchemical Stressors with Early-Adulthood Anxiety and Depressive Symptoms. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:27004. [PMID: 36749608 PMCID: PMC9904409 DOI: 10.1289/ehp11171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Prenatal exposure to environmental chemicals may increase risk of childhood internalizing problems, but few studies have explored the potential for longer-term consequences of such exposures. OBJECTIVE We evaluated associations between prenatal organochlorine and metal levels and early adulthood internalizing symptoms, considering whether sociodemographic/nonchemical stressors modified these associations. METHODS Participants were 209 young adults, born (1993-1998) to mothers residing in or near New Bedford, Massachusetts. As part of the early-adult assessment, self-reported anxiety (7-item Generalized Anxiety Disorder scale) and depressive (8-item Patient Health Questionnaire) symptoms (≥10: elevated symptoms) were ascertained. We previously analyzed levels of cord serum organochlorines [hexachlorobenzene, dichlorodiphenyldichloroethylene (p,p'-DDE), polychlorinated biphenyls (ΣPCB4: sum of congeners 118, 138, 153, 180)] and whole blood lead shortly after participants' birth, and levels of cord whole blood manganese from archived samples at the time of the adolescent study visit. We used modified Poisson regression models and quantile g-computation, adjusting for sociodemographics, and explored whether biological sex, race/ethnicity (proxy for unmeasured consequences of racism), prenatal social disadvantage (assessed when participants were neonates), and quality of the home environment (assessed during adolescence) modified these associations. RESULTS Participants were (mean±standard deviation) 22.1±1.5 y old, 76% Non-Hispanic White, and 67% female. Prenatal hexachlorobenzene, p,p'-DDE, and lead exposures were moderately associated with increased risk of elevated anxiety symptoms. There were strata-specific associations for prenatal social disadvantage and quality of home environment such that adverse associations of p,p'-DDE and lead and the overall mixture with anxiety and depressive symptoms were largely only evident in those with lower nonchemical stress [e.g., risk ratio and 95% confidence interval (CI) per doubling p,p'-DDE for anxiety: 1.54 (95% CI: 1.20, 1.99) in high-quality home environments and 0.77 (95% CI: 0.51, 1.16) in low-quality home environments]. Associations between prenatal hexachlorobenzene and p,p'-DDE and anxiety symptoms were stronger for underrepresented racial/ethnic group participants vs. Non-Hispanic Whites. We found minimal evidence for sex-specific effects, and no consistent associations with manganese or ΣPCB4. DISCUSSION Prenatal organochlorine pesticides and lead exposure possibly increases risk of internalizing problems, particular anxiety symptoms, in young adults. Varying risk was observed by sociodemographic/nonchemical stressor strata, demonstrating the importance of considering interactions between chemical and other stressors. https://doi.org/10.1289/EHP11171.
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Affiliation(s)
- Lisa B. Rokoff
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Population Health Sciences Program, Harvard University, Cambridge, Massachusetts, USA
| | - Brent A. Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Susan A. Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Pepió Espuny M, Ortega Vila Y, Aragonès Benaiges E, Fernández Sáez J, Pallejà Millán M, Cabré Vila JJ. [Influence of gender and place of residence differences on the evolution and mortality of ischemic cardiopathy in Catalonia: a population-based study.]. Rev Esp Salud Publica 2023; 97:e202301004. [PMID: 36655384 PMCID: PMC10558106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Some bibliography supports a diagnostic and therapeutic delay in women with high cardiovascular risk. The objective of this paper was to know the incidence of cardiovascular disease (CVD) and mortality in a cohort with Metabolic Syndrome (MetS); analyze possible differences in gender and place of residence, regarding the performance of primary angioplasties in patients with ischemic heart disease (IHD). METHODS Population cohort study, with SIDIAP database (Sistema de Información para la Investigación en Atención Primaria), in primary care in Catalonia. We selected people of both sexes, between 35-75 years old, exempt from CVD at the beginning (2009), fulfilling MetS criteria (NCEP-ATPIII-National Cholesterol Education Program-Adult Treatment Panel III- criteria diagnoses). We performed descriptive statistics, and ANOVA and Chi-square test to evaluate differences between variables. RESULTS 167,673 people met MetS criteria (5.2% of the population), 105,969 men (63.2%). 22% of the population belonged to rural areas. Those urban areas with the most socioeconomic differences (urban-1 and urban-5) exhibited the highest incidences of CVD and IHD. We registered 51,129 CVD (30.7%) of which 8,889 were acute myocardial infarctions (AMI) (5,3%) and 24,284 were IHD (14,5%). 1.758 primary angioplasties procedures were performed, 1,467 in men and 291 in women, representing, respectively, 4.4% and 0.9% (p<0.005). CONCLUSIONS The incidence of IHD and AMI in subjects with MetS is high in Catalonia. There is a difference in the angioplasties performed, according to sex and place of residence. Probably a practical implication would be to detect IHD in time in women with MetS, so that they can benefit from revascularization therapy in the same way as men.
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Affiliation(s)
- Marta Pepió Espuny
- Área Básica de Salud CAR Salou, Institut Català de la SalutInstitut Català de la SalutSalouSpain
| | - Yolanda Ortega Vila
- Área Básica de Salud CAR Salou, Institut Català de la SalutInstitut Català de la SalutSalouSpain
- IDIAP Jordi Gol, Institut Català de la SalutInstitut Català de la SalutBarcelonaSpain
- IISPV Pere VirgiliIISPV Pere VirgiliTarragonaSpain
| | - Enric Aragonès Benaiges
- IDIAP Jordi Gol, Institut Català de la SalutInstitut Català de la SalutBarcelonaSpain
- Área Básica de Salud Constantí, Institut Català de la SalutInstitut Català de la SalutConstantí (Tarragona)Spain
| | - José Fernández Sáez
- IDIAP Jordi Gol, Institut Català de la SalutInstitut Català de la SalutBarcelonaSpain
| | | | - Joan-Josep Cabré Vila
- IDIAP Jordi Gol, Institut Català de la SalutInstitut Català de la SalutBarcelonaSpain
- Área Básica de Salud Sant Pere Centre, Institut Català de la SalutInstitut Català de la SalutReus (Tarragona)Spain
- IISPV Pere VirgiliIISPV Pere VirgiliTarragonaSpain
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Nichols OI, Fuller-Rowell TE, Robinson AT, Eugene D, Homandberg LK. Neighborhood Socioeconomic Deprivation in Early Childhood Mediates Racial Disparities in Blood Pressure in a College Student Sample. J Youth Adolesc 2022; 51:2146-2160. [PMID: 35852667 PMCID: PMC9744188 DOI: 10.1007/s10964-022-01658-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/02/2022] [Indexed: 12/14/2022]
Abstract
The influence of childhood contexts on adult blood pressure is an important yet understudied topic. Using a developmental perspective, this study examines the association between neighborhood socioeconomic disadvantage in early childhood (0-5 yrs), middle childhood (6-12 yrs) and adolescence (13-18 yrs) on subsequent blood pressure in young adulthood. Data were from 263 college students (52% Black; Mage = 19.21 years) and neighborhood socioeconomic disadvantage was measured using a tract-level Area Deprivation Index. Neighborhood disadvantage in early childhood was significantly associated with diastolic blood pressure and explained 22% of the race difference between Black and White adults. The findings are consistent with the notion that early childhood may be a sensitive period for the effects of neighborhood disadvantage on blood pressure.
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Affiliation(s)
- Olivia I Nichols
- Department of Human Development and Family Science, Auburn University, 203 Spidle Hall, Auburn, AL, 36849, USA.
| | - Thomas E Fuller-Rowell
- Department of Human Development and Family Science, Auburn University, 203 Spidle Hall, Auburn, AL, 36849, USA
| | - Austin T Robinson
- School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 36849, USA
| | - DaJuandra Eugene
- Center for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Lydia K Homandberg
- Sociology Department, Cornell University, 323 Uris Hall, Ithaca, NY, 14853, USA
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Rokoff LB, Shoaff JR, Coull BA, Enlow MB, Bellinger DC, Korrick SA. Prenatal exposure to a mixture of organochlorines and metals and internalizing symptoms in childhood and adolescence. ENVIRONMENTAL RESEARCH 2022; 208:112701. [PMID: 35016863 PMCID: PMC8917058 DOI: 10.1016/j.envres.2022.112701] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/23/2021] [Accepted: 01/05/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Although prenatal chemical exposures influence neurobehavior, joint exposures are not well explored as risk factors for internalizing disorders through adolescence. OBJECTIVE To evaluate associations of prenatal organochlorine and metal exposures, considered individually and as a mixture, with mid-childhood and adolescent internalizing symptoms. METHODS Participants were 468 children from a prospective cohort recruited at birth (1993-1998) in New Bedford, Massachusetts. Organochlorines (hexachlorobenzene, p,p'-dichlorodiphenyl dichloroethylene, polychlorinated biphenyls) and metals (lead, manganese) were analyzed in cord blood. Internalizing symptoms (anxiety, depressive, somatic) were assessed via multiple informants on the Conners' Rating Scale (CRS) at 8-years and Behavior Assessment System for Children, Second Edition (BASC-2) at 15-years; higher T-scores indicate greater symptoms. Overall and sex-specific covariate-adjusted associations were evaluated using Bayesian Kernel Machine Regression (BKMR) and five-chemical linear regression models. RESULTS The cohort was socioeconomically diverse (35% household income <$20,000; 55% maternal ≤ high school education at birth). Most chemical concentrations were consistent with background levels [e.g., median (range) cord blood lead: 1.1 (0-9.4) μg/dL]. BKMR suggested linear associations and no interactions between chemicals. The overall mixture was positively associated with Conners' Parent Rating Scale (CPRS) and BASC-2 Self Report of Personality (SRP) anxiety and depressive symptoms, and negatively with somatic symptoms. Prenatal lead was positively associated with adolescent anxiety symptoms [1.56 (95% CI: 0.50, 2.61) BASC-2 SRP Anxiety score increase per doubling lead]. For CRPS and BASC-2 SRP, a doubling of cord blood manganese was positively associated with internalizing symptoms for girls [e.g., 3.26 (95% CI: 0.27, 6.25) BASC-2 SRP Depression score increase], but not boys. Organochlorine exposures were not adversely associated with internalizing symptoms. DISCUSSION Low-level prenatal lead exposure was positively associated with adolescent anxiety symptoms, and prenatal manganese exposure was positively associated with internalizing symptoms for girls from mid-childhood through adolescence. In utero neurotoxicant metal exposures may contribute to the emergence of anxiety and depression.
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Affiliation(s)
- Lisa B Rokoff
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Population Health Sciences Program, Harvard University, Cambridge, MA, USA.
| | - Jessica R Shoaff
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David C Bellinger
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan A Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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DePuy AM, Patterson ML, Rodriguez NP, Patel‐Shori NM, Yu D, Jacob R. Evaluating the Impact of Adverse Childhood Experiences on Medication Use. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ashley M. DePuy
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Michelle L. Patterson
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Natalie P. Rodriguez
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Nima M. Patel‐Shori
- Department of Pharmacy Practice Temple University School of Pharmacy Philadelphia PA
| | - Daohai Yu
- Department of Biomedical Education and Data Science Lewis Katz School of Medicine at Temple University Philadelphia PA
| | - Regina Jacob
- MSCE Section of General Internal Medicine Lewis Katz School of Medicine at Temple University Philadelphia PA
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Kempel MK, Winding TN, Böttcher M, Andersen JH. Evaluating the association between socioeconomic position and cardiometabolic risk markers in young adulthood by different life course models. BMC Public Health 2022; 22:694. [PMID: 35397504 PMCID: PMC8994289 DOI: 10.1186/s12889-022-13158-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cardiometabolic health in adulthood is associated with socioeconomic position (SEP) in childhood. Although this has been studied by previous research several questions need to be addressed. E.g. knowledge about the association with timing, extent of the exposure as well as lifestyle and adult SEP, is essential to address the increasing social gradient in cardiometabolic diseases.
Methods
This study included a sub-sample (N = 264, 50% women, age 28–30) from an ongoing cohort study. We used a combination of national registers, longitudinal questionnaire data and clinical data. We examined the association between childhood SEP and cardiometabolic risk, measured by a score of multiple risk markers in young adulthood. SEP-indicators included mother’s educational level and household income. The association was evaluated by four different life course models; the latent effects model, the pathway model, the cumulative model and the social mobility model.
Results
We found an inverse association between mother’s educational level and cardiometabolic risk. The association was statistically significant evaluated by the pathway and cumulative life course models, however statistically insignificant evaluated by the latent effects model. No specific association with social mobility was observed. However, high adult educational level seems to have a protecting impact on the association. No association was found between household income and cardiometabolic risk in any of the applied life course models.
Conclusion
Low childhood SEP, represented by mother’s educational level but not household income, is associated with increased cardiometabolic risk in young adulthood. The accumulation of exposure, lifestyle and adult educational attainment are important for the association. In contrast, intergenerational social mobility does not seem to have a specific impact on the association and we find no evidence for a particular timing in childhood.
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Kempel MK, Winding TN, Böttcher M, Andersen JH. Subjective social status and cardiometabolic risk markers in young adults. Psychoneuroendocrinology 2022; 137:105666. [PMID: 35038663 DOI: 10.1016/j.psyneuen.2022.105666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Low subjective social status (SSS), the perceived status in the social hierarchy, is associated with cardiometabolic risk in middle-aged and older adults. However, most studies are cross-sectional and very little is known about the association in adolescence and young adulthood. The aims of this study were; a) to prospectively investigate the association between SSS at ages 15 and 28 and cardiometabolic risk at age 28-30 and b) to examine if such an association was independent of smoking, physical activity and objective measures of social position. METHODS The study used questionnaire information at ages 15 and 28 from the West Jutland Cohort Study (N = 3681), health measurements from a sub-sample of the cohort (N = 264, age 28-30, 50% women) and information from population-based national registers. The independent variable was a measure of SSS evaluated by a 10-rung ladder scale and dichotomized at the 25th percentile of data from the cohort study population. The outcome measure was a composite score of cardiometabolic risk including measures of lipids, inflammation, blood pressure and glucose-metabolism. Co-variates included smoking, physical activity, childhood and adulthood socioeconomic position. Sex-stratified linear regression analyses were performed to evaluate the associations between SSS and cardiometabolic risk. RESULTS In both sexes, low SSS at age 28, but not at age 15, was significantly associated with increased cardiometabolic risk at age 28-30. Neither smoking, physical activity, childhood or adulthood objective socioeconomic position fully explained the associations. CONCLUSION In young adulthood, SSS was inversely related to cardiometabolic risk after accounting for smoking, physical activity and objective measures of socioeconomic position. These findings suggest that SSS could play a role in the social disparities in cardiometabolic risk in addition to traditional measures of socioeconomic position.
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Affiliation(s)
- Mia Klinkvort Kempel
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark.
| | - Trine Nøhr Winding
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Morten Böttcher
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Cardiovascular Research Unit - University Research Clinic, Department of Cardiology, Goedstrup Hospital, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
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Johnson SB, Raghunathan RS, Li M, Nair D, Matson PA. Moving up but not getting ahead: Family socioeconomic position in pregnancy, social mobility, and child cognitive development in the first seven years of life. SSM Popul Health 2022; 17:101064. [PMID: 35313608 PMCID: PMC8933511 DOI: 10.1016/j.ssmph.2022.101064] [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: 11/07/2021] [Revised: 01/17/2022] [Accepted: 03/02/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Understanding when and how socioeconomic position (SEP) influences cognitive development is key to reducing population inequalities in health and achievement. The objective of this study was to determine the unique association between prenatal family SEP and child cognitive development, and to determine whether marked postnatal social mobility was associated with improvements in child cognitive performance to age 7. Methods Data were from children enrolled in the US National Collaborative Perinatal Project (NCPP) (n = 28,761) during 1959-1965, a dataset large enough to observe marked mobility, which remains uncommon. Multivariable linear regression was used to examine the relationship between SEP (i.e., parental income, education, occupation) during gestation and cognitive performance at 8 months (Bayley Scales of Infant Development Mental Development Index) and at 7 years (Wechsler Intelligence Scale for Children). Results Holding demographic and perinatal factors constant, family SEP during gestation was not associated with cognitive performance at 8 months (B = -0.03, 95% CI: -0.07-0.01) but was positively associated with performance at 7 years even after accounting for SEP at 7 years (B = 1.28, 95% CI: 1.11-1.45). Children whose families experienced the most extreme upward mobility (from the lowest to highest income quartile) showed a 12 percentile increase in cognitive performance in the first 7 years of life. Those with the most extreme downward mobility (from the highest to lowest income quartile) still experienced an 8 percentile increase in cognitive performance in this interval. Conclusions The proportion of children in poverty today is similar to 1965 and intergenerational mobility has declined markedly. Prenatal SEP may contribute to inequalities in child cognitive performance that even extraordinary social mobility cannot erase. To optimize cognitive development across generations, current means-tested programs to support families with young children should be supplemented by universal approaches to ensure access to opportunity before young people become parents.
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Affiliation(s)
- Sara B. Johnson
- Department of Pediatrics, Johns Hopkins School of Medicine, Division of General Pediatrics, Baltimore, MD, USA
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Radhika S. Raghunathan
- Department of Pediatrics, Johns Hopkins School of Medicine, Division of General Pediatrics, Baltimore, MD, USA
| | - Mengying Li
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Divya Nair
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Pamela A. Matson
- Department of Pediatrics, Johns Hopkins School of Medicine, Division of General Pediatrics, Baltimore, MD, USA
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Lee H, Slack KS, Berger LM, Mather RS, Murray RK. Childhood Poverty, Adverse Childhood Experiences, and Adult Health Outcomes. HEALTH & SOCIAL WORK 2021; 46:159-170. [PMID: 34312679 DOI: 10.1093/hsw/hlab018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 06/13/2023]
Abstract
This study aimed to consider childhood poverty in relation to a count measure of adverse childhood experiences (ACEs) as a predictor of adult health outcomes and to determine whether associations are sensitive to how childhood poverty is operationalized. A sample of 10,784 adult residents was derived using data 2014-2015 Wisconsin annual Behavioral Risk Factor Survey data, derived from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS). Adult health outcomes (health risk behaviors, general health problems, chronic health problems, and depression) were predicted using a more conservative and severe indicator of childhood poverty, and authors tested whether observed associations were attenuated by the inclusion of an ACE count variable. Findings showed that severe indicators of childhood poverty are associated with general and chronic health problems as well as adult depression. These associations are attenuated, but remain intact, when ACEs are included in regression models. Using the CDC BRFSS data for Wisconsin, the study showed that associations between childhood poverty and adult health are sensitive to the way in which childhood poverty is operationalized. The relationship between childhood poverty and other ACEs is complex and thus warrants treating the former as a distinct childhood adversity rather than an item in an ACE summary score.
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Affiliation(s)
| | - Kristen S Slack
- postdoctoral researcher, Department of Social Welfare, Ewha Womens University, Seoul, Korea
| | - Lawrence M Berger
- interim director, professor, and doctoral program chair, School of Social Work, University of Wisconsin-Madison
| | - Rebecca S Mather
- Vilas Distinguished Achievement Professor, School of Social Work, University of Wisconsin-Madison
| | - Rebecca K Murray
- executive director, Wisconsin Child Abuse and Neglect Prevention Board, Madison
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Psychological resilience predicting cardiometabolic conditions in adulthood in the Midlife in the United States Study. Proc Natl Acad Sci U S A 2021; 118:2102619118. [PMID: 34341103 DOI: 10.1073/pnas.2102619118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Early adversity is associated with poor cardiometabolic health, potentially via psychological distress. However, not everyone exposed to adversity develops significant distress. Psychological resilience and positive psychological health despite adversity may protect against unfavorable cardiometabolic outcomes that are otherwise more likely. We examined early adversity, psychological resilience, and cardiometabolic risk among 3,254 adults in the Midlife in the United States Study. Psychological resilience was defined according to both early psychosocial adversity and adult psychological health (characterized by low distress and high wellbeing) at Wave 1 (1994 to 1995). Categorical resilience was derived by cross-classifying adversity (exposed versus unexposed) and psychological health (higher versus lower). We also assessed count of adversities experienced and psychological symptoms as separate variables. Incident cardiometabolic conditions (e.g., heart attack, stroke, and diabetes) were self-reported at Waves 2 (2004 to 2005) and 3 (2013 to 2014). Secondary analyses examined biological cardiometabolic risk using a composite of biomarkers available within a Wave-2 subsample. Logistic and Poisson regressions evaluated associations of resilience with cardiometabolic health across 20 follow-up y, adjusting for relevant covariates. In this initially healthy sample, nonresilient (adversity-exposed, lower psychological health) versus resilient (adversity-exposed, high psychological health) individuals had 43% higher odds of cardiometabolic conditions (95% CI 1.10 to 1.85). Odds of cardiometabolic conditions were similar among resilient versus unexposed, psychologically healthy individuals. More adversity experiences were associated with increased odds, while better psychological health with decreased odds of cardiometabolic conditions, and effects were largely independent. Patterns were similar for objectively assessed cardiometabolic risk. Psychological resilience in midlife may protect against negative cardiometabolic impacts of early adversity.
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Wang T, Townsend MK, Vinci C, Jake-Schoffman DE, Tworoger SS. Early life exposure to tobacco smoke and ovarian cancer risk in adulthood. Int J Epidemiol 2021; 50:965-974. [PMID: 33647961 PMCID: PMC8495775 DOI: 10.1093/ije/dyab018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ovarian cancer risk in adulthood may be affected by early life exposure to tobacco smoke. We investigated this relationship in two large prospective cohorts, the Nurses' Health Study (NHS) and NHSII. METHODS In total, analyses included 110 305 NHS participants (1976-2016) and 112 859 NHSII participants (1989-2017). Self-reported early life smoking exposures were queried at baseline or follow-up questionnaires. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of ovarian cancer overall and by tumour histotype. RESULTS Overall, ovarian cancer risk was not different among participants whose mothers did versus did not smoke during pregnancy (HR = 1.05, 95% CI: 0.87-1.27); however, an increased risk was observed among women who themselves were never smokers (HR = 1.38, 95% CI: 1.05-1.81) but not among ever smokers (HR = 0.86, 95% CI: 0.66-1.14; Pheterogeneity = 0.02). Compared with women who never smoked, ovarian cancer risk was similar for women who started to smoke at age <18 (HR = 0.98, 95% CI: 0.86-1.11) or ≥18 (HR = 1.02, 95% CI: 0.93-1.12). These associations did not differ by histotype (Pheterogeneity ≥0.35). Parental smoking in the home during childhood/adolescence was related to a 15% increased risk of ovarian cancer in adulthood (HR = 1.15, 95% CI: 1.04-1.27) and this association was suggestively stronger among women with non-serous/low-grade serous tumours (HR = 1.28, 95% CI: 1.02-1.61) versus high-grade serous/poorly differentiated tumours (HR = 1.09, 95% CI: 0.93-1.28; Pheterogeneity = 0.25). CONCLUSIONS Exposure to parental tobacco smoke in the home, but not early initiation of smoking, was associated with a modest elevated risk of ovarian cancer. Further investigations are required to confirm these findings and elucidate underlying mechanisms.
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Affiliation(s)
- Tianyi Wang
- Department of Cancer Epidemiology, H. Lee Moffitt
Cancer Center and Research Institute, Tampa, FL, USA
| | - Mary K Townsend
- Department of Cancer Epidemiology, H. Lee Moffitt
Cancer Center and Research Institute, Tampa, FL, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, University of
South Florida, Tampa, FL, USA
| | | | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt
Cancer Center and Research Institute, Tampa, FL, USA
- Department of Oncologic Sciences, University of
South Florida, Tampa, FL, USA
- Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, USA
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Maternal Education in Early Life and Risk of Metabolic Syndrome in Young Adult American Females and Males: Disentangling Life Course Processes Through Causal Models. Epidemiology 2020; 30 Suppl 2:S28-S36. [PMID: 31569150 DOI: 10.1097/ede.0000000000001068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Maternal education in a child's early life may directly affect the child's adult cardiometabolic health, but this is difficult to disentangle from biological, social, and behavioral life course processes that are associated with maternal education. These processes may also differ between males and females. METHODS Using data from the National Longitudinal Study of Adolescent to Adult Health (1995-2009) (N = 4,026 females and 3,192 males), we estimated sex-stratified associations between maternal attainment of less than high school (<HS), high school diploma (HS), or college degree (CD) at the respondent's birth and respondent's risk of metabolic syndrome (MetS); we used marginal structural models (MSM) to account for the influence of major life course risk factors, such as childhood maltreatment, adolescent overweight, adult education, household income, smoking, and physical activity, in mediating associations between maternal education and offspring MetS risk. RESULTS Each higher level of maternal education was associated with a 36% (Relative Risk = 0.64 [95% Confidence Interval (CI): 0.50-0.82]) reduced risk of MetS among females, but only 19% (RR = 0.81 [95% CI: 0.64-1.01]) reduction among males (P-value interaction < 0.05). Stronger inverse associations were also observed for waist circumference and glycated hemoglobin (HbA1c) among females compared with males (-5 cm vs. -2.4 cm and -1.5% vs. -1.0%, respectively). CONCLUSION High maternal education in early life was associated with a lower risk of MetS in young adulthood even after accounting for life course risk factors, particularly among females. Results were robust to altered model specifications.
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Optimism and Social Support Predict Healthier Adult Behaviors Despite Socially Disadvantaged Childhoods. Int J Behav Med 2020; 27:200-212. [PMID: 31933126 DOI: 10.1007/s12529-020-09849-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Studies have shown adverse effects of a disadvantaged childhood on adult health-promoting behaviors and related outcomes. Optimism and social support have been linked to greater likelihood of engaging in healthy behavior, but it is unclear whether these positive psychosocial factors may buffer harmful effects of early adversity. This study aims to determine if optimism and social support in adulthood can modify effects of childhood disadvantage on health behavior-related outcomes. METHODS Longitudinal data were analyzed from a subset of participants in a US birth cohort established in 1959-1966 (ns of 681-840, per outcome). An index of childhood social disadvantage was derived from adverse socioeconomic and family stability factors reported by mothers at child's birth and age 7 years. Health behavior-related outcomes were self-reported when participants were of mean age 47 years. Multivariable adjusted robust Poisson regressions were performed. RESULTS Regardless of level of childhood social disadvantage, we found higher levels of optimism and social support were both associated with higher probabilities of being a non-smoker (relative risk [RR]optimism = 1.17, 95% confidence interval [CI] = 1.09-1.26; RRsocial support = 1.24, 95%CI = 1.11-1.39), having a healthy diet (RRoptimism = 1.25, 95%CI = 1.10-1.43; RRsocial support = 1.27, 95%CI = 1.04-1.56), and a healthy body mass index (RRoptimism = 1.18, 95%CI = 1.00-1.40; RRsocial support = 1.29, 95%CI = 1.00-1.66). Interactions link higher optimism or social support with lower risk of smoking among those with moderate childhood disadvantage. CONCLUSIONS Overall, these findings are consistent with the possibility that positive psychosocial resources contribute to maintaining a healthy lifestyle in mid-adulthood and may buffer effects of childhood social disadvantage.
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Soares S, Santos AC, Peres FS, Barros H, Fraga S. Early life socioeconomic circumstances and cardiometabolic health in childhood: Evidence from the Generation XXI cohort. Prev Med 2020; 133:106002. [PMID: 32007527 DOI: 10.1016/j.ypmed.2020.106002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/09/2020] [Accepted: 01/25/2020] [Indexed: 11/15/2022]
Abstract
Social adversity is thought to become biologically embedded during sensitive periods of development which could set children on a trajectory of increased risk for later diseases. This study estimated the association between early socioeconomic circumstances and cardiometabolic biomarkers during childhood. We analyzed data from 2962 participants in the birth cohort Generation XXI. Early socioeconomic circumstances included parental education and occupation and household income measured at the child's birth; cardiometabolic biomarkers included a set of parameters that were determined at seven and 10years old. The association between early socioeconomic circumstances and cardiometabolic biomarkers in children aged seven and 10years old was estimated using generalized estimating equations. We observed, after adjustment for birth weight, sex, five-a-day fruit and vegetable intake and sedentary activity, that children with low educated mothers presented higher body mass index z-score (β=0.22; 95%CI: 0.12, 0.33), higher waist circumference (β=1.14; 95%CI: 0.55, 1.73) and increased systolic blood pressure z-score (β=0.15; 95%CI: 0.08, 0.22) at the age of seven. At 10years, children with mothers with low education, presented higher body mass index z-score (β =0.32; 95%CI: 0.21, 0.43), higher waist circumference (β=2.79; 95%CI: 1.94, 3.64), increased diastolic blood pressure z-score (β=0.11; 95%CI: 0.06, 0.17) and increased systolic blood pressure s-score (β=0.20; 95%CI: 0.12, 0.28). When repeated measures of cardiometabolic biomarkers were taken into account, the association between socioeconomic circumstances and cardiometabolic biomarkers remained significant. Low socioeconomic circumstances have a possible detrimental effect on children's cardiometabolic health. Thus, socioeconomic adversity might impact health outcomes already in the first decade of life, emphasizing the early social patterning of cardiometabolic health and the need of social policies targeting children and families to modify or reverse its negative impact on health.
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Affiliation(s)
- Sara Soares
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | | | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Sílvia Fraga
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal.
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Boylan JM, Cundiff JM, Jakubowski KP, Pardini DA, Matthews KA. Pathways Linking Childhood SES and Adult Health Behaviors and Psychological Resources in Black and White Men. Ann Behav Med 2019; 52:1023-1035. [PMID: 29546291 DOI: 10.1093/abm/kay006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health. Purpose In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources. Methods Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32). Results Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups. Conclusions Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.
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Affiliation(s)
| | - Jenny M Cundiff
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX
| | - Karen P Jakubowski
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Dustin A Pardini
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ
| | - Karen A Matthews
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA
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Palar K, Lemus Hufstedler E, Hernandez K, Chang A, Ferguson L, Lozano R, Weiser SD. Nutrition and Health Improvements After Participation in an Urban Home Garden Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1037-1046. [PMID: 31601420 PMCID: PMC6949143 DOI: 10.1016/j.jneb.2019.06.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To elucidate the perceived health benefits of an urban home gardening and nutritional education program in a population at high cardiometabolic risk. DESIGN Qualitative data collected via in-depth, semistructured interviews in Spanish or English. SETTING Community-based program offering supported urban home gardening together with nutrition education in Santa Clara County, CA. PARTICIPANTS A total of 32 purposively sampled low-income participants in an urban home gardening program. Participants were primarily female (n = 24) and Latino/a (n = 22). PHENOMENON OF INTEREST Perceptions of the nutrition and health benefits of education-enhanced urban home gardening. ANALYSIS Bilingual researchers coded transcripts using a hybrid inductive and deductive approach. Two coders double coded at intervals, independently reviewed coding reports, organized content into key themes, and selected exemplary quotations. RESULTS The most salient perceived impacts were greater food access, increased consumption of fresh produce, a shift toward home cooking, and decreased fast food consumption. Participants attributed these changes to greater affordability, freshness, flavor, and convenience of their garden produce; increased health motivation owing to pride in their gardens; and improved nutritional knowledge. Participants also reported improved physical activity, mental health, and stress management; some reported improved weight and adherence to diabetes-healthy diets. CONCLUSIONS AND IMPLICATIONS Education-enhanced urban home gardening may facilitate multidimensional nutrition and health improvements in marginalized populations at high cardiometabolic risk.
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Affiliation(s)
- Kartika Palar
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA.
| | - Emiliano Lemus Hufstedler
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA; University of California, Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Karen Hernandez
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Annie Chang
- University of California, Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Laura Ferguson
- Global Health Sciences, University of California, San Francisco, San Francisco, CA
| | | | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA; Institute for Global Health, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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Wade TJ, O'Leary DD, Dempster KS, MacNeil AJ, Molnar DS, McGrath J, Cairney J. Adverse childhood experiences (ACEs) and cardiovascular development from childhood to early adulthood: study protocol of the Niagara Longitudinal Heart Study. BMJ Open 2019; 9:e030339. [PMID: 31315878 PMCID: PMC6661634 DOI: 10.1136/bmjopen-2019-030339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Recent reviews have found substantial links between a toxic childhood environment including child abuse and severe household dysfunction and adult cardiovascular disease (CVD). Collectively referred to as adverse childhood experiences (ACEs), this toxic environment is prevalent among children, with recent Canadian estimates of child abuse at 27%-32%, and severe household dysfunction at 49%. Based on these prevalence rates, the potential effect of ACEs on CVD is more significant than previously thought. Yet, how ACEs amplify the risk for later CVD remains unclear. Lifestyle risk factors only partially account for this connection, instead directing attention to the interaction between psychosocial factors and physiological mechanisms such as inflammation. The Niagara Longitudinal Heart Study (NLHS) examines how ACEs influence cardiovascular health (CVH) from childhood to early adulthood. Integrating the stress process and biological embedding models, this study examines how psychosocial and physiological factors in addition to lifestyle factors explain the relationship between ACEs and CVH. METHODS This follow-up study combines three baseline studies from 2007 to 2012 that collected CVH measures including child blood pressure, heart rate, left ventricular structure and function, arterial stiffness indices and baroreflex sensitivity on 564 children. Baseline data also include anthropometric, biological, lifestyle, behavioural, and psychosocial measures that varied across primary studies. Now over 18 years of age, we will recruit and retest as many participants from the baseline studies as possible collecting data on ACEs, CVH, anthropometric, lifestyle and psychosocial measures as well as blood, saliva and hair for physiological biostress markers. ETHICS AND DISSEMINATION Ethics approval has been received for the NLHS follow-up. Written consent to participate in the follow-up study is obtained from each participant. Results testing all proposed hypotheses will be submitted for publication in peer-reviewed journals.
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Affiliation(s)
- Terrance J Wade
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
- Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
| | - Kylie S Dempster
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Danielle S Molnar
- Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Jennifer McGrath
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - John Cairney
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Heyden JCVD, Birnie E, Bovenberg SA, Dekker P, Veeze HJ, Mul D, Aanstoot HJ. Losing Track of Lipids in Children and Adolescents with Type 1 Diabetes: Towards Individualized Patient Care. Exp Clin Endocrinol Diabetes 2019; 129:510-518. [PMID: 31272109 DOI: 10.1055/a-0950-9677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM To assess 1) the prevalence of children and adolescents with type 1 diabetes (T1D) changing from low-risk into borderline-high-risk lipid levels or from borderline-high-risk into high-risk lipid levels ('lose track of lipids') and 2) the power of a risk score including the determinants HbA1c, body mass index (BMI), gender, age, diabetes duration and ethnicity in predicting which patients lose track of lipids. METHODS 651 children and adolescents with T1D were included in this longitudinal retrospective cohort study. Lipid dynamics and the impact of the risk score on losing track of lipids were evaluated. Kaplan-Meier analysis was used to estimate screening intervals. RESULTS 31-43% percent of the patients had lost track of one or more lipids at the next lipid measurement. This happened more frequently in patients with a low-risk lipid level at start. Depending on the lipid parameter, 5% of patients with low-risk lipid levels lost track of lipids after 13-23 months. The risk score based on concomitant information on the determinants was moderately able to predict which patients would lose track of lipids on the short term. CONCLUSIONS A considerable number of children and adolescents with T1D loses track of lipids and does so within a 2-year screening interval. The predictive power of a risk score including age, BMI, gender, HbA1c, diabetes duration and ethnicity is only moderate. Future research should focus on another approach to the determinants used in this study or other determinants predictive of losing track of lipids on the short term.
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Affiliation(s)
- Josine C van der Heyden
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands.,Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Erwin Birnie
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands.,Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sarah A Bovenberg
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Pim Dekker
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Henk J Veeze
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Dick Mul
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Henk-Jan Aanstoot
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
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Family income from birth through adolescence: Implications for positive youth development. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2019. [DOI: 10.1016/j.appdev.2019.101055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hossin MZ, Koupil I, Falkstedt D. Early life socioeconomic position and mortality from cardiovascular diseases: an application of causal mediation analysis in the Stockholm Public Health Cohort. BMJ Open 2019; 9:e026258. [PMID: 31209086 PMCID: PMC6588973 DOI: 10.1136/bmjopen-2018-026258] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We aimed to quantify the mediating impact of adult social and behavioural mechanisms in the association between childhood socioeconomic position (SEP) and cardiovascular disease (CVD) mortality by employing a weighting approach to mediation analysis. DESIGN Prospective cohort study. SETTING Stockholm County, Sweden. PARTICIPANTS 19 720 individuals who participated in the Stockholm Public Health Cohort survey in 2002 and were older than 40 years. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was CVD mortality. Non-CVD mortality was additionally analysed for comparison. METHODS Study subjects were followed in routine registers from 2002 to 2011 for mortality. Data on father's SEP and adult social and behavioural factors came from questionnaire survey. The inverse odds weighting method was used to estimate the total effect, the natural direct effect and the natural indirect effect (NIE) in Poisson regression models. All results were adjusted for gender, age, country of birth and marital status. Multiple imputation was used to handle missing data. RESULTS The total effect of manual versus non-manual father's SEP on CVD mortality was estimated as an incidence rate ratio (IRR) of 1.24 (95% CI 1.09 to 1.41). When the social and behavioural factors were accounted for, the IRR for the NIE was 1.09 (95% CI 1.04 to 1.14), suggesting a mediation of 44% of the total effect. As for non-CVD mortality, father's manual SEP was associated with 1.15 fold excess risk (IRR: 1.15; 95% CI 1.04 to 1.27) of which the effect represented by the whole set of mediators was 1.06 (95% CI 1.01 to 1.10). CONCLUSION Adult social and behavioural factors had a considerable mediating effect on the early life social origin of mortality from CVDs and other causes. Future research employing causal mediation analysis may nevertheless have to consider additional factors for a fuller understanding of the mechanisms.
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Affiliation(s)
| | - Ilona Koupil
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm Universitet, Stockholm, Sweden
| | - Daniel Falkstedt
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Slopen N, Tang A, Nelson CA, Zeanah CH, McDade TW, McLaughlin KA, Fox N. The Consequences of Foster Care Versus Institutional Care in Early Childhood on Adolescent Cardiometabolic and Immune Markers: Results From a Randomized Controlled Trial. Psychosom Med 2019; 81:449-457. [PMID: 31008902 PMCID: PMC6544473 DOI: 10.1097/psy.0000000000000696] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Children exposed to institutional rearing often exhibit problems across a broad array of developmental domains. We compared the consequences of long-term, high-quality foster care versus standard institution-based care, which began in early childhood on cardiometabolic and immune markers assessed at the time of adolescence. METHODS The Bucharest Early Intervention Project is a longitudinal investigation of children institutionalized during early childhood (ages 6 to 30 months at baseline) who were subsequently randomized to either high-quality foster care or continued institutional care. At the age of 16 years, 127 respondents participated in a biomarker collection protocol, including 44 institutionalized children randomly assigned to receive care as usual, 41 institutionalized children randomized to be removed from institutional care and placed in high-quality foster care in infancy, and a control group of 42 demographically matched children raised in biological families. Outcomes included body mass index (BMI), systolic and diastolic blood pressure, C-reactive protein, interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor α, glycosylated hemoglobin A1c, and Epstein-Barr virus antibody titers. RESULTS Early institutional rearing was not associated with differences in cardiometabolic or immune markers. Randomization to foster care and age of placement into foster care were also unrelated to these markers, with the exception of BMI z-score, where children assigned to care as usual had lower BMI z-scores relative to children assigned to foster care (-0.23 versus 0.08, p = .06), and older age at placement was associated with lower BMI (β = -0.07, p = .03). CONCLUSIONS The impact of institutional rearing on measures of cardiometabolic health and immune system functioning is either absent or not evident until later in development. These findings provide new insights into the biological embedding of adversity and how it varies developmentally and across regulatory systems and adversity type. CLINICAL TRIAL REGISTRATION NCT00747396.
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Affiliation(s)
- Natalie Slopen
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Charles A. Nelson
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | | | - Thomas W. McDade
- Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | | | - Nathan Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
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Peele ME. Domains of Childhood Disadvantage and Functional Limitation Trajectories Among Midlife Men and Women in China. J Aging Health 2019; 32:501-512. [PMID: 30845868 DOI: 10.1177/0898264319834813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: To examine the impacts of four childhood disadvantage domains-parental behavior, hunger, health, and socioeconomic status (SES)-on functional limitation trajectories among midlife adults in China. Method: Data (2011-2015) from the China Health and Retirement Longitudinal Study (N = 8,646) were used to examine the associations between different domains of childhood disadvantage and functional limitation trajectories among adults aged 45 to 64. Results: Adverse parental behavior was not associated with baseline functional limitation but was associated with steeper trajectories for men. Health, hunger, and SES were associated with more functional limitations at baseline, and SES with steeper trajectories for men and women. Adulthood SES largely accounted for the associations between childhood SES and functional limitations for men. Discussion: It is important to examine multiple domains of childhood conditions because the type and magnitude of disadvantage may influence functional limitations in different ways among men and women in China.
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Deighton S, Neville A, Pusch D, Dobson K. Biomarkers of adverse childhood experiences: A scoping review. Psychiatry Res 2018; 269:719-732. [PMID: 30273897 DOI: 10.1016/j.psychres.2018.08.097] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences that occur during childhood. Research has demonstrated a link between ACEs and risk of physical and mental health disorders, where early life adversity may become "biologically embedded" and have wide-ranging effects on various physiological systems. The aim of this study was to identify the extent and breadth of recent research activity relating to biological measures of ACEs in adulthood. We undertook a scoping review including published research articles. Medline and PsycINFO were searched for articles from 2007 to July 2017. Articles were eligible if they included adult participants, were written in English, and reported on a biomarker of childhood adversity in adulthood. Forty articles met our inclusion criteria. Studies investigated a range of ACEs that were often measured retrospectively. The studies identified biomarkers related to inflammation (e.g., CRP), cardio/metabolic systems (e.g., BMI), genetics (e.g., telomere length), and endocrine systems (e.g., cortisol), as well as composites of multiple physiological systems. However, not every study identified found significant associations. Health behaviours, emotional distress, social relationships, and socioeconomic factors may help explain some of these associations. Further research is needed to better understand biomarkers of ACEs in adulthood and their relationship to health conditions.
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Affiliation(s)
| | | | - Dennis Pusch
- Southport Psychological Services, Alberta, Calgary, Canada
| | - Keith Dobson
- University of Calgary, Department of Psychology, Alberta, Canada
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Peele ME. Childhood Conditions Predict Chronic Diseases and Functional Limitations Among Older Adults: The Case of Indonesia. J Aging Health 2018; 31:1892-1916. [DOI: 10.1177/0898264318799550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Limited knowledge exists about whether childhood health and socioeconomic status (SES) conditions influence health among older adults in Indonesia. Method: Data from Wave 5 (2014/2015) of the Indonesian Family Life Survey ( N = 6,530) was used to examine associations between childhood health and SES and hypertension, lung conditions, diabetes, lower body functional limitations (LBFL), and instrumental activities of daily living limitations (IADL). Results: Poor childhood health was associated with 34% higher odds of hypertension (odds ratio [OR] = 1.34, p < .05), 37% higher odds of diabetes (OR = 1.37, p < .05), and 32% higher odds of lung conditions (OR = 1.32, p < .05). Household overcrowding was associated with 22% higher odds of a LBFL (OR = 1.22, p < .05) and 24% higher odds of an IADL (OR = 1.24, p < .01). Lacking a household toilet was associated with 18% higher odds of a LBFL (OR = 1.18, p < .05). Adjusting for adult SES and current health did not account for these relationships. Discussion: Childhood conditions appear to shape older adult health in Indonesia.
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Roussel A, Michel M, Lefevre-Utile A, De Pontual L, Faye A, Chevreul K. Impact of social deprivation on length of stay for common infectious diseases in two French university-affiliated general pediatric departments. Arch Pediatr 2018; 25:359-364. [PMID: 30041884 DOI: 10.1016/j.arcped.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/14/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Adult deprived patients consume more healthcare resources than others, particularly in terms of increased length of stay (LOS) and costs. Very few pediatric studies have focused on LOS, although the effect of deprivation could be greater in children due to the vulnerability of this population. Our objective was to compare LOS between deprived and nondeprived children hospitalized for acute infectious diseases in two university-affiliated pediatric departments located in a low-income area of northern Paris. METHODS We performed a prospective observational multicenter study in two university-affiliated hospitals, Hôpital Robert-Debré and Hôpital Jean-Verdier. All the patients under 15 years of age admitted to the general pediatric department for pneumonia, bronchiolitis, gastroenteritis, or pyelonephritis between 20 October 2016 and 20 March 2017 were included. Deprivation was assessed with an individual questionnaire and score (EPICES). Endpoints included length of stay, costs, and readmission rates at 15 days in each quintile of deprivation. Multivariate regression assessed the association between deprivation and each endpoint. RESULTS A total of 556 patients were included in the study and 540 were analyzed. Sixty percent were boys and the mean age was 9 months±18. Bronchiolitis was the most frequent diagnosis (67.8%). Fifty-six percent of patients were considered to be deprived based on the EPICES questionnaire. Mean LOS was 4.6±3.5 days and we found no significant difference in LOS between the different deprivation quintiles (P=0.83). Multivariate regression did not show an association between LOS and deprivation. CONCLUSION There was no difference between deprived and nondeprived patients in terms of LOS. Deprivation may therefore impact hospitals in other ways such as admission rates. The impact of deprivation during hospitalization for chronic diseases should also be investigated.
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Affiliation(s)
- A Roussel
- Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique des Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France; Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France.
| | - M Michel
- Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France; URC Eco Île-de-France, DRCD, Assistance publique-Hôpitaux de Paris, Hôtel Dieu, 1, place du Parvis-de-Notre-Dame, 75004 Paris, France
| | - A Lefevre-Utile
- Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique des Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France
| | - L De Pontual
- Service de pédiatrie générale, hôpital Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - A Faye
- Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique des Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France; Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France
| | - K Chevreul
- Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France; URC Eco Île-de-France, DRCD, Assistance publique-Hôpitaux de Paris, Hôtel Dieu, 1, place du Parvis-de-Notre-Dame, 75004 Paris, France
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McCurley JL, Penedo F, Roesch SC, Isasi CR, Carnethon M, Sotres-Alvarez D, Schneiderman N, Gonzalez P, Chirinos DA, Camacho A, Teng Y, Gallo LC. Psychosocial Factors in the Relationship between Socioeconomic Status and Cardiometabolic Risk: the HCHS/SOL Sociocultural Ancillary Study. Ann Behav Med 2018; 51:477-488. [PMID: 28130624 DOI: 10.1007/s12160-016-9871-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND U.S. Hispanics/Latinos display a high prevalence of metabolic syndrome (MetSyn), a group of co-occurring cardiometabolic risk factors (abdominal obesity, impaired fasting glucose, dyslipidemia, elevated blood pressure) associated with higher cardiovascular disease and mortality risk. Low socioeconomic status (SES) is associated with higher risk for MetSyn in Hispanics/Latinos, and psychosocial factors may play a role in this relationship. PURPOSE This cross-sectional study examined psychosocial factors in the association of SES and MetSyn components in 4,996 Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. METHODS MetSyn components were measured at the baseline examination. Participants completed interviews to determine psychosocial risks (e.g., depression) and resources (e.g., social support) within 9 months of baseline (< 4 months in 72.6% of participants). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to identify latent constructs and examine associations. RESULTS Participant mean age was 41.7 years (SE = 0.4) and 62.7% were female. CFA identified single latent factors for SES and psychosocial indicators, and three factors for MetSyn [blood pressure, lipids, metabolic factors]. SEMs showed that lower SES was related to MetSyn factors indirectly through higher psychosocial risk/lower resources (Y-Bχ2 (df = 420) = 4412.90, p < .05, RMSEA = .042, SRMR = .051). A statistically significant effect consistent with mediation was found from lower SES to higher metabolic risk (glucose/waist circumference) via psychosocial risk/resource variables (Mackinnon's 95% asymmetric CI = -0.13 to -0.02). CONCLUSIONS SES is related to metabolic variables indirectly through psychosocial factors in U.S. Hispanics/Latinos of diverse ancestries.
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Affiliation(s)
- Jessica L McCurley
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Frank Penedo
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Carmen R Isasi
- Deptartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Diana A Chirinos
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Alvaro Camacho
- Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
| | - Yanping Teng
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA. .,South Bay Latino Research Center, 450 4th Ave, Suite 304, Chula Vista, CA, 91910, USA.
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Harris KM, Schorpp KM. Integrating Biomarkers in Social Stratification and Health Research. ANNUAL REVIEW OF SOCIOLOGY 2018; 44:361-386. [PMID: 30918418 PMCID: PMC6433161 DOI: 10.1146/annurev-soc-060116-053339] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This article provides an overview of the integration of biomarkers and biological mechanisms in social science models of stratification and health. The goal in reviewing this literature is to highlight research that identifies the social forces that drive inequalities over the life course and across generations. The article is structured in the following way. First, descriptive background information on biomarkers is presented, followed secondly by a review of the general theoretical paradigms that lend themselves to an integrative approach. Third, the biomarkers used to capture several biological systems that are most responsive to social conditions are described. Fourth, research that explicates how social exposures "get under the skin" to affect physiological functioning and downstream health is discussed, using socioeconomic disadvantage as an illustrative social exposure. The review ends with emerging directions in the use of biomarkers in social science research. This article endeavors to encourage sociologists to embrace biosocial approaches in order to elevate the importance of social factors in biomedical processes and to intervene on the social conditions that create inequities.
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Abstract
A quarter of the global population meets diagnostic criteria for metabolic syndrome (MetS). MetS prevalence stratifies by socioeconomic status (SES), such that low SES is associated with higher MetS risk starting in childhood. Despite this trend, some low-SES children maintain good metabolic health across the life span, but the factors responsible for their resilience are not well understood. This study examined the role of threat vigilance as either a moderator or a mediator of the effects of low early life SES on adult metabolic risk. Three hundred twenty-five Canadians aged 15-55 participated (M = 36.4 years, SD = 10.7; 55.4% female). We coded parental occupational status between the ages of 0 and 5 to index early life SES. We used the International Diabetes Federation case definition for MetS based on waist circumference, blood pressure, triglyceride levels, HDL cholesterol, and glycosylated hemoglobin measures. Threat vigilance was assessed using the Weapons Identification Procedure, a visual discrimination paradigm that captures implicit perceptions of threat. Analyses supported the moderator hypothesis: low early life SES was associated with MetS diagnosis exclusively among those with high levels of threat vigilance. This suggests that low early life SES environments that heighten vigilance to threat might be particularly detrimental for metabolic health. Conversely, low threat vigilance may buffer against the metabolic risks associated with socioeconomic disadvantage.
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Horn K, Ali M, Gray T, Anesetti-Rothermel A, Branstetter S. School-level disadvantage and failed cessation treatment among adolescent smokers. Tob Prev Cessat 2018; 4:11. [PMID: 32411839 PMCID: PMC7205073 DOI: 10.18332/tpc/87074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION While understanding factors that lead to successful adolescent smoking cessation outcomes is necessary, it is also prudent to determine factors and conditions that contribute to failure to quit smoking. The present study posits that adolescents' proximal environments, such as schools, may influence cessation treatment outcomes. METHODS Using aggregated and geographically-referenced data from multi-year school-based cessation trials with 14-19 year olds seeking cessation in 5 States of the USA, the present study developed and applied a tobacco-specific socio-spatial model inclusive of Hierarchical Linear Modeling. Specifically, this novel approach spatially joined individual data files (n=8855) with measures of school (n=807) and county socio-economic factors. Once linked multi-level analyses explored the extent to which cessation treatment failure was explained by the interplay of individual, school and county-level factors. Treatment was deemed as failing to meet its primary goals if participants continued to smoke cigarettes, measured 3-months post baseline. RESULTS Ten per cent of the variation in cessation treatment failure was attributable to school-level variables. Adolescent smokers were more likely to experience failure to quit in: a) school districts with large percentages of the population having less than high-school education, and b) schools with a higher ratio of students to teachers. The strength of the relationship between cessation self-efficacy and treatment success was further weakened among adolescents attending schools with higher percentages of students eligible for free or reduced lunch programs. CONCLUSIONS Findings implicate school-level socio-economic disadvantage as a significant factor inhibiting cessation, regardless of adolescent self-efficacy to quit smoking. Understanding the interplay of proximal school environments and individual-level factors may provide insights to educators, policy makers and practitioners into the complexities that inhibit or strengthen an adolescent's smoking cessation treatment experience.
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Affiliation(s)
- Kimberly Horn
- Department of Population Health Sciences, Virginia Tech Carilion Research Institute, Virginia, United States
| | - Maliha Ali
- Milken Institute School of Public Health, Department of Prevention and Community and Health, George Washington University, Washington, United States
| | - Tiffany Gray
- Milken Institute School of Public Health, Department of Prevention and Community and Health, George Washington University, Washington, United States
| | | | - Steve Branstetter
- Department of Biobehavioral, Health Pennsylvania State University, United States
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Rosendaal NTA, Alvarado B, Wu YY, Velez MP, da Câmara SMA, Pirkle CM. Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study). J Am Heart Assoc 2017; 6:e007058. [PMID: 29092844 PMCID: PMC5721784 DOI: 10.1161/jaha.117.007058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/11/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous studies observe associations between lifetime parity and cardiovascular disease, but relatively fewer investigate age at first childbirth (AFB). Herein, we examine the association of AFB with a summary cardiovascular risk measure (Framingham Risk Score [FRS]). METHODS AND RESULTS As part of the IMIAS (International Mobility in Aging Study), data were collected in 2012 among 1047 women, aged 65 to 74 years, from Canada, Albania, Colombia, and Brazil. FRSs were calculated to describe cardiovascular risk profiles, and linear regression analyses were performed, adjusting for early life and socioeconomic variables. Women with an AFB of <20 years were compared with women with an AFB of 20 to 24, 25 to 29, and ≥30 years, as well as nulliparous women. We also compared FRS between combinations of AFB and parity categories: nulliparous women, parity 1 to 3 combined with AFB <20 years, parity ≥4 with AFB <20 years, parity 1 to 3 with AFB ≥20 years, and parity ≥4 with AFB ≥20 years. Women with an AFB of <20 years had a higher mean FRS compared with all other AFB groups. Compared with the lowest AFB risk group (25-29 years), women with an AFB of <20 years had a 5.8-point higher mean FRS (95% confidence interval, 3.4-8.3 points). Nulliparous women presented the lowest mean FRS in all analyses. The analysis comparing combinations of AFB and parity categories showed no meaningful differences in FRS between women who had 1 to 3 childbirths and those who had ≥4 childbirths within the stratum of AFB <20 years, and in the stratum of AFB ≥20 years. CONCLUSIONS Our analyses suggest that nulliparity and AFB, rather than increasing parity, drive the association with cardiovascular disease risk.
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Affiliation(s)
| | - Beatriz Alvarado
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | - Maria P Velez
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | - Saionara M Aires da Câmara
- Faculty of Health Sciences of Trairí, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
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Abstract
OBJECTIVES Exposure to child abuse (CA) is associated with an increased risk of developing asthma and allergies; it is unknown if that risk is present across generations. This study investigated if 2-year-old children born to mothers with a history of CA were at an increased risk of receiving a diagnosis of asthma or allergies. METHODS Data from 1,551 participants were collected as part of the All Our Babies (AOB) study, a prospective pregnancy cohort. During pregnancy, each woman provided information about her own history of CA, and at 24 months postpartum, she provided information about her child's medical diagnoses. Symptoms of maternal depression and anxiety were assessed during pregnancy and at 24 months postpartum. RESULTS Unadjusted models showed that compared to children born to mothers without a history of CA, 2-year-old children born to mothers with a history of CA were more likely to have had a diagnosis of asthma (7.4% vs 4.2%, p = .016) or allergy (15.6% vs 9.2%, p < .001). Maternal symptoms of depression assessed in late pregnancy and symptoms of depression and anxiety at 24 months postpartum were significant mediators of the relationship between maternal CA and 2-year-old asthma diagnosis. Maternal symptoms of depression and anxiety assessed in late pregnancy were also significant mediators of the relationship between maternal CA and 2-year-old allergy diagnosis. CONCLUSIONS The results indicate that maternal exposure to CA is associated with increased risk of asthma and allergy in their 2-year-old children; symptoms of maternal depression and anxiety were identified as pathways linking the variables.
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Childhood Psychological Distress as a Mediator in the Relationship Between Early-Life Social Disadvantage and Adult Cardiometabolic Risk: Evidence From the 1958 British Birth Cohort. Psychosom Med 2017; 78:1019-1030. [PMID: 27763989 DOI: 10.1097/psy.0000000000000409] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Prior research on the relationship between early adversity and adult chronic disease has often relied on retrospective reports of a limited range of exposures and has not considered childhood psychological distress as a mediator. We investigate whether distress in childhood is one pathway by which early social disadvantage leads to greater cardiometabolic risk in middle adulthood. METHODS Data are from the 1958 British Birth Cohort study (sample n = 6027). We created an early social disadvantage index based on 16 exposures related to family and socioeconomic hardship from birth to age 7. Childhood psychological distress was ascertained from internalizing and externalizing symptoms at ages 7, 11, and 16 years. Cardiometabolic risk was assessed with a Z-standardized score derived from 9 immune, cardiovascular, and metabolic biomarkers measured at age 45. We used linear regression models and formal tests of mediation to assess relationships between disadvantage, distress, and subsequent cardiometabolic risk. RESULTS Higher social disadvantage predicted increased adult cardiometabolic risk (β = 0.05; 95% CI = 0.03-0.07). Mediation analyses revealed a significant direct (path c'; β = 0.03; 95% CI = 0.01-0.05) and indirect (path ab; β = 0.02; 95% CI = 0.01-0.02) effect of social disadvantage on cardiometabolic risk, adjusting for potential confounders. Child psychological distress accounted for 37% (95% CI = 34-46%) of the observed association. CONCLUSIONS Results suggest childhood distress may be one factor on the pathway linking early disadvantage to higher risk of developing cardiometabolic diseases. Such results may point to the importance of blocking the translation of psychosocial to biological risk during a potentially sensitive developmental window.
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Childhood socioeconomic circumstances and depressive symptom burden across 15 years of follow-up during midlife: Study of Women's Health Across the Nation (SWAN). Arch Womens Ment Health 2017; 20:495-504. [PMID: 28660469 PMCID: PMC5575748 DOI: 10.1007/s00737-017-0747-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 06/06/2017] [Indexed: 12/29/2022]
Abstract
Childhood socioeconomic disadvantage may contribute to adult depression. Understanding pathways by which early socioeconomic adversity may shape adult depression is important for identifying areas for intervention. Studies to date have focused on one potential pathway, adult socioeconomic status (SES), and assessed depression at only one or a few time points. Our aims were to examine (a) the association between childhood SES (low vs. high) and depressive symptom burden in midlife and (b) whether adult socioeconomic, psychosocial, and physical health characteristics are important pathways. Using annual data from a cohort of 1109 black and white US women recruited in 1996-1997, we evaluated the association between childhood SES and depressive symptom burden across 15 years in midlife and whether adult characteristics-financial difficulty, lower education, stressful events, low social support, low role functioning, medical conditions, and bodily pain-mediated the association. Depressive symptom burden was estimated by calculating area under the curve of annual scores across 15 years of the Center for Epidemiological Studies Depression (CES-D). In unadjusted models, low childhood SES was associated with greater depressive burden (P = 0.0002). Each hypothesized mediator, individually, did not reduce the association. However, when five of the hypothesized mediators were included together in the same analysis, they explained more than two thirds of the association between childhood SES and depressive symptom burden reducing the P value for childhood SES to non-significance (P = 0.20). These results suggest that childhood SES influences midlife depressive symptom burden through a cluster of economic stress, limited social resources, and physical symptoms in adulthood.
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A healthy mix of emotions: underlying biological pathways linking emotions to physical health. Curr Opin Behav Sci 2017. [DOI: 10.1016/j.cobeha.2017.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
OBJECTIVE A quarter of the world's population have metabolic syndrome (MetS). MetS prevalence is stratified by socioeconomic status (SES), such that low SES is associated with higher MetS risk. The present study examined the relative roles of early-life SES and current SES in explaining MetS risk. METHODS Participants (N = 354; ages = 15-55 years, M [SD] = 36.5 [10.7] years; 55% female; 72.9% white, 16.9% Asian, 10.2% others) were evaluated for SES and MetS. All were in good health, defined as free of chronic medical illness and acute infectious disease. Using occupational status as a proxy for SES, we recruited roughly equal numbers of participants with low-low, low-high, high-low, and high-high combinations of early-life and current SES. We used the International Diabetes Federation definition for MetS using race- and sex-specific cutoffs for waist circumference, triglyceride levels, high-density lipoprotein cholesterol, blood pressure, and glycosylated hemoglobin levels. RESULTS Analyses revealed a main effect of low early-life SES on increased MetS risk according to the three separate definitions. They included the traditional MetS diagnosis (odds ratio [OR] = 1.53, confidence interval [CI] = 1.01-2.33, p = .044), the number of MetS components for which diagnostic thresholds were met (OR = 1.61, CI = 1.10-2.38, p = .015), and a continuous indicator of metabolic risk based on factor analysis (F(1,350) = 6.71, p = .010, partial η = .019). There was also a significant interaction of early-life SES and current SES in predicting MetS diagnosis (OR = 1.54, CI = 1.02-2.34). The main effects of current SES were nonsignificant in all analyses. CONCLUSIONS These findings suggest that MetS health disparities originate in childhood, which may be an opportune period for interventions.
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Abstract
OBJECTIVE Identifying the life course health effects of childhood adversity is a burgeoning area of research, particularly in relation to cardiovascular disease (CVD). However, adversity measurement varies widely across studies, which may hamper our ability to make comparisons across studies and identify mechanisms linking adversity to CVD. The purposes of this review are to summarize adversity measurement approaches in the context of CVD, identify gaps, and make recommendations for future research. METHODS PubMed and PsycINFO searches were conducted through June 2016. Studies were selected if CVD end point or predisease risk markers were investigated in association with a measure of childhood adversity. Forty-three studies were reviewed. A meta-analysis was not conducted because of the variation in exposures and outcomes assessed. RESULTS Adversity measurement was heterogeneous across studies. Metrics included different sets of adverse events, relational factors, and socioeconomic indicators. Thirty-seven percent measured childhood adversity prospectively, 23% examined a CVD end point, and 77% treated adversity as an unweighted summary score. Despite the heterogeneity in measurement, most studies found a positive association between childhood adversity and CVD risk, and the association seems to be dose-response. CONCLUSIONS The literature on childhood adversity and CVD would benefit from improving consistency of measurement, using weighted adversity composites, modeling adversity trajectories over time, and considering socioeconomic status as an antecedent factor instead of a component part of an adversity score. We suggest conceptual and analytic strategies to enhance, refine, and replicate the observed association between childhood adversity and CVD risk.
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Kilpi F, Silventoinen K, Konttinen H, Martikainen P. Early-life and adult socioeconomic determinants of myocardial infarction incidence and fatality. Soc Sci Med 2017; 177:100-109. [DOI: 10.1016/j.socscimed.2017.01.055] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/16/2022]
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Pagani LS, Lévesque-Seck F, Fitzpatrick C. Prospective associations between televiewing at toddlerhood and later self-reported social impairment at middle school in a Canadian longitudinal cohort born in 1997/1998. Psychol Med 2016; 46:3329-3337. [PMID: 27618949 DOI: 10.1017/s0033291716001689] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Using a large Canadian population-based sample, this study aimed to verify whether televiewing in toddlerhood is prospectively associated with self-reported social impairment in middle school. METHOD Participants are from a prospective-longitudinal birth cohort of 991 girls and 1006 boys from the Quebec Longitudinal Study of Child Development. Child self-reported ratings of relational difficulties at age 13 years were linearly regressed on parent-reported televiewing at age 2 years while adjusting for potential confounders. RESULTS Every additional 1 h of early childhood television exposure corresponded to an 11% s.d. unit increase in self-reported peer victimization [unstandardized β = 0.03, 95% confidence interval (CI) 0.02-0.04], a 10% s.d. unit increase in self-reported social isolation (unstandardized β = 0.04, 95% CI 0.03-0.05), a 9% s.d. unit increase in self-reported proactive aggression (unstandardized β = 0.02, 95% CI 0.01-0.03) and a 6% s.d. unit increase in self-reported antisocial behavior (unstandardized β = 0.01, 95% CI 0.01-0.01) at age 13 years. These results are above and beyond pre-existing individual and family factors. CONCLUSIONS Televiewing in toddlerhood was prospectively associated with experiencing victimization and social withdrawal from fellow students and engaging in antisocial behavior and proactive aggression toward fellow students at age 13 years. Adolescents who experience relational difficulties are at risk of long-term health problems (like depression and cardiometabolic disease) and socio-economic problems (like underachievement and unemployment). These relationships, observed more than a decade later, and independent of key potential confounders, suggest a need for better parental awareness of how young children invest their limited waking hours.
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Affiliation(s)
- L S Pagani
- School of Psycho-Education and Sainte-Justine's Hospital Research Center (Brain Diseases Axis),Université de Montréal,Montréal,Québec,Canada
| | - F Lévesque-Seck
- School of Psycho-Education and Sainte-Justine's Hospital Research Center (Brain Diseases Axis),Université de Montréal,Montréal,Québec,Canada
| | - C Fitzpatrick
- Psychology Department,Université Ste-Anne,Church Point,Nova Scotia,Canada
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Delpierre C, Fantin R, Barboza-Solis C, Lepage B, Darnaudéry M, Kelly-Irving M. The early life nutritional environment and early life stress as potential pathways towards the metabolic syndrome in mid-life? A lifecourse analysis using the 1958 British Birth cohort. BMC Public Health 2016; 16:815. [PMID: 27538482 PMCID: PMC4989336 DOI: 10.1186/s12889-016-3484-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 08/11/2016] [Indexed: 12/25/2022] Open
Abstract
Background Lifecourse studies suggest that the metabolic syndrome (MetS) may be rooted in the early life environment. This study aims to examine the pathways linking early nutritional and psychosocial exposures and the presence of MetS in midlife. Methods Data are from the National Child Development Study including individuals born during 1 week in 1958 in Great Britain and followed-up until now. MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III classification. Mother’s pre-pregnancy body mass index (BMI) was used as a proxy of the early nutritional environment and Adverse Childhood Experiences (ACE) as a proxy for early psychosocial stress. Socioeconomic characteristics, pregnancy and birth conditions were extracted as potential confounders. Adult health behaviors, BMI, socioeconomic environment and psychological state were considered as mediating variables. Multivariate models were performed by including variables sequentially taking a lifecourse approach. Results 37.5 % of men and 19.8 % of women had MetS. Participants with an obese/overweight mother presented a higher risk of MetS than those whose mother had a normal pre-pregnancy BMI. Men exposed to two ACE or more, and women exposed to one ACE, were more at risk of MetS compared to unexposed individuals. After including confounders and mediators, mother’s pre-pregnancy BMI was still associated with MetS in midlife but the association was weakened after including participant’s adult BMI. ACE was no longer associated with MetS after including confounders in models. Conclusions The early nutritional environment, represented by mother’s pre-pregnancy BMI, was associated with the risk of MetS in midlife. An important mechanism involves a mother-to-child BMI transmission, independent of birth or perinatal conditions, socioeconomic characteristics and health behaviors over the lifecourse. However this mechanism is not sufficient for explaining the influence of mother’s pre-pregnancy BMI which implies the need to further explore other mechanisms in particular the role of genetics and early nutritional environment. ACE is not independently associated with MetS. However, other early life stressful events such as emergency caesarean deliveries and poor socioeconomic status during childhood may contribute as determinants of MetS.
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Affiliation(s)
- C Delpierre
- INSERM, UMR1027, Toulouse, F-31000, France. .,Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, F-31000, France.
| | - R Fantin
- INSERM, UMR1027, Toulouse, F-31000, France.,Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, F-31000, France
| | - C Barboza-Solis
- INSERM, UMR1027, Toulouse, F-31000, France.,Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, F-31000, France.,Universidad de Costa Rica, 2060, San José, Costa Rica
| | - B Lepage
- INSERM, UMR1027, Toulouse, F-31000, France.,Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, F-31000, France.,Department of Epidemiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - M Darnaudéry
- Université Bordeaux, Laboratoire NUTRINEURO, UMR 1286, F-33076, Bordeaux, France.,INRA, Lab NUTRINEURO, UMR 1286, F-33076, Bordeaux, France
| | - M Kelly-Irving
- INSERM, UMR1027, Toulouse, F-31000, France.,Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, F-31000, France
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Boehm JK, Chen Y, Williams DR, Ryff CD, Kubzansky LD. Subjective well-being and cardiometabolic health: An 8-11year study of midlife adults. J Psychosom Res 2016; 85:1-8. [PMID: 27212662 PMCID: PMC4889157 DOI: 10.1016/j.jpsychores.2016.03.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 01/19/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Individuals who are satisfied and experience frequent positive emotions tend to have reduced risk for coronary heart disease (CHD). However, conflicting evidence exists and little research has investigated whether well-being is associated with early-warning indicators of biological risk that precede CHD. We investigated whether life satisfaction and positive emotions longitudinally predicted reduced risk of incident cardiometabolic conditions and healthier cardiometabolic risk scores, which may provide insight into underlying mechanisms and novel prevention targets. METHODS Initially healthy men and women (N=754-854) reported their baseline life satisfaction and positive emotions. During follow-up, presence of manifest cardiometabolic conditions was assessed and a separate cardiometabolic risk score was constructed from eight biomarkers. Poisson and linear regression analyses tested whether life satisfaction and positive emotions were associated with reduced incident disease risk and lower cardiometabolic risk scores 8-11years later. RESULTS Life satisfaction and positive emotions were each prospectively associated with reduced risk of manifest conditions, controlling for demographics and family history of CHD. Associations were attenuated for positive emotions after adjusting for depressive symptoms and for life satisfaction after adjusting for health behaviors. Life satisfaction was associated with lower cardiometabolic risk scores until adding health behaviors, but positive emotions were not (regardless of the included covariates). CONCLUSION Well-being, particularly life satisfaction, is associated with reduced risk for incident cardiometabolic conditions in minimally-adjusted models. However, accounting for underlying behavioral pathways attenuates the association. Low levels of life satisfaction (but not positive emotions) may also provide early warning of cardiometabolic risk prior to disease development.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology, Chapman University, One University Drive, Orange, CA 92866
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115,Department of African and African American Studies and Sociology, Harvard University, Cambridge, MA 02138
| | - Carol D. Ryff
- Department of Psychology, University of Wisconsin, Madison, 1202 West Johnson Street, Madison, WI 53706,Institute on Aging, University of Wisconsin, Madison, 1300 University Avenue, Madison, WI 53706
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115
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Quadros TMBD, Gordia AP, Silva LR, Silva DAS, Mota J. [Epidemiological survey in schoolchildren: determinants and prevalence of cardiovascular risk factors]. CAD SAUDE PUBLICA 2016; 32:e00181514. [PMID: 26958824 DOI: 10.1590/0102-311x00181514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/26/2015] [Indexed: 11/22/2022] Open
Abstract
This study focused on the prevalence of dyslipidemia, high blood glucose, and high blood pressure in scho-olchildren and the associations with demographic, socioeconomic, biological, and behavior factors using a cross-sectional design with 1,139 schoolchildren from six to 18 years of age in Amargosa, Bahia State, Brazil. Prevalence ratio (PR) was used as the measure of association. Prevalence rates for dyslipidemia, high blood glucose, and high blood pressure were 62.1%, 6.6%, and 27%, respectively. Dyslipidemia was associated with the school's geographic location (PR = 1.52) and child's waist circumference (PR = 1.20), and high blood glucose with the school's geographic location (PR = 3.41) and child's peripheral adiposity (PR = 3.13). High blood pressure was associated with age bracket (PR = 2.34), waist-for-height ratio (PR = 1.62), sexual ma-turation (PR = 2.06), and physical activity (PR = 1.32). Intervention programs are needed to change life habits in schoolchildren.
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Montez JK, Bromberger JT, Harlow SD, Kravitz HM, Matthews KA. Life-Course Socioeconomic Status and Metabolic Syndrome Among Midlife Women. J Gerontol B Psychol Sci Soc Sci 2016; 71:1097-1107. [PMID: 26926957 DOI: 10.1093/geronb/gbw014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/05/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We examine whether women's risks of having metabolic syndrome (MetS) at pre/early-menopausal baseline, and of developing MetS after baseline, are associated with childhood and adult socioeconomic statuses (SESs); and whether the associations are mediated by adult reproductive, economic, behavioral, and psychosocial factors. METHOD Using data on white and black women collected prospectively for 12 years in the Study of Women's Health Across the Nation, we estimated odds of MetS at pre/early-menopausal baseline with logistic regression, and incidence of MetS after baseline with Cox proportional hazards models. RESULTS Women raised in "adverse" childhood SES had marginally greater odds of MetS at baseline than did women raised in "good" SES, and women with a high school credential or less had significantly greater odds than college-educated women, in mutually adjusted models. The elevated odds partly reflected SES-related differences in exercise and alcohol consumption. Incidence after baseline was associated with education, not childhood SES, and partly mediated by health behaviors. Differences in the probability of surviving without MetS between the most and least socioeconomically advantaged women nearly doubled between ages 50 and 60. DISCUSSION Childhood and adult SES predict women's risks of MetS as they approach the menopause transition; adult SES is primarily important afterwards.
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Affiliation(s)
| | - Joyce T Bromberger
- Department of Psychiatry and.,Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Siobán D Harlow
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Howard M Kravitz
- Department of Psychiatry and.,Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | - Karen A Matthews
- Department of Psychiatry and.,Department of Psychology, University of Pittsburgh, Pennsylvania
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Non AL, Román JC, Gross CL, Gilman SE, Loucks EB, Buka SL, Kubzansky LD. Early childhood social disadvantage is associated with poor health behaviours in adulthood. Ann Hum Biol 2016; 43:144-53. [PMID: 26727037 DOI: 10.3109/03014460.2015.1136357] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Individual health behaviours are considered important risk factors for cardiometabolic diseases. These behaviours may be socially patterned by early exposure to social disadvantage, but few studies have prospectively tested this hypothesis empirically. AIM This study investigated whether childhood social disadvantage was associated with likelihood of engaging in less healthy behaviours 40 years later. SUBJECTS AND METHODS Prospective data were analysed from the New England Family Study, a 2005-2007 adult follow-up of a cohort initiated in 1959-1966 (n = 565). Childhood social environment (age 7 years) was assessed using a cumulative index of socioeconomic and family stability factors. Logistic regression models evaluated associations between social disadvantage and each health-related behaviour and obesity in adulthood. RESULTS Relative to low disadvantage, higher disadvantage was associated with 3.6-fold greater odds of smoking (95% CI = 1.9-7.0), 4.8-fold greater odds (in women only) of excess alcohol consumption (95% CI = 1.6-14.2) and 2.7-fold greater odds of obesity (95% CI = 1.3-5.5), but was not associated with unhealthy diet or physical inactivity. CONCLUSION These findings suggest childhood social disadvantage may contribute to adult cardiometabolic disease by predisposing children to adopt certain unhealthy behaviours. If replicated, such findings may support intervention strategies that target social environmental factors and behavioural pathways that are established early in life.
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Affiliation(s)
- Amy L Non
- a Department of Anthropology , University of California , San Diego, La Jolla, CA , USA
| | - Jorge Carlos Román
- b Department of Mathematics and Statistics , San Diego State University , San Diego , CA , USA
| | - Christopher L Gross
- c Department of Medicine , Health, and Society, Vanderbilt University , Nashville , TN , USA
| | - Stephen E Gilman
- d Division of Intramural Population Health Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda , MD , USA ;,e Department of Social and Behavioural Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA ;,f Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Eric B Loucks
- g Department of Epidemiology , Brown University , Providence , RI , USA
| | - Stephen L Buka
- g Department of Epidemiology , Brown University , Providence , RI , USA
| | - Laura D Kubzansky
- e Department of Social and Behavioural Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA
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Li A, Tu MT, Sousa AC, Alvarado B, Kone GK, Guralnik J, Zunzunegui MV. Early life adversity and C-reactive protein in diverse populations of older adults: a cross-sectional analysis from the International Mobility in Aging Study (IMIAS). BMC Geriatr 2015; 15:102. [PMID: 26286183 PMCID: PMC4544803 DOI: 10.1186/s12877-015-0104-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 08/06/2015] [Indexed: 12/15/2022] Open
Abstract
Background Recent studies suggest potential associations between childhood adversity and chronic inflammation at older ages. Our aim is to compare associations between childhood health, social and economic adversity and high sensitivity C-reactive protein (hsCRP) in populations of older adults living in different countries. Methods We used the 2012 baseline data (n = 1340) from the International Mobility in Aging Study (IMIAS) of community-dwelling people aged 65–74 years in Natal (Brazil), Manizales (Colombia) and Canada (Kingston, Ontario; Saint-Hyacinthe, Quebec). Multiple linear and Poisson regressions with robust covariance were fitted to examine the associations between early life health, social, and economic adversity and hsCRP, controlling for age, sex, financial strain, marital status, physical activity, smoking and chronic conditions both in the Canadian and in the Latin American samples. Results Participants from Canadian cities have less adverse childhood conditions and better childhood self-reported health. Inflammation was lower in the Canadian cities than in Manizales and Natal. Significant associations were found between hsCRP and childhood social adversity in the Canadian but not in the Latin American samples. Among Canadian older adults, the fully-adjusted mean hsCRP was 2.2 (95 % CI 1.7; 2.8) among those with none or one childhood social adversity compared with 2.8 (95 % CI 2.1; 3.8) for those with two or more childhood social adversities (p = 0.053). Similarly, the prevalence of hsCRP > 3 mg/dL was 40 % higher among those with higher childhood social adversity but after adjustment by health behaviors and chronic conditions the association was attenuated. No associations were observed between hsCRP and childhood poor health or childhood economic adversity. Conclusions Inflammation was higher in older participants living in the Latin American cities compared with their Canadian counterparts. Childhood social adversity, not childhood economic adversity or poor health during childhood, was an independent predictor of chronic inflammation in old age in the Canadian sample. Selective survival could possibly explain the lack of association between social adversity and hsCRP in the Latin American samples.
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Affiliation(s)
- Annie Li
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.
| | - Mai Thanh Tu
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
| | - Ana Carolina Sousa
- CNPQ Programa de Pós Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
| | - Beatriz Alvarado
- Department of Public Health Sciences, 2nd and 3rd Floors, Carruthers Hall, Kingston, ON, K7L 3 N6, Canada.
| | - Georges Karna Kone
- Centre de recherche du CHUM (CRCHUM), 900, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.
| | - Jack Guralnik
- Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.
| | - Maria Victoria Zunzunegui
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
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Childhood adversity as a predictor of non-adherence to statin therapy in adulthood. PLoS One 2015; 10:e0127638. [PMID: 26011609 PMCID: PMC4444303 DOI: 10.1371/journal.pone.0127638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 04/17/2015] [Indexed: 12/13/2022] Open
Abstract
Purpose To investigate whether adverse experiences in childhood predict non-adherence to statin therapy in adulthood. Methods A cohort of 1378 women and 538 men who initiated statin therapy during 2008–2010 after responding to a survey on childhood adversities, was followed for non-adherence during the first treatment year. Log-binomial regression was used to estimate predictors of non-adherence, defined as the proportion of days covered by dispensed statin tablets <80%. In fully adjusted models including age, education, marital status, current smoking, heavy alcohol use, physical inactivity, obesity, presence of depression and cardiovascular comorbidity, the number of women ranged from 1172 to 1299 and that of men from 473 to 516, because of missing data on specific adversities and covariates. Results Two in three respondents reported at least one of the following six adversities in the family: divorce/separation of the parents, long-term financial difficulties, severe conflicts, frequent fear, severe illness, or alcohol problem of a family member. 51% of women and 44% of men were non-adherent. In men, the number of childhood adversities predicted an increased risk of non-adherence (risk ratio [RR] per adversity 1.11, 95% confidence interval [CI] 1.01–1.21], P for linear trend 0.013). Compared with those reporting no adversities, men reporting 3–6 adversities had a 1.44-fold risk of non-adherence (95% CI 1.12–1.85). Experiencing severe conflicts in the family (RR 1.27, 95% CI 1.03–1.57]) and frequent fear of a family member (RR 1.27, 95% CI 1.00–1.62]) in particular, predicted an increased risk of non-adherence. In women, neither the number of adversities nor any specific type of adversity predicted non-adherence. Conclusions Exposure to childhood adversity may predict non-adherence to preventive cardiovascular medication in men. Usefulness of information on childhood adversities in identification of adults at high risk of non-adherence deserves further research.
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Friedman EM, Montez JK, Sheehan CM, Guenewald TL, Seeman TE. Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter? J Aging Health 2015; 27:1311-38. [PMID: 25903978 DOI: 10.1177/0898264315580122] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. METHOD We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. RESULTS The best-fitting specification of quantity of events was a linear measure reflecting a dose-response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women's risk of heart disease. DISCUSSION Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures.
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Early origins of inflammation: An examination of prenatal and childhood social adversity in a prospective cohort study. Psychoneuroendocrinology 2015; 51:403-13. [PMID: 25462912 PMCID: PMC4268261 DOI: 10.1016/j.psyneuen.2014.10.016] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/23/2014] [Accepted: 10/15/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Children exposed to social adversity carry a greater risk of poor physical and mental health into adulthood. This increased risk is thought to be due, in part, to inflammatory processes associated with early adversity that contribute to the etiology of many adult illnesses. The current study asks whether aspects of the prenatal social environment are associated with levels of inflammation in adulthood, and whether prenatal and childhood adversity both contribute to adult inflammation. METHODS We examined associations of prenatal and childhood adversity assessed through direct interviews of participants in the Collaborative Perinatal Project between 1959 and 1974 with blood levels of C-reactive protein in 355 offspring interviewed in adulthood (mean age=42.2 years). Linear and quantile regression models were used to estimate the effects of prenatal adversity and childhood adversity on adult inflammation, adjusting for age, sex, and race and other potential confounders. RESULTS In separate linear regression models, high levels of prenatal and childhood adversity were associated with higher CRP in adulthood. When prenatal and childhood adversity were analyzed together, our results support the presence of an effect of prenatal adversity on (log) CRP level in adulthood (β=0.73, 95% CI: 0.26, 1.20) that is independent of childhood adversity and potential confounding factors including maternal health conditions reported during pregnancy. Supplemental analyses revealed similar findings using quantile regression models and logistic regression models that used a clinically-relevant CRP threshold (>3mg/L). In a fully-adjusted model that included childhood adversity, high prenatal adversity was associated with a 3-fold elevated odds (95% CI: 1.15, 8.02) of having a CRP level in adulthood that indicates high risk of cardiovascular disease. CONCLUSIONS Social adversity during the prenatal period is a risk factor for elevated inflammation in adulthood independent of adversities during childhood. This evidence is consistent with studies demonstrating that adverse exposures in the maternal environment during gestation have lasting effects on development of the immune system. If these results reflect causal associations, they suggest that interventions to improve the social and environmental conditions of pregnancy would promote health over the life course. It remains necessary to identify the mechanisms that link maternal conditions during pregnancy to the development of fetal immune and other systems involved in adaptation to environmental stressors.
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