The Biological Residue of Childhood Poverty

Exposure to parental depression in adolescence and proinflammatory phenotypes 20 years later

Although the biological embedding model of adversity proposes that stressful experiences in childhood create a durable proinflammatory phenotype in immune cells, research to date has relied on study designs that limit our ability to make conclusions about whether the phenotype is long-lasting. The present study leverages an ongoing 20-year investigation of African American youth to test research questions about the extent to which stressors measured in childhood forecast a proinflammatory phenotype in adulthood, as indicated by exaggerated cytokine responses to bacterial stimuli, monocyte insensitivity to inhibitory signals from hydrocortisone, and low-grade inflammation. Parents reported on their depressive symptoms and unsupportive parenting tendencies across youths' adolescence. At age 31, youth participants (now adults) completed a fasting blood draw. Samples were incubated with lipopolysaccharide and doses of hydrocortisone to evaluate proinflammatory processes. Additionally, blood samples were tested for indicators of low-grade inflammation, including IL-6, IL-8, IL-10, and TNF-α, and soluble urokinase plasminogen activator receptor. Analyses revealed that parental depression across youths' adolescence prospectively predicted indicators of proinflammatory phenotypes at age 31. Follow-up analyses suggested that unsupportive parenting mediated these associations. These findings suggest that exposure to parental depression in adolescence leaves an imprint on inflammatory activity that can be observed 20 years later.

Frailty, sex, and poverty are associated with DNA damage and repair in frail, middle-aged urban adults

Frailty is an age-related syndrome characterized by reduced recovery from stressors and increased risks of morbidity and mortality. Although frailty is usually studied in those over 65 years, our previous work showed that frailty is both present and a risk factor for premature mortality in midlife. We identified altered gene expression patterns and biological pathways associated with inflammation in frailty. Evidence suggests DNA oxidation damage related to inflammation accumulates with age, and that DNA repair capacity (DRC) declines with age and age-related conditions. We hypothesized that inter-individual differences in DNA oxidation damage and DRC are associated with frailty status and poverty level. Using the CometChip assay, we assessed baseline single-strand breaks and hydrogen peroxide (H2O2)-induced DNA oxidation damage and DRC in non-frail and frail middle-aged African American and White individuals with household incomes above and below poverty. Analysis of baseline single-strand breaks showed no associations with frailty, poverty, race, or sex. However, we identified an interaction between frailty and poverty in H2O2-induced DNA oxidation damage. We also identified interactions between sex and frailty as well as sex and poverty status with DRC. The social determinant of health, poverty, associates with DRC in men. Baseline DNA damage, H2O2-induced DNA damage as well as DRC were associated with serum cytokine levels. IL-10 levels were inversely associated with baseline DNA damage as well as H2O2-induced DNA damage, DRC was altered by IL-4 levels and sex, and by TNF-α levels in the context of sex and poverty status. This is the first evidence that DRC may be influenced by poverty status at midlife. Our data show that social determinants of health should be considered in examining biological pathways through which disparate age-related health outcomes become manifest.

Association between prenatal socioeconomic disadvantage, adverse birth outcomes, and inflammatory response at birth

Prenatal socioeconomic disadvantage is associated with inflammation in mid- to late-life, yet whether a pro-inflammatory phenotype is present at birth and the role of adverse birth outcomes in this pathway remains unclear. We utilized data on prenatal socioeconomic disadvantage at the individual- (i.e., mother's and father's education level, insurance type, marital status, and Women, Infants, and Children benefit receipt) and census-tract level as well as preterm (< 37 weeks gestation) and small-for-gestational-age (SGA) (i.e., < 10th percentile of sex-specific birth weight for gestational age) birth status, and assessed inflammatory markers (i.e., C-reactive protein, serum amyloid p, haptoglobin, and α-2 macroglobulin) in archived neonatal bloodspots from a Michigan population-based cohort of 1000 neonates. Continuous latent variables measuring individual- and combined individual- and neighborhood-level prenatal socioeconomic disadvantage were constructed and latent profile analysis was used to create a categorical inflammatory response variable (high versus low) based on continuous inflammatory marker levels. Structural equation models were used to estimate the total and direct effect of prenatal socioeconomic disadvantage on the inflammatory response at birth as well as indirect effect via preterm or SGA birth (among term neonates only), adjusting for mother's age, race/ethnicity, body mass index, smoking status, comorbidities, and antibiotic use/infection as well as grandmother's education level. There was a statistically significant total effect of both individual- and combined individual- and neighborhood-level prenatal socioeconomic disadvantage on high inflammatory response among all neonates as well as among term neonates only, and a positive but not statistically significant direct effect in both groups. The indirect effects via preterm and SGA birth were both negative, but not statistically significant. Our findings suggest prenatal socioeconomic disadvantage contributes to elevated neonatal inflammatory response, but via pathways outside of these adverse birth outcomes.

Natural history of long-COVID in a nationwide, population cohort study

Previous studies on the natural history of long-COVID have been few and selective. Without comparison groups, disease progression cannot be differentiated from symptoms originating from other causes. The Long-COVID in Scotland Study (Long-CISS) is a Scotland-wide, general population cohort of adults who had laboratory-confirmed SARS-CoV-2 infection matched to PCR-negative adults. Serial, self-completed, online questionnaires collected information on pre-existing health conditions and current health six, 12 and 18 months after index test. Of those with previous symptomatic infection, 35% reported persistent incomplete/no recovery, 12% improvement and 12% deterioration. At six and 12 months, one or more symptom was reported by 71.5% and 70.7% respectively of those previously infected, compared with 53.5% and 56.5% of those never infected. Altered taste, smell and confusion improved over time compared to the never infected group and adjusted for confounders. Conversely, late onset dry and productive cough, and hearing problems were more likely following SARS-CoV-2 infection.

Associations of household unmet basic needs and health outcomes among very low birth weight children

OBJECTIVE

We examined associations of past year household hardships (housing, energy, food, and healthcare hardships) with postnatal growth, developmental risk, health status, and hospitalization among children 0-36 months born with very low birth weight (VLBW) and the extent that these relationships differed by receipt of child supplemental security income (SSI).

STUDY DESIGN

We examined cross-sectional data from 695 families. Growth was measured as weight-for-age z-score change. Developmental risk was defined as ≥1 concerns on the "Parents' Evaluation of Developmental Status" screening tool. Child health status was categorized as excellent/good vs. fair/poor. Hospitalizations excluded birth hospitalizations.

RESULTS

Compared to children with no household hardships, odds of developmental risk were greater with 1 hardship (aOR 2.0 [1.26, 3.17]) and ≥2 hardships (aOR) 1.85 [1.18, 2.91], and odds of fair/poor child health (aOR) 1.59 [1.02, 2.49] and hospitalizations (aOR) 1.49 [1.00, 2.20] were greater among children with ≥2 hardships. In stratified analysis, associations of hardships and developmental risk were present for households with no child SSI and absent for households with child SSI.

CONCLUSION

Household hardships were associated with developmental risk, fair/poor health status, and hospitalizations among VLBW children. Child SSI may be protective against developmental risk among children living in households with hardships.

The Link Between Positive and Negative Parenting Behaviors and Child Inflammation: A Systematic Review

Children's inflammation may be an important link between parenting behaviors and health outcomes. The aims of this systematic review were to: (1) describe associations between parenting behaviors and child inflammatory markers, and (2) evaluate the relevance of existing literature to the review question. Database searches identified 19 studies that included a measure of positive or negative parenting behaviors and a marker of child inflammation, 53% of which measured parental responsiveness/warmth. Greater parental responsiveness/warmth was associated with lower levels of child pro-inflammatory markers in 60% of studies. Across studies, the association between parenting and child inflammation varied as a function of parenting construct, inflammatory measure, and sample characteristics. Studies were highly relevant, with 42% rated 5 + out of 6 for study's ability to address links between parenting behavior and child inflammation. If future research uncovers causal effects of parenting behaviors on inflammation, parenting interventions could be employed as a preventative tool.

Points of divergence on a bumpy road: early development of brain and immune threat processing systems following postnatal adversity

Lifelong indices of maladaptive behavior or illness often stem from early physiological aberrations during periods of dynamic development. This is especially true when dysfunction is attributable to early life adversity (ELA), when the environment itself is unsuitable to support development of healthy behavior. Exposure to ELA is strongly associated with atypical sensitivity and responsivity to potential threats-a characteristic that could be adaptive in situations where early adversity prepares individuals for lifelong danger, but which often manifests in difficulties with emotion regulation and social relationships. By synthesizing findings from animal research, this review will consider threat sensitivity through the lenses of associated corticolimbic brain circuitry and immune mechanisms, both of which are immature early in life to maximize adaptation for protection against environmental challenges to an individual's well-being. The forces that drive differential development of corticolimbic circuits include caretaking stimuli, physiological and psychological stressors, and sex, which influences developmental trajectories. These same forces direct developmental processes of the immune system, which bidirectionally communicates with sensory systems and emotion regulation circuits within the brain. Inflammatory signals offer a further force influencing the timing and nature of corticolimbic plasticity, while also regulating sensitivity to future threats from the environment (i.e., injury or pathogens). The early development of these systems programs threat sensitivity through juvenility and adolescence, carving paths for probable function throughout adulthood. To strategize prevention or management of maladaptive threat sensitivity in ELA-exposed populations, it is necessary to fully understand these early points of divergence.

Family environment characteristics and sleep duration in children: Maternal mental health as a mediator

BACKGROUND

Family environment is a key factor affecting children's health. However, little is known about whether and how the family environment affects sleep duration in children. This study investigated the effects of both physical and social characteristics of the family environment on sleep duration in children and determined whether these associations were mediated by maternal mental health.

METHODS

Data were obtained from the Taiwan Birth Cohort Study. A total of 19,400 children who completed 6-month, 18-month, 3-year, 5.5-year, and 8-year surveys were analyzed. The physical family environment characteristics were household crowding and housing quality. Family functioning was used as an indicator of family social environment. Multiple linear regression and path analysis were performed to test the hypotheses.

RESULTS

The children living in crowded households had shorter sleep durations (β = -0.03, p < .001). Superior housing quality and family functioning were associated with longer sleep durations (β = 0.04 and 0.02, respectively, ps < .01). The effects of housing quality and family functioning on sleep duration were mediated by maternal mental health.

CONCLUSIONS

Both physical and social characteristics of the family environment are critical to sleep duration in children. The effects of family environment characteristics on sleep duration in children are in part mediated by maternal mental health. Interventions to improve sleep during childhood by targeting the family environment may be more effective when maternal mental health is considered.

Childhood poverty and psychological well-being: The mediating role of cumulative risk exposure

The current study assessed whether the proportion of childhood (age 0-9 years) in poverty altered the developmental trajectories (ages 9-24) of multimethodological indicators of psychological well-being. In addition, we tested whether exposure to cumulative risk over time mediated the association between poverty exposure and psychological well-being. Measures of psychological well-being included internalizing and externalizing symptoms, a behavioral index of learned helplessness (task persistence), and chronic physiological stress (allostatic load). Exposure to poverty during childhood predicted the trajectory of each development outcome: individuals with more poverty exposure during childhood showed (a) relatively high levels of internalizing symptoms that diminished more slowly with maturation, (b) relatively high levels of externalizing symptoms that increased faster over time, (c) less task persistence indicative of greater learned helplessness, and (d) higher levels of chronic physiological stress which increased faster over time relative to persons with less childhood poverty exposure. Trajectories of cumulative risk exposure from physical and psychosocial surroundings from 9-24 years accounted for the association between childhood poverty and the growth curves of internalizing and externalizing symptoms but not for learned helplessness or chronic physiological stress. Additional sensitivity analyses indicate that early childhood disadvantage is particularly problematic for each outcome, except for internalizing symptoms which seem sensitive to the combination of early and lifetime poverty exposure. We also explored whether domains of cumulative risk as well as two alternatives, maternal sensitivity or family cohesion, functioned as mediators. Little evidence emerged for any of these alternative mediating constructs.

Environmental Conditions to Promote Healthy Childhood Brain/Behavioral Development: Informing Early Preventive Interventions for Delivery in Routine Care

Environmental experiences early in life have strong and enduring consequences for cognitive, emotional, and neurobiological development and related physical and mental health trajectories. The powerful influence of early caregiver nurturance and stimulation on promoting positive neurodevelopmental outcomes has been demonstrated across species. These findings elucidate the environmental conditions known to facilitate healthy neurodevelopment and underscore the potential for modifiable psychosocial factors in the environment to be harnessed to inform early preventive interventions to promote health and adaptive development. A framework for early preventive interventions to enhance nurturing and responsive caregiving for implementation during early sensitive periods of brain development delivered within existing health or educational infrastructures is proposed. Emotional development during sensitive periods is an important, under-recognized, and abundantly modifiable predictor of mental and physical health outcomes that warrants investment of resources and integration of interventions into public health infrastructure for children worldwide. Future studies are needed to further clarify whether and when sensitive periods are present for key developmental domains to inform the optimal timing and targets of these interventions. Numerous available empirically supported early interventions may be modified and applied in briefer and more feasible modalities of delivery to broader populations of developing children. As well established in growth and development across species, essential environmental inputs that are particularly important at specified developmental periods facilitate optimal growth trajectories. Such principles hold great potential in application to early child neurodevelopment to facilitate a thriving and resilient human population.

Early life adversity, inflammation, and immune function: An initial test of adaptive response models of immunological programming

Much research indicates that exposure to early life adversity (ELA) predicts chronic inflammatory activity, increasing one's risk of developing diseases of aging later in life. Despite its costs, researchers have proposed that chronic inflammation may be favored in this context because it would help promote immunological vigilance in environments with an elevated risk of infection and injury. Although intuitively appealing, the assumption that exaggerated inflammatory activity predicts favorable immunological outcomes among those exposed to ELA has not been tested. Here, we seek to address this gap, examining the links between exposure to ELA, inflammation, and immune function. Consistent with others' work, results revealed that those from low socioeconomic status (SES) childhood environments exhibited exaggerated unstimulated inflammatory activity relative to what was observed among those from higher SES childhood environments. Further, results revealed that - although levels of inflammation predicted the magnitude of immunological responses in those from higher SES backgrounds - for those who grew up in low SES environments, higher levels of inflammation were unrelated to the magnitude of immunological responses. Results suggest that exaggerated inflammatory activity in the context of ELA may not predict improved ability to manage acute immunological threats.

Maternal stress, child behavior and the promotive role of older siblings

BACKGROUND

In the first years of their lives, children develop the cognitive, social and emotional skills that will provide the foundations for their lifelong health and achievements. To increase their life prospects and reduce the long-term effects of early aversive conditions, it is therefore crucial to understand the risk factors that negatively affect child development and the factors that are instead beneficial. In this study, we tested (i) the effects of different social and environmental stressors on maternal stress levels, (ii) the dynamic relationship between maternal stress and child behavior problems during development, and (iii) the potential promotive (i.e. main) or protective (i.e. buffering) effect of siblings on child behavior problems during development.

METHODS

We used longitudinal data from 373 mother-child pairs (188 daughters, 185 sons) from pregnancy until 10 years of age. We assessed maternal stress and child behavior problems (internalizing and externalizing) with validated questionnaires, and then used linear mixed models, generalized linear mixed models and longitudinal cross-lagged models to analyze the data.

RESULTS

Our results showed that higher maternal stress levels were predicted by socio-environmental stressors (i.e. the lack of sufficient social areas in the neighborhood). Moreover, prenatal maternal stress reliably predicted the occurrence of behavior problems during childhood. Finally, the presence of older siblings had a promotive function, by reducing the likelihood that children developed externalizing problems.

CONCLUSIONS

Overall, our results confirm the negative effects that maternal stress during pregnancy may have on the offspring, and suggest an important main effect of older siblings in promoting a positive child development.

Household unmet basic needs in the first 1000 days and preterm birth status

OBJECTIVE

To examine the relationship of individual and composite number of unmet basic needs (housing, energy, food, and healthcare hardships) in the past year with preterm birth status among children aged 0-24 months.

STUDY DESIGN

We examined cross-sectional 2011-18 data of 17,926 families with children aged 0-24 months. We examined children born <31 weeks', 31-33 weeks', and 34-36 weeks' gestation versus term (≥37 weeks) using multivariable multinomial logistic regression.

RESULTS

At least 1 unmet basic need occurred among ≥60% of families with preterm children, compared to 56% of families with term children (p = 0.007). Compared to term, children born ≤30 weeks' had increased odds of healthcare hardships (aOR 1.28 [1.04, 1.56]) and children born 34-36 weeks' had increased odds of 1 (aOR 1.19 [1.05, 1.35]) and ≥2 unmet needs (aOR 1.15 [1.01, 1.31]).

CONCLUSION

Unmet basic needs were more common among families with preterm, compared to term children.

Systemic Inflammation Contributes to the Association Between Childhood Socioeconomic Disadvantage and Midlife Cardiometabolic Risk

BACKGROUND

Childhood socioeconomic disadvantage is associated with increased risk for chronic inflammation and cardiometabolic disease at midlife.

PURPOSE

As it is presently unknown whether inflammation mediates the relationship between childhood socioeconomic status (SES) and adulthood cardiometabolic risk, we investigated associations between retrospectively reported childhood SES, circulating levels of inflammatory markers, and a latent construct of cardiometabolic risk in midlife adults.

METHODS

Participants were 1,359 healthy adults aged 30-54 (Adult Health and Behavior I&II; 52% women, 17% Black) who retrospectively reported childhood SES (parental education, occupational grade). Measures included plasma interleukin (IL)-6, C-reactive protein (CRP), and cardiometabolic risk factors. Structural equation modeling was conducted, with cardiometabolic risk modeled as a second-order latent variable with adiposity, blood lipids, glucose control, and blood pressure as first-order components.

RESULTS

Lower childhood SES was associated with greater risk for cardiometabolic disease at midlife (β = -0.08, CI[-0.04, -0.01], p = .01) in models adjusted for demographics, but this association was attenuated in models that adjusted for adulthood SES and health behaviors. In fully-adjusted models, the relationship between lower childhood SES and adult cardiometabolic risk was partially explained by higher circulating levels of CRP (β = -0.05, CI[-0.02, -0.01], p = .001), but not by IL-6. In an exploratory model, lower adulthood SES was also found to independently contribute to the association between childhood SES and adult cardiometabolic risk (β = -0.02, CI[-0.01, -0.001], p = .02).

CONCLUSIONS

The current study provides initial evidence that systemic inflammation may contribute to childhood socioeconomic disparities in cardiometabolic risk in midlife. Future work would benefit from prospective investigation of these relationships.

School Climate, Cortical Structure, and Socioemotional Functioning: Associations across Family Income Levels

School climates are important for children's socioemotional development and may also serve as protective factors in the context of adversity. Nevertheless, little is known about the potential neural mechanisms of such associations, as there has been limited research concerning the relation between school climate and brain structure, particularly for brain regions relevant for mental health and socioemotional functioning. Moreover, it remains unclear whether the role of school climate differs depending on children's socioeconomic status. We addressed these questions in baseline data for 9- to 10-year-olds from the Adolescent Brain and Cognitive Development study (analytic sample for socioemotional outcomes, n = 8,887), conducted at 21 sites across the United States. Cortical thickness, cortical surface area, and subcortical volume were derived from T1-weighted brain magnetic resonance imaging. School climate was measured by youth report, and socioemotional functioning was measured by both youth and parent report. A positive school climate and higher family income were associated with lower internalizing and externalizing symptoms, with no evidence of moderation. There were no associations between school climate and cortical thickness or subcortical volume, although family income was positively associated with hippocampal volume. For cortical surface area, however, there was both a positive association with family income and moderation: There was an interaction between school climate and income for total cortical surface area and locally in the lateral orbitofrontal cortex. In all cases, there was an unexpected negative association between school climate and cortical surface area in the lower-income group. Consequently, although the school climate appears to be related to better socioemotional function for all youth, findings suggest that the association between a positive school environment and brain structure only emerges in the context of socioeconomic stress and adversity. Longitudinal data are needed to understand the role of these neural differences in socioemotional functioning over time.

Childhood Violence Exposure, Inflammation, and Cardiometabolic Health

Exposure to interpersonal violence during childhood, a severe and often traumatic form of social stress, is an enduring problem that an emerging body of work suggests may be relevant to cardiometabolic health and the progression of cardiovascular disease (CVD) across the life course. Less is known about this association causally, and consequently, the biological mechanisms that may confer risk for, and resilience to, poor health outcomes in the aftermath of violence are not well understood. Drawing on recent theoretical insights and empirical research in both humans and non-human animal models, the current paper articulates a hypothesis for one way that childhood violence could get "under the skin" to influence CVD. Based on this emerging literature, one plausible way that childhood violence exposure could increase susceptibility to CVD in later life is by sensitizing stress-response neurobiology and immune processes that regulate and promote inflammation, which is a key pathogenic mechanism in CVD. This is inherently a developmental process that begins in early life and that unfolds across the life course, although less is known about the specific mechanisms through which this occurs. The goal of this paper is to articulate some of these plausible mechanisms and to suggest areas for future research that aims to reduce the burden of disease among individuals who are exposed to violence.

Bidirectional spillover across days between family assistance and physical health experiences during adolescence

Helping the family may either promote or undermine adolescents' physical health and well-being. Adolescents (N = 396, 58% female, Mage = 14.57 years) completed diary checklists for 14 days, reporting whether they provided instrumental assistance (e.g., tangible tasks) and emotional support (e.g., listening, giving advice) to family, as well as their amount of physical activity, sleep, and physical symptoms (e.g., headache, backpain) each day. After providing emotional support, adolescents slept more that night and experienced fewer physical symptoms the next day, over and above prior day levels. When adolescents provided instrumental assistance on school days (but not nonschool days), they engaged in less physical activity that day. These results were consistent across individual differences in gender, age, socioeconomic status, and ethnicity. In addition, bidirectional associations emerged such that adolescents were more likely to provide instrumental assistance on days after they slept more. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Weak and uneven associations of home, neighborhood, and school environments with stress hormone output across multiple timescales

The progression of lifelong trajectories of socioeconomic inequalities in health and mortality begins in childhood. Dysregulation in cortisol, a stress hormone that is the primary output of the hypothalamus-pituitary-adrenal (HPA) axis, has been hypothesized to be a mechanism for how early environmental adversity compromises health. However, despite the popularity of cortisol as a biomarker for stress and adversity, little is known about whether cortisol output differs in children being raised in socioeconomically disadvantaged environments. Here, we show that there are few differences between advantaged and disadvantaged children in their cortisol output. In 8-14-year-old children from the population-based Texas Twin Project, we measured cortisol output at three different timescales: (a) diurnal fluctuation in salivary cortisol (n = 400), (b) salivary cortisol reactivity and recovery after exposure to the Trier Social Stress Test (n = 444), and (c) cortisol concentration in hair (n = 1210). These measures converged on two moderately correlated, yet distinguishable, dimensions of HPA function. We tested differences in cortisol output across nine aspects of social disadvantage at the home (e.g., family socioeconomic status), school (e.g., average levels of academic achievement), and neighborhood (e.g., concentrated poverty). Children living in neighborhoods with higher concentrated poverty had higher diurnal cortisol output, as measured in saliva; otherwise, child cortisol output was unrelated to any other aspect of social disadvantage. Overall, we find limited support for alteration in HPA axis functioning as a general mechanism for the health consequences of socioeconomic inequality in childhood.

Socioeconomic status, financial stress, and glucocorticoid resistance among youth with asthma: Testing the moderation effects of maternal involvement and warmth

OBJECTIVES

Children who grow up in more socioeconomically disadvantaged homes experience greater levels of inflammation and worse asthma symptoms than children from more advantaged families. However, recent evidence suggests that certain family-level factors can mitigate health disparities associated with socioeconomic status (SES). In a sample of youth with asthma, we investigated the potential buffering effects of maternal involvement and warmth on SES disparities in asthma-related immune responses, assessed via glucocorticoid resistance (GR) of immune cells.

METHODS

One hundred and forty-three youth (10-16 years of age) with asthma completed measures of maternal involvement and warmth, and their primary caregivers reported their levels of education, income, and financial stress. Peripheral blood mononuclear cells from youth's blood were isolated, cultured, and assayed to determine mitogen-stimulated (PMA/INO + Etho) and mitogen/hydrocortisone-stimulated (PMA/INO + Cort) levels of two Th-2 cytokines (i.e., interleukin-5, interleukin-13) and one Th-1 cytokine (i.e., interferon-γ). GR was calculated by subtracting log-transformed cytokine concentration in the PMA/INO + Etho samples from log-transformed cytokine concentration in the PMA/INO + Cort samples.

RESULTS

Both maternal involvement and warmth moderated the indirect pathway from family SES to GR of Th-2 cytokines via financial stress. Specifically, we found that low family SES was associated with elevated GR of Th-2 cytokines via increased financial stress among youth reporting low levels of maternal involvement and warmth, but not among those reporting high levels of maternal involvement or warmth.

CONCLUSIONS

These results highlight the protective role of maternal involvement and warmth in health-related biological processes modulated by family SES among youth with asthma.

Acknowledging Systemic Discrimination in the Context of a Pandemic: Advancing an Anti-Racist and Anti-Ageist Movement

This commentary draws together the confluence of current events - COVID-19 pandemic and racial injustice. Vulnerability to COVID-19 cannot be understood by age alone but within the context of inequity. We first review how COVID-19 has disproportionately affected Black and Latinx populations across the life span with the latest data from New York City Department of Health. We then discuss critical race theory and analyze longstanding inequities in health, economic, and social conditions that heighten the risk for vulnerability. We conclude with a discussion for the social work profession on the issues of defunding the police to undoing stereotypes.

Early childhood poverty and adult executive functioning: Distinct, mediating pathways for different domains of executive functioning

Executive functioning in adulthood is associated with early-in-life disadvantage. Furthermore, distinct and independent underlying processes account for differences in specific domains of adult executive functioning. The duration of poverty from birth to age 9 is associated with reduced adult inhibitory control assessed by the Flanker task (n = 233, M = 23.52 years). This effect is largely explained by lower levels of maternal responsiveness in adolescence. Early poverty also related to worse working memory in adulthood, and this effect is partially explained by elevated allostatic load during adolescence, an index of chronic physiological stress.

How developmental neuroscience can help address the problem of child poverty

Nearly 1 in 5 children in the United States lives in a household whose income is below the official federal poverty line, and more than 40% of children live in poor or near-poor households. Research on the effects of poverty on children's development has been a focus of study for many decades and is now increasing as we accumulate more evidence about the implications of poverty. The American Academy of Pediatrics recently added "Poverty and Child Health" to its Agenda for Children to recognize what has now been established as broad and enduring effects of poverty on child development. A recent addition to the field has been the application of neuroscience-based methods. Various techniques including neuroimaging, neuroendocrinology, cognitive psychophysiology, and epigenetics are beginning to document ways in which early experiences of living in poverty affect infant brain development. We discuss whether there are truly worthwhile reasons for adding neuroscience and related biological methods to study child poverty, and how might these perspectives help guide developmentally based and targeted interventions and policies for these children and their families.

Maximizing research on the adverse effects of child poverty through consensus measures

A variety of new research approaches are providing new ways to better understand the developmental mechanisms through which poverty affects children's development. However, studies of child poverty often characterize samples using different markers of poverty, making it difficult to contrast and reconcile findings across studies. Ideally, scientists can maximize the benefits of multiple disciplinary approaches if data from different kinds of studies can be directly compared and linked. Here, we suggest that individual studies can increase their potential usefulness by including a small set of common key variables to assess socioeconomic status and family income. These common variables can be used to (a) make direct comparisons between studies and (b) better enable diversity of subjects and aggregation of data regarding many facets of poverty that would be difficult within any single study. If kept brief, these items can be easily balanced with the need for investigators to creatively address the research questions in their specific study designs. To advance this goal, we identify a small set of brief, low-burden consensus measures that researchers could include in their studies to increase cross-study data compatibility. These US based measures can be adopted for global contexts.

Child diurnal cortisol differs based on profiles of maternal emotion socialization in high risk, low income, and racially diverse families

Young children's physiological and emotional regulation depend on supportive caregiving, especially in the context of stress and adversity. Experiences of child maltreatment become biologically embedded by shaping stress physiology. Maternal emotion socialization may have an important influence on children's limbic-hypothalamic-pituitary-adrenal (LHPA) functioning. Grounded in theories of caregiver emotion socialization, a person-centered latent profile analysis was utilized to identify profiles of maternal emotion socialization among a high risk, low income, and racially diverse group of 248 mothers and their young children (M_age  = 4.39 years, SD = 1.10). The majority of the mothers (n = 165) had a history of involvement with the Department of Child Services for substantiated cases of child maltreatment. A latent profile analysis was conducted revealing three emotion socialization profiles: disengaged, engaged, and engaged + supportive. Emotion socialization profile differences in children's diurnal cortisol levels and slope (using area under the curve with respect to ground and increase, respectively) were examined. Children's diurnal cortisol levels were higher, and slopes were flatter, when mothers used more disengaged emotion socialization strategies. Mothers who neglected their children were more likely to fit the disengaged profile than the engaged profile. Implications for the socialization of regulation in children exposed to adversity are discussed.

Clinical correlates of socioeconomic status in adolescent bipolar disorder

BACKGROUND

Lower socioeconomic status (SES) is associated with symptomatic severity, comorbidity, and functional impairment in adults with bipolar disorder (BD). Little is known about clinical correlates of SES in adolescents with BD.

METHODS

Participants included 195 adolescents, 13-20 years old, with BD type I, II or not otherwise specified (NOS). Diagnoses were determined by standardized semi-structured interviews. Based on the Hollingshead scale, participants were divided into "low" (SES 1-3) and the "high" (SES 4-5) SES groups. Demographic and clinical correlates of SES were evaluated in univariate analyses; significant variables were evaluated in a logistic regression model.

RESULTS

Compared to participants in the high SES group (n = 150), participants in the low SES group (n = 45) were significantly younger, less likely to be of Caucasian race and living with natural parents. In the logistic regression model, controlling for age and race, the low SES group had higher risk of police contact or arrest (OR = 2.41, 95% CI:1.14-5.11, p = 0.022), less treatment with stimulants(OR = 0.20 95% CI: 0.06-0.67, p = 0.009), and more post-traumatic stress disorder (PTSD) (OR = 4.08, 95% CI:1.33-12.46, p = 0.014) compared to the high SES group. In sensitivity analyses that further controlled for intact family, the finding of higher rates of police contact or arrest was no longer significant.

LIMITATIONS

Cross-sectional design; higher-skewed SES sample.

CONCLUSIONS

Lower SES in adolescent BD is associated with higher legal risk, increased PTSD, and under-treatment of attention-deficit/hyperactivity disorder (ADHD). Future studies are needed to evaluate the inter-relationships of these correlates, using prospective designs that can evaluate the direction of these associations. Further studies incorporating neurobiological markers are also needed to explore mechanisms underlying SES-related differences in BD.

Early Childhood Development Risks and Protective Factors in Vulnerable Preschool Children from Low-Income Communities in South Africa

Age-appropriate early childhood development is greatly influenced by exposure to various mediating and moderating factors. Developmental outcomes cannot be viewed in isolation, but by considering the interaction of the various risks and protective factors that influence early child development. A non-experimental, cross-sectional research design was employed. Data was collected in a low-income community in Gauteng, South Africa. Caregivers with children (n = 276) between the ages of 3 years and 6 years 11 months (mean 51.57 months; SD ± 12.4) whose children were in a preschool were invited to participate in the research study. Participants were divided into two groups, children with developmental delays and children without a developmental delay. The study sample included high risk, vulnerable preschool children, with a developmental delay prevalence of 80.1% (221/276). Families included were exposed to an average of five (SD ± 1.86) environmental and/or biological risks. According to a logistic regression model, three factors were significantly associated with increasing resilience amongst children with no developmental delay: living with both parents (p < 0.031, OR 4.5, 95% CI 1.2-17.2), caregivers having at least completed Grade 8 to 12 (p < 0.027, OR 11.9, 95% CI 1.4-10.5) and parents being married (p < 0.023, OR 5.1, 95% CI 1.3-20.9). Important protective factors in low-income communities like caregiver education, living with both parents and parental marriage can inform public health messaging and other population-based interventions to support early childhood development.

Indirect Effects of the Family Check-Up on Youth Extracurricular Involvement at School-Age through Improvements in Maternal Positive Behavior Support in Early Childhood

Extracurricular involvement in the school-age years has widespread potential benefits for children's subsequent socioemotional development, especially for low-income youth. However, there is a dearth of research on interventions aimed at increasing school-age extracurricular involvement in low-income youth. Thus, the present study aimed to test the collateral effect of a brief, family-focused intervention for low-income families, the Family Check-Up, on children's school-age extracurricular involvement via improvements in maternal Positive Behavior Support in early childhood. The sample (n = 630, 50% female, 50% White, 28% Black/African American) represented a subsample of families from the Early Steps Multisite Study. At age 2, families were randomly assigned to the Family Check-Up or Women, Infants, and Children Nutritional Supplement Services as usual. Mother-child dyads participated in observed interaction tasks at child ages 2 and 3 that were subsequently coded to assess positive behavior support. Primary caregivers reported on children's school-age extracurricular involvement at ages 7.5, 8.5, and 9.5. Results indicated that although there was not a direct path between intervention status and children's school-age extracurricular involvement, a significant indirect path emerged from intervention group to changes in positive behavior support between ages 2 to 3 to children's school-age extracurricular involvement. The results are discussed in terms of implications for designing preventive interventions in early childhood that promote extracurricular involvement at school-age, particularly for children at risk for maladaptive outcomes.

Pathways to inflammation in adolescence through early adversity, childhood depressive symptoms, and body mass index: A prospective longitudinal study of Chilean infants

Early adversity, depression, and obesity are associated with increases in low-grade inflammation. However, there are few prospective and longitudinal studies to elucidate how these associations unfold in children. The present study used latent growth curve models to examine pathways between family adversity in infancy, depressive symptoms in childhood, body mass index (BMI) in childhood, and inflammation in adolescence (age = 16-18). The study is an adolescent follow-up of infants from working-class communities around Santiago, Chile, who participated in a preventive trial of iron supplementation at 6 months of age. Anthropometrics, stressful life events, maternal depression, socioeconomic status, and developmental assessments were measured at 12 months, 5 years, 10 years, and adolescence. In adolescence, participants provided blood samples for high-sensitivity C-reactive protein (hsCRP) assessment. Greater exposure to early adversity in the form of interpersonal conflict stress in infancy indirectly associated with increased hsCRP through its association to increased intercept and slope of childhood BMI. Depressive symptoms at any time were not directly or indirectly associated with increased hsCRP. These findings contribute to our understanding of how early family adversity and its associations with obesity and depressive symptoms across childhood are linked to low-grade, chronic inflammation in adolescence. The model identified as best capturing the data supported the pivotal role of childhood BMI in explaining how early-life adversity is associated with inflammation in adolescence.

Internalizing symptoms and sleep outcomes in urban children with and without asthma

STUDY OBJECTIVES

This study examines associations between internalizing symptoms and sleep in a sample of urban children with and without asthma, whether asthma status moderates these associations, and whether associations differ by ethnic group.

METHODS

Participants were Latino, African American (AA), and non-Latino white (NLW) urban 7- to 9-year-olds with (n = 259) and without (n = 122) persistent asthma. Teacher-reported internalizing symptoms (anxiety, depressive, and somatic) were assessed using the Behavioral Assessment System for Children-2. Sleep duration, variability in sleep duration, and sleep onset latency were assessed with actigraphy.

RESULTS

Depressive symptoms were associated with variability in sleep duration and shorter sleep onset latency; somatic symptoms were associated with variability in sleep duration. In Latino children, depressive symptoms were associated with shorter sleep onset latency. In AA children, anxiety, depressive, and somatic symptoms were associated with variability in sleep duration; somatic symptoms were related to variability in sleep duration in NLW children. The association between internalizing symptoms and sleep outcomes did not differ by asthma status. However, asthma status was a significant moderator when examining these associations by ethnic group: among AA children, depressive symptoms were significantly related to variability in sleep duration only in children with asthma, whereas in NLW children, somatic symptoms were related to variability in sleep duration only in children without asthma.

CONCLUSIONS

Targeting specific internalizing symptoms and sleep outcomes may be beneficial in the development of interventions tailored for urban children with and without asthma from specific ethnic groups.

Infant Vagal Tone and Maternal Depressive Symptoms: A Bottom-Up Perspective

Children vary in their susceptibility to environmental exposures such as maternal depression, but little is known about how children shape those same environments. When raising an infant with low arousal, mothers at risk of depression may experience decreased parenting self-efficacy and increased depressive symptoms. We evaluated a longitudinal mediated moderation model that hypothesized interactive effects of infant vagal tone (indexed by respiratory sinus arrhythmia [RSA]) and maternal postpartum depressive (PPD) symptoms on maternal depressive symptoms in early childhood via parenting self-efficacy. Among a sample of 322 very low-income Mexican American mother-infant dyads (46% male infants), infant RSA was assessed at 6 weeks of age; mothers (M_age = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 weeks to 6 months, parenting self-efficacy at 18 and 24 months, and depressive symptoms at 18 and 36 months. Higher PPD symptoms predicted higher maternal depressive symptoms at 36 months, especially among mothers whose infants had lower resting RSA. The interactive effect of PPD symptoms and infant RSA on 36-month depressive symptoms was partially mediated by lower parenting self-efficacy. Lower infant RSA may exacerbate the detrimental effects of PPD symptoms on subsequent maternal well-being via damage to mothers' beliefs in their ability to parent effectively.

Early life socioeconomic status moderates associations between objective sleep and weight-related indicators in middle childhood

OBJECTIVES

This study tested whether early socioeconomic status moderated links between objective and subjective sleep and weight indicators during middle childhood.

DESIGN

The study design was cross-sectional but included data from earlier assessment points in the study.

SETTING

Data were collected from families across the state of Arizona.

PARTICIPANTS

Participants were 382 children recruited from birth records (49.5% female; M_age = 8.47 years; 56.5% European American; 25.1% Latino; 25% living at or below the poverty line).

MEASUREMENTS

Assessments included socioeconomic status at 12 months of age, and sleep and weight indicators at 8 years.

RESULTS

Longer sleep durations predicted lower body mass index and decreased odds of being overweight/obese across all children, regardless of socioeconomic background. For children from low socioeconomic backgrounds, longer sleep duration predicted lower percent body fat, greater efficiency predicted lower percent body fat and body mass index and smaller waist circumference, and more sleep problems predicted larger waist circumference. For children from low socioeconomic backgrounds, greater sleep duration and efficiency also predicted the lowest odds of being overweight/obese, and more sleep problems predicted the greatest odds of being overweight/obese.

CONCLUSIONS

Early life may be a sensitive period that sets the stage for stronger links between sleep and weight indicators in middle childhood. Findings offer important information regarding the protective role of sleep in the promotion of health, as well as the negative consequences that may be stronger for children who experienced low early-life socioeconomic status.

Socioeconomic status and early blood concentrations of inflammation-related and neurotrophic proteins among extremely preterm newborns

The main objective of this study was to evaluate the relationship between mother’s socioeconomic disadvantage and blood concentrations of inflammation-related proteins among extremely preterm newborns (<28 weeks gestation), a group at heightened risk of cognitive impairment when exposed to systemic inflammation. We measured the concentrations of 27 inflammatory and neurotrophic proteins in blood specimens collected a week apart during the first postnatal month from 857 extremely preterm newborns in the United States. We classified children according to 3 indicators/correlates of socioeconomic disadvantage, mother’s eligibility for government-provided medical care insurance (Medicaid), mother’s formal education level, and mother’s IQ approximated with the Kaufman Brief Intelligence Test– 2. The risks of a top-quartile concentration of each protein on each of 5 days a week apart, on two occasions during the first two postnatal weeks, and during the next two weeks were modeled as functions of each indicator of socioeconomic disadvantage. The risks of top quartile concentrations of multiple (2–5) inflammation-related proteins on multiple days during the first two weeks were increased for each of the 3 indicators of socioeconomic disadvantage, while the risks of top quartile concentrations of selected neurotrophic proteins were reduced. Adjustment for socioeconomic disadvantage did not alter the relationships between protein concentrations and both low IQ and low working memory 10 years later. Among extremely preterm newborns, indicators of socioeconomic disadvantage are associated with modestly increased risk of systemic inflammation in postnatal blood during the first postnatal month and with a slightly reduced risk of a neurotrophic signal, but do not confound relationships between protein concentrations and outcomes.

Inflammation-related epigenetic risk and child and adolescent mental health: A prospective study from pregnancy to middle adolescence

In 785 mother-child (50% male) pairs from a longitudinal epidemiological birth cohort, we investigated associations between inflammation-related epigenetic polygenic risk scores (i-ePGS), environmental exposures, cognitive function, and child and adolescent internalizing and externalizing problems. We examined prenatal and postnatal effects. For externalizing problems, one prenatal effect was found: i-ePGS at birth associated with higher externalizing problems (ages 7-15) indirectly through lower cognitive function (age 7). For internalizing problems, we identified two effects. For a prenatal effect, i-ePGS at birth associated with higher internalizing symptoms via continuity in i-ePGS at age 7. For a postnatal effect, higher postnatal adversity exposure (birth through age 7) associated with higher internalizing problems (ages 7-15) via higher i-ePGS (age 7). Hence, externalizing problems were related mainly to prenatal effects involving lower cognitive function, whereas internalizing problems appeared related to both prenatal and postnatal effects. The present study supports a link between i-ePGS and child and adolescent mental health.

Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health

Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.

Association between mobile technology use and child adjustment in early elementary school age

The time that children spend using digital devices is increasing rapidly with the development of new portable and instantly accessible technology, such as smartphones and digital tablets. Although prior studies have examined the effects of traditional media on children’s development, there is limited evidence on the impact of mobile device use. The current study aimed to clarify the link between mobile device use and child adjustment. The sample included 1,642 children aged 6 in first grade at elementary schools in Japan. Parents completed a self-report questionnaire regarding their children’s use of mobile devices and emotional/behavioral adjustment. We performed inverse probability of treatment weighted (IPTW) logistic regression to compute odds ratios (OR) for emotional/behavioral problems according to mobile device use. The values for IPTW analysis were computed based on variables assessing sociodemographics and child characteristics. Among the participants, 230 (14.0%) were regular users (60 minutes or more on a typical day) and 1,412 (86.0%) non-regular users (under 60 minutes on a typical day). Relative to non-regular use, regular use of mobile devices was significantly linked to conduct problems (IPTW-OR: 1.77, 95% CI: [1.03–3.04], p < .05) and hyperactivity/inattention (IPTW-OR: 1.82, 95% CI: [1.15–2.87], p < .01). Based on these results, routine and frequent use of mobile devices appear to be associated with behavioral problems in childhood.

Childhood abuse and neglect and physical health at midlife: Prospective, longitudinal evidence

Previous research suggests that the experience of abuse and neglect in childhood has negative implications for physical health in adulthood. Using data from the Minnesota Longitudinal Study of Risk and Adaptation (N = 115), the present research examined the predictive significance of childhood physical abuse, sexual abuse, and physical/cognitive neglect for multilevel assessments of physical health at midlife (age 37-39 years), including biomarkers of cardiometabolic risk, self-reports of quality of health, and a number of health problems. Analyses revealed that childhood physical/cognitive neglect, but not physical or sexual abuse, predicted all three health outcomes in middle adulthood, even when controlling for demographic risk factors and adult health maintenance behaviors. We discuss possible explanations for the unique significance of neglect in this study and suggest future research that could clarify previous findings regarding the differential impact of different types of abuse and neglect on adult health.

Childhood close family relationships and health

Emerging data suggest that during childhood, close family relationships can ameliorate the impact that adversity has on life span physical health. To explain this phenomenon, a developmental stress buffering model is proposed in which characteristics of family relationships including support, conflict, obligation, and parenting behaviors evolve and change from childhood to adolescence. Together, these characteristics govern whether childhood family relationships are on balance positive enough to fill a moderating role in which they mitigate the effects that childhood adversities have on physical health. The benefits of some family relationship characteristics are hypothesized to stay the same across childhood and adolescence (e.g., the importance of comfort and warmth from family relationships) whereas the benefits of other characteristics are hypothesized to change from childhood to adolescence (e.g., from a need for physical proximity to parents in early childhood to a need for parental availability in adolescence). In turn, close, positive family relationships in childhood operate via a variety of pathways, such as by reducing the impact that childhood stressors have on biological processes (e.g., inflammation) and on health behaviors that in turn can shape physical health over a lifetime. (PsycINFO Database Record

Socioeconomic status, family negative emotional climate, and anti-inflammatory gene expression among youth with asthma

The glucocorticoid receptor gene NR3C1 is an important down-regulator of inflammation and is typically under-expressed in individuals with low socioeconomic status (SES). Negative emotionality has been suggested as a potential mediator of SES disparities in health outcomes. In this study, we expand this literature by naturalistically assessing negative emotionality in a key emotional environment: the family. In a sample of 104 youth with asthma (10-17 years) and their primary caregiver, we assessed SES via caregiver report, emotional expression by youth and parents in the home over four days using the electronically activated recorder (EAR), and NR3C1 expression via blood collected from youth. Although there was not a direct effect of SES on NR3C1 expression, bootstrapping mediation analyses showed a significant indirect path such that lower SES was associated with a more negative family emotional climate, which in turn predicted reduced NR3C1 expression. No mediation effects were found for family positive emotional climate. This research demonstrates the importance of examining the effects of SES on emotion expression in the family context and suggests a critical biopsychosocial pathway underlying SES-based health disparities that may extend beyond youth.

Early Childhood Adverse Experiences, Inferior Frontal Gyrus Connectivity, and the Trajectory of Externalizing Psychopathology

OBJECTIVE

Early adverse childhood experiences (ACEs) have been linked to the development of both internalizing and externalizing psychopathology. In our prior work, we found that ACEs predicted reductions in the volume of the inferior frontal gyrus (IFG), a brain region important for impulse control and emotion regulation. Here we tested the hypothesis that ACEs might influence child behavioral outcomes through an impact on IFG functional connectivity, which may influence impulsive or risk-taking behavior.

METHOD

We examined the effects of prospectively assessed ACEs on IFG connectivity in childhood, and their relationship to the trajectory of subsequent psychopathology from late school age and early adolescence, using data from an 11-year longitudinal study of children starting in preschool that included 3 waves of resting state functional connectivity across childhood and early adolescence.

RESULTS

ACEs predicted functional connectivity of both left and right IFG. Multi-level modeling of symptoms across 3 waves of assessments indicated that more ACEs predicted both internalizing and externalizing symptoms. However, altered IFG connectivity specifically predicted greater externalizing symptoms over time in middle childhood and early adolescence, as compared to internalizing symptoms. Longitudinal modeling indicating that the relationships between externalizing and functional connectivity were maintained across 3 waves of functional connectivity assessment.

CONCLUSION

These findings underscore the relationship of ACEs to later psychopathology, and suggest that connectivity of the IFG, a region known to play an important role in impulse control and emotion regulation, may play a key role in the risk trajectory of ACEs to externalizing problems. However, further work is needed to understand whether these relationships reflect a direct effect of ACEs or whether ACEs are a marker for other environmental or genetic factors that may also influence brain development and behavior.

Early life socioeconomic status associates with interleukin-6 responses to acute laboratory stress in adulthood

It is proposed that environmental exposures in early life influence immune programming. Specifically, socioeconomic disadvantage is thought to program an immune phenotype that is prone to inflammation and associated with increased risk for inflammatory disease later in life. Existing literature shows an inverse association of early childhood socioeconomic status (SES) with adult levels of systemic inflammation. Here, we extend that literature to examine whether early childhood SES also relates to the magnitude of inflammatory response to acute psychological stress in adulthood. Healthy volunteers (N = 110; 40-58 years; 59% female; 90% white) performed a laboratory stress protocol, with blood samples drawn at the end of a 30-min baseline, a 5-min speech task, and a 30-min recovery to assess interleukin (IL)-6 stress responses. An early childhood SES index was derived from reports of parental home and vehicle ownership, and number of bedrooms per child in the home across ages 1-2, 3-4, and 5-6. Regressions adjusted for current age, sex, race, and BMI showed that lower SES at age 1-2 was associated with larger IL-6 stress responses in adulthood (ΔR² = 0.05, β = -0.24, p = .03). This association was independent of adult SES and task-evoked affective responses. No association was found between SES at ages 3-4 or 5-6 and IL-6 responses. These results provide initial evidence for a link between disadvantage in the first 2 years of life and heightened inflammatory response to stress in adulthood; this link may contribute to the increased disease risk that accompanies being raised in disadvantaged socioeconomic circumstances.

Trends and Divergences in Childhood Income Dynamics, 1970-2010

Earnings and income variability have increased since the 1970s, particularly at the bottom of the income distribution. Considerable evidence suggests that childhood income levels-captured as average or point-in-time yearly income-are associated with numerous child and adult outcomes. The importance to child development of stable proximal processes during childhood suggests that income variability may also be important, particularly if it is unpredictable, unintentional, or does not reflect an upward trend in family income. Using the Panel Study of Income Dynamics, this study documents trends since the 1970s in three dimensions of childhood income dynamics: level, variability, and growth (n=7991). The analysis reveals that income variability during childhood has grown over time, while income growth rates have not. In addition, the economic context of childhood has diverged substantially by socioeconomic status, race, and family structure, with the most disadvantaged children facing a double-whammy of low income and high variability.

Association Between Early Life Adversity and Risk for Poor Emotional and Physical Health in Adolescence: A Putative Mechanistic Neurodevelopmental Pathway

IMPORTANCE

Adverse childhood experiences (ACEs) have been associated with poor mental and physical health outcomes. However, the mechanism of this effect, critical to enhancing public health, remains poorly understood.

OBJECTIVE

To investigate the neurodevelopmental trajectory of the association between early ACEs and adolescent general and emotional health outcomes.

DESIGN, SETTING, AND PARTICIPANTS

A prospective longitudinal study that began when patients were aged 3 to 6 years who underwent neuroimaging later at ages 7 to 12 years and whose mental and physical health outcomes were observed at ages 9 to 15 years. Sequential mediation models were used to investigate associations between early ACEs and brain structure, emotion development, and health outcomes longitudinally. Children were recruited from an academic medical center research unit.

EXPOSURE

Early life adversity.

MAIN OUTCOMES AND MEASURES

Early ACEs in children aged 3 to 7 years; volume of a subregion of the prefrontal cortex, the inferior frontal gyrus, in children aged 6 to 12 years; and emotional awareness, depression severity, and general health outcomes in children and adolescents aged 9 to 15 years.

RESULTS

The mean (SD) age of 119 patients was 9.65 (1.31) years at the time of scan. The mean (SD) ACE score was 5.44 (3.46). The mean (SD) depression severity scores were 2.61 (1.78) at preschool, 1.77 (1.58) at time 2, and 2.16 (1.64) at time 3. The mean (SD) global physical health scores at time 2 and time 3 were 0.30 (0.38) and 0.33 (0.42), respectively. Sequential mediation in the association between high early ACEs and emotional and physical health outcomes were found. Smaller inferior frontal gyrus volumes and poor emotional awareness sequentially mediated the association between early ACEs and poor general health (model parameter estimate = 0.002; 95% CI, 0.0002-0.056) and higher depression severity (model parameter estimate = 0.007; 95% CI, 0.001-0.021) in adolescence. An increase from 0 to 3 early ACEs was associated with 15% and 25% increases in depression severity and physical health problems, respectively.

CONCLUSIONS AND RELEVANCE

Study findings highlight 1 putative neurodevelopmental mechanism by which the association between early ACEs and later poor mental and physical health outcomes may operate. This identified risk trajectory may be useful to target preventive interventions.

Exploring longitudinal associations between neighborhood disadvantage and cortisol levels in early childhood

Children who grow up in poverty are more likely to experience chronic stressors that generate "wear" on stress regulatory systems including the hypothalamus-pituitary-adrenal (HPA) axis. This can have long-term consequences for health and well-being. Prior research has examined the role of proximal family and home contributions to HPA axis functioning. However, there is evidence to suggest that more distal levels of context, including neighborhoods, also matter. Prior evidence has primarily focused on adolescents and adults, with little evidence linking the neighborhood context with HPA activity in infancy and toddlerhood. We tested whether neighborhood disadvantage (indexed by US Census data) was associated with basal salivary cortisol levels at 7, 15, and 24 months of child age in a large sample of families (N = 1,292) residing in predominately low-income and rural communities in the United States. Multilevel models indicated that neighborhood disadvantage was positively associated with salivary cortisol levels and that this effect emerged across time. This effect was moderated by the race/ethnicity of children such that the association was only observed in White children in our sample. Findings provide preliminary evidence that the neighborhood context is associated with stress regulation during toddlerhood, elucidating a need for future work to address possible mechanisms.

Why is parental lifespan linked to children's chances of reaching a high age? A transgenerational hypothesis

Purpose

Transgenerational determinants of longevity are poorly understood. We used data from four linked generations (G0, G1, G2 and G3) of the Uppsala Birth Cohort Multigeneration Study to address this issue.

Methods

Mortality in G1 (N = 9565) was followed from 1961–2015 and analysed in relation to tertiles of their parents’ (G0) age-at-death using Cox regression. Parental social class and marital status were adjusted for in the analyses, as was G1’s birth order and adult social class. For an almost entirely deceased segment of G1 (n = 1149), born 1915–1917, we compared exact age-at-death with G0 parents’ age-at-death. Finally, we explored ‘resilience’ as a potentially important mechanism for intergenerational transmission of longevity, using conscript information from psychological interviews of G2 and G3 men.

Results

G0 men’s and women’s ages-at-death were independently associated with G1 midlife and old age mortality. This association was robust and minimally reduced when G0 and G1 social class were adjusted for. We observed an increased lifespan in all social groups. Median difference in age-at-death for sons compared to fathers was + 3.9 years, and + 6.9 years for daughters compared to mothers.

Parents’ and maternal grandmother’s longevity were associated with resilience in subsequent generations. Resilience scores of G2 men were also associated with those of their G3 sons and with their own mortality in midlife.

Conclusions

The chance of reaching a high age is transmitted from parents to children in a modest, but robust way. Longevity inheritance is paralleled by the inheritance of individual resilience. Individual resilience, we propose, develops in the first part of life as a response to adversity and early experience in general. This gives rise to a transgenerational pathway, distinct from social class trajectories. A theory of longevity inheritance should bring together previous thinking around general susceptibility, frailty and resilience with new insights from epigenetics and social epidemiology.

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Parents’ ages-at-death predict children's midlife and old-age mortality.

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We speculate that these results reflect early programming of resilience.

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Male resilience, measured at age 18, predicts mortality between ages 50 and 65.

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Resilience is transmitted across generations, from fathers to sons.

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Male descendants to long-lived parents are somewhat more resilient than their peers.

Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease

Childhood adversity has been repeatedly and robustly linked to physical and mental illness across the lifespan. Yet, the biological pathways through which this occurs remain unclear. Functioning of the inflammatory arm of the immune system and the hypothalamic-pituitary-adrenal (HPA)-axis are both hypothesized pathways through which childhood adversity leads to disease. This review provides a novel developmental framework for examining the role of adversity type and timing in inflammatory and HPA-axis functioning. In particular, we identify elements of childhood adversity that are salient to the developing organism: physical threat, disrupted caregiving, and unpredictable environmental conditions. We propose that existing, well-characterized animal models may be useful in differentiating the effects of these adversity elements and review both the animal and human literature that supports these ideas. To support these hypotheses, we also provide a detailed description of the development and structure of both the HPA-axis and the inflammatory arm of the immune system, as well as recent methodological advances in their measurement. Recommendations for future basic, developmental, translational, and clinical research are discussed.