Health Disparities Beginning in Childhood: A Life-Course Perspective

Braveman, Paula; Barclay, Colleen

doi:10.1542/peds.2009-1100d

Cited by 535 publications

(396 citation statements)

References 99 publications

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“…[3][4][5] Although new discoveries in basic science, clinical subspecialties, and high-technology medical interventions continue to advance our capacity to treat patients who are ill, there is growing appreciation that a successful well-care system must expand its scope beyond the traditional realm of individualized, clinical practice to address the complex social, economic, cultural, environmental, and developmental influences that lead to population-based health disparities and unsustainable medical care expenditures. 2,6,7 The science of early childhood development has much to offer in the realization of this vision, and the well-being of young children and their families is emerging as a promising focus for creative investment.…”

Section: Introductionmentioning

confidence: 99%

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

Shonkoff¹,

Siegel²,

Dobbins³

et al. 2012

Pediatrics

3,963

2,375

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Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.

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Section: Introductionmentioning

confidence: 99%

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

Shonkoff¹,

Siegel²,

Dobbins³

et al. 2012

Pediatrics

3,963

2,375

View full text Add to dashboard Cite

show abstract

“…A loss may be particularly consequential if it occurs earlier in the life course than expected (28)(29)(30). For example, the death of a parent in childhood is particularly likely to trigger biopsychosocial sequelae that undermine health (9,(29)(30)(31)(32). Off-time losses in adulthood-such as losing a spouse as a young adult-may also have a more pronounced impact (4,33).…”

mentioning

confidence: 99%

Death of family members as an overlooked source of racial disadvantage in the United States

Umberson

Olson

Crosnoe

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

159

138

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Long-standing racial differences in US life expectancy suggest that black Americans would be exposed to significantly more family member deaths than white Americans from childhood through adulthood, which, given the health risks posed by grief and bereavement, would add to the disadvantages that they face. We analyze nationally representative US data from the National Longitudinal Study of Youth (n = 7,617) and the Health and Retirement Study (n = 34,757) to estimate racial differences in exposure to the death of family members at different ages, beginning in childhood. Results indicate that blacks are significantly more likely than whites to have experienced the death of a mother, a father, and a sibling from childhood through midlife. From young adulthood through later life, blacks are also more likely than whites to have experienced the death of a child and of a spouse. These results reveal an underappreciated layer of racial inequality in the United States, one that could contribute to the intergenerational transmission of health disadvantage. By calling attention to this heightened vulnerability of black Americans, our findings underscore the need to address the potential impact of more frequent and earlier exposure to family member deaths in the process of cumulative disadvantage.race | life expectancy | bereavement | family | disparities

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“…Previous literature identified the carer's depression scale, carer's health behaviour, SEP, and neighbourhood characteristics as significant predictors for concurrent health outcome [5,6,10], as well as for a longer lasting effect on later adult health [5,6,[8][9][10]28]. The literature also showed that excessive consumption of alcohol or cigarettes among Indigenous carers, to some extent, led to financial or depression problems and resulted in poor care for their children [29,30].…”

Section: Discussionmentioning

confidence: 99%

“…Our study was based on the life-course epidemiology concept [28,[35][36][37]. The life-course perspective concentrates on understanding early-life experiences and how they can shape health across an entire lifetime and potentially across generations by systematically concentrating on the role of context, including the social and physical context along with biological factors, over time.…”

Section: Discussionmentioning

confidence: 99%

Have the Health Gaps Between Indigenous and Non-Indigenous Australian Children Changed over Time? Results from an Australian National Representative Longitudinal Study

Chen

Hillman

2011

Matern Child Health J

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The purpose of this study was to evaluate the changes of health gaps between Indigenous and nonIndigenous children over time and to explore critical factors that contribute to the changes. We employed data consisting of two cohorts of Australian children: infant (0/1 year) and children (4/5 years) that are part of the Longitudinal Study of Australian Children. Health outcomes were measured by physical outcome index (POI) and parent-rated health during 2004, 2006 and 2008. We used first-order autoregressive modelling to examine the longitudinal relationship between the changes in health outcomes and possible contributing risk factors. The results showed that the trends of POIs between Indigenous and nonIndigenous children were closing, while the gap of parentrated health between the two populations persisted. We found that health outcomes (both POI and parent-rated health) at an earlier time point (t -1) were significant predictors of the outcomes at the later time point (t). Carer's depression status, socio-economic position and neighbourhood liveability had significant and consistent impacts on parent-rated health, but had only varying impacts on POIs between Indigenous and non-Indigenous children as well as between the birth cohorts at different time periods. Similarly, low birth weight, carer's binge drinking behaviour and other risk factors showed such varying impacts at a particular time period. The study implied that appropriate interventions accompanied by monitoring of health outcomes are necessary in order to decrease the health gaps between Indigenous and non-Indigenous children.

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Health Disparities Beginning in Childhood: A Life-Course Perspective

Cited by 535 publications

References 99 publications

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

Death of family members as an overlooked source of racial disadvantage in the United States

Have the Health Gaps Between Indigenous and Non-Indigenous Australian Children Changed over Time? Results from an Australian National Representative Longitudinal Study

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