Poverty-alleviation program participation and salivary cortisol in very low-income children.
Poverty-alleviation program participation and salivary cortisol in very low-income children.
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DOI：
10.1016/j.socscimed.2009.03.032
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发表时间：
2009-06
影响因子：
5.4
通讯作者：
Gunnar, Megan R.
中科院分区：
文献类型：
--
作者：
Fernald, Lia C. H.;Gunnar, Megan R.
关键词：
相关性研究表明，社会阶层和唾液皮质醇之间的关联表明，儿童贫困和压力敏感的下丘脑-垂体-肾上腺皮质（HPA）系统的活动之间存在因果关系。使用准实验设计，我们评估了一个家庭的参与，在墨西哥的大规模，有条件的现金转移计划（Oakidades，以前Progresa）在孩子的生命早期和儿童的唾液皮质醇（基线和反应）之间的关联。我们还研究了是否产妇抑郁症状缓和程序参与的影响。1998年至1999年，墨西哥农村低收入家庭（全国收入低于第20百分位）参加了一项大规模扶贫方案。2003年，从人口统计学上相似的社区招募了一组家庭作为比较。在Oakidades项目实施3.5年后，从干预和对照家庭（n=1197）的2-6岁儿童中采集了3份唾液样本。采用流行病学调查中心抑郁量表（CES-D）获得母亲抑郁症状。与未参加该项目的儿童相比，参加过Oakidades项目的儿童唾液皮质醇水平较低，同时控制了广泛的个人、家庭和社区变量。干预组和对照组儿童的反应模式没有差异。母亲抑郁调节儿童Oakidades项目参与和基线唾液皮质醇之间的关联。具体来说，有一个大的和显着的Oakidades程序的影响，降低皮质醇的母亲与高抑郁症状的儿童，但不是在儿童的母亲与低抑郁症的抑郁症。这些研究结果提供了迄今为止最有力的证据，表明家庭的经济状况影响儿童不断发展的压力系统，并提供了一种机制，通过这种机制，生命早期的贫困可能会影响一生中身心健康障碍的风险。
Correlational studies have shown associations between social class and salivary cortisol suggestive of a causal link between childhood poverty and activity of the stress-sensitive hypothalamic-pituitary-adrenocortical (HPA) system. Using a quasi-experimental design, we evaluated the association between a family’s participation in a large-scale, conditional cash transfer program in Mexico (Oportunidades, formerly Progresa) during the child’s early years of life and children’s salivary cortisol (baseline and responsivity). We also examined whether maternal depressive symptoms moderated the impact of program participation. Low-income households (income <20th percentile nationally) from rural Mexico were enrolled in a large-scale poverty-alleviation program between 1998 and 1999. A comparison group of households from demographically similar communities was recruited in 2003. Following 3.5 years of the Oportunidades program, three saliva samples were obtained from children age 2-6 years old from intervention and comparison households (n=1197). Maternal depressive symptoms were obtained using the Center for Epidemiologic Studies-Depression Scale (CES-D). Children who had been in the Oportunidades program had lower salivary cortisol levels when compared with those who had not participated in the program, while controlling for a wide range of individual-, household- and community-level variables. Reactivity patterns did not differ between intervention and comparison children. Maternal depression moderated the association between Oportunidades program participation and baseline salivary cortisol in children. Specifically, there was a large and significant Oportunidades program effect of lowering cortisol in children of mothers with high depressive symptoms but not in children of mothers with low depressive symptomatology. These findings provide the strongest evidence to date that the economic circumstances of the family impact the child’s developing stress system and provide a mechanism through which poverty early in life could impact life-course risk for physical and mental health disorders.
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影响因子：
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作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
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Fernald, Lia C. H.;Gertler, Paul J.;Neufeld, Lynnette M.
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Neufeld, Lynnette M.
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