Early Life Stress and the Environmental Origins of Disease: a Population-based Prospective Longitudinal Study of Children in Rural Poverty (ECHO)

项目总结/摘要 社会经济地位和健康之间的负相关关系已经得到很好的确立。其根本原因则不然。这 应用程序利用并扩展了农村地区儿童和家庭的积极前瞻性纵向队列， 测试关于早期心理社会和化学品接触（0- 5岁） 在神经发育和肥胖方面对儿科健康结果产生不利影响。我们描述了一个 正在进行的基于人群的纵向研究，家庭生活项目（FLP），N=1292名儿童及其 主要和次要照顾者（如果有的话），从出生起就跟踪，并因贫困而过度抽样， 非裔美国人在主要是低收入，非城市县在宾夕法尼亚州和北 卡罗莱纳。参与者在出生至5岁的8个时间点和7至13岁的6个时间点进行观察。主 数据收集和分析的重点一直是前瞻性调查之间的关联 心理社会早期生活压力和执行功能，情绪调节， 延迟容忍，语言，学业成绩，ADHD和LD。此应用程序建立在我们的 回顾性和前瞻性地收集先前的数据，以扩大和加强我们对不良反应的关注。 暴露与神经发育和肥胖风险有关。在UG 3回顾阶段，我们扩展了 研究对象为0 ~ 5岁儿童，调查其化学品和邻居水平暴露。在UH 3 前瞻性阶段，我们建议在16岁和18岁的儿童进行两次门诊访视时收集数据。这些 访视将包括采集所有ECHO核心要素和生物标本（血液、唾液、尿液）。与这些 数据，我们将制定明确定义的神经发育和肥胖表型，并测试我们的主要 将早期暴露与后期健康结果联系起来的假设。我们假设化学物质的直接影响， 心理社会暴露对我们的表型以及通过非稳态负荷效应介导的暴露 对中枢神经系统的发展和免疫系统的炎症过程。 重要的是，随访FLP样本到青春期后期将提供急需的信息， 这是为了减少高风险、研究不足的农村人口的健康差距。这一后续行动将提供数据 解决有关农村背景和与种族、性别和性别有关的个体差异的关键问题， 地理位置，缓和早期暴露和后来的健康结果之间的关系。FLP将 为ECHO合成队列做出独特而有价值的贡献。纳入FLP将允许 确定与农村卫生结果有机械关系的因素，并作为 预防和干预工作。

Project Summary/ Abstract The inverse association between SES and health is well established. Its underlying causes are not. This application leverages and extends an active prospective longitudinal cohort of children and families in rural poverty to test key hypotheses about the ways in which early psychosocial and chemical exposures (0-5yrs) adversely affect pediatric health outcomes in the areas of neurodevelopment and obesity. We describe an ongoing population-based longitudinal study, the Family Life Project (FLP) with N=1292 children and their primary and when available, secondary caregivers, followed from birth and oversampled for poverty and African American ethnicity in predominantly low-income, non-urban counties in Pennsylvania and in North Carolina. Participants were seen at 8 time points birth to 5 years and at 6 time points 7 to 13 years. A primary focus of data collection and analysis has been the prospective investigation of associations between psychosocial early life stress and neurodevelopment in the areas of executive function, emotion regulation, tolerance for delay, language, school achievement, ADHD and LD. This application builds on and extends our prior data collection retrospectively and prospectively in order to amplify and enhance our focus on adverse exposures in relation to neurodevelopment and obesity risk. In the UG3 retrospective phase we expand our investigation of chemical and neighborhood level exposures when study children were 0 to 5yrs. In the UH3 prospective phase we propose data collection during two clinic visits when children are 16 and 18yrs. These visits will include the collection of all ECHO core elements plus biospecimens (blood, saliva, urine). With these data we will develop clearly defined neurodevelopment and obesity phenotypes and test our primary hypotheses linking early exposures to later health outcomes. We hypothesize direct effects of chemical and psychosocial exposures on our phenotypes as well as mediation of exposures through effects of allostatic load on the development of the central nervous system and the inflammatory processes of the immune system. Importantly, follow-up of the FLP sample into late adolescence will provide much needed information with which to reduce health disparities in high-risk, understudied rural populations. This follow-up will provide data to address key questions about the rural context and individual differences relating to race, gender, and geographic location that moderate relations between early exposures and later health outcomes. The FLP will make a unique and valued contribution to the ECHO synthetic cohort. Inclusion of the FLP will allow for the identification of factors that relate mechanistically to rural health outcomes and that can serve as the focus of prevention and intervention efforts.