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

项目摘要/摘要 SES和健康之间的反向关联已经得到了很好的证实。其根本原因并非如此。这 应用程序利用并扩展了农村儿童和家庭的积极预期纵向队列 贫困，以测试关于早期心理社会和化学暴露(0-5岁)方式的关键假设 在神经发育和肥胖领域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名儿童和他们的 初级照料者和次级照料者(如果有)，出生后跟踪，并因贫困而过度抽样 宾夕法尼亚州和北部以低收入为主的非城市县的非洲裔美国人 卡罗莱纳。参与者被观察到出生到5岁的8个时间点和7到13岁的6个时间点。一个主要的 数据收集和分析的重点一直是前瞻性调查 心理社会早期生活压力和神经发育在执行功能、情绪调节、 容忍延迟、语言、学业成绩、多动症和学习障碍。此应用程序构建在我们的 回顾和前瞻性地收集以前的数据，以扩大和加强我们对不利因素的关注 暴露与神经发育和肥胖风险有关。在UG3回顾阶段，我们扩展了我们的 研究儿童0-5岁时化学物质和邻里水平暴露的调查。在UH3 前瞻性阶段，我们建议在16岁和18岁儿童的两次门诊中收集数据。这些 访问将包括收集所有ECHO核心元素以及生物标本(血液、唾液、尿液)。有了这些 我们将开发明确定义的神经发育和肥胖表型，并测试我们的初级 将早期暴露与后来的健康结果联系起来的假说。我们假设化学和化学物质的直接影响 心理社会暴露对我们表型的影响以及通过恒定负荷效应对暴露的调节 关于中枢神经系统的发育和免疫系统的炎症过程。 重要的是，对FLP样本的追踪到青春期晚期将提供急需的信息 以减少高危、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人差异的关键问题 地理位置，在早期暴露和后来的健康结果之间的关系是协调的。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联系并可作为重点的因素 预防和干预努力。

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.