Multiple Risk Factors and Neurodevelopment Deficits in Rural Appalachian Children

描述(申请人提供)：尽管农村儿童之间的健康差距被广泛记录在案，但阿巴拉契亚地区的美国农村儿童背负着不必要的心理、社会经济和环境因素的负担，这些因素是造成这些健康差距的原因。阿巴拉契亚社区儿童的父母报告说，与国家父母报告相比，他们的儿童中行为问题的患病率更高。此外，阿巴拉契亚社区暴露在已知会导致神经发育障碍的环境毒物中。心理、社会和环境对儿童神经发育的影响之间的关系尚不清楚。因此，我们假设暴露在空气中的神经毒物与神经行为缺陷有关，包括在服务不足的阿巴拉契亚美国儿科人群中的认知、注意力、记忆和神经运动功能的测量，并且这种联系被社会经济条件、养育环境和其他因素改变。为了验证这一假设，将实现以下具体目标：具体目标1：评估儿童环境暴露发生的总体背景，包括社会经济、家庭、营养和其他因素，以检查农村贫困社区环境健康的动态过程。具体目标2：使用一系列经过充分验证的评估，确定暴露在空气中的神经毒物是否会增加儿童神经发育缺陷的风险。我们的项目是一个新颖的、以社区为基础的参与性研究项目，将首次使用敏感的生物学和生物学方法评估据信影响阿巴拉契亚儿童健康的多种风险因素。 行为标记物。最终，该项目将为阿巴拉契亚地区缺乏服务的农村美国人确定有针对性的公共卫生干预的关键多重风险暴露。鉴于儿童对神经毒物暴露和心理社会因素的独特易感性，我们预计这项研究的结果将对社区、国家政策和监管变化产生重大影响，并对解决阿巴拉契亚美国人的健康差距产生广泛影响。

DESCRIPTION (provided by applicant): Although health disparities among rural children are widely documented, rural Appalachian American children bear an undue burden of psychological, socioeconomic, and environmental factors known to attribute to these health disparities. Parents of children in Appalachian communities report a greater prevalence of behavioral problems in their children of as compared to national parental reports. Moreover, Appalachian communities are exposed to environmental toxicants known to cause deficits in neurodevelopment. The relationship among psychosocial and environmental influences on children's neurodevelopment remains unclear. Thus, we hypothesize that exposure to airborne neurotoxicants are associated with neurobehavioral deficits including measures of cognition, attention, memory, neuromotor function in an underserved Appalachian American pediatric population and this association is modified by socioeconomic conditions, rearing environment, and other factors. In order to test the hypothesis, the following specific aims will be accomplished: Specific Aim 1: Assess the overall context in which childhood environmental exposure occurs, including socioeconomic, familial, nutrition, and other factors, in order to examine the dynamic process of environmental health in rural underserved communities. Specific Aim 2: Determine if children exposed to airborne neurotoxicants are at increased risk for deficits in neurodevelopment using a battery of well-validated assessments. Our project is a novel, community-based participatory research project that will for the first time evaluate multiple risk factors believed to influence Appalachian child health using sensitive biological and behavioral markers. Ultimately, this project will lead to the identification of the key multiple rik exposures for targeted public health interventions for rural, underserved Appalachian Americans. Given the unique susceptibility of children to neurotoxicant exposure in combination with psychosocial factors, we anticipate the results of this study to have a major impact on the community, national policy, and regulatory changes and broad implications for addressing health disparities in Appalachian Americans.