DATA COORDINATING CENTER FOR THE PRENATAL AND CHILDHOOD MECHANISMS OF HEALTH DISPARITIES: FOLLOW-UP OF THE FIRST SUBCOHORT AND INITIATION OF RECRUITMENT OF THE SECOND SUBCOHORT OF PREGNANT WOMEN

美国的健康差距早在产前就有了根源。早期生活条件，包括贫穷和歧视，在整个生命过程中造成健康方面的差异，这种差异通过代代相传而进一步加深。 父母的心理健康，这是密切相关的社会和经济的劣势，以及儿童的发展，可能会发挥关键的中介作用，在跨代的差异传输，但在差异文献中的一个持续的差距是，母亲和父亲的精神病理学没有被充分考虑的机制，也没有使用表型验证的方法进行测量。 因此，尽管健康方面的差异有充分的文献记载，但在生命之初影响差异的发育机制却没有，特别是那些导致发育缺陷的机制，这些缺陷早在疾病状态之前就出现了。美国国立卫生研究院（NIH）的战略计划（2016-2020）强调了研究的必要性，以改善“理解导致种族/民族和社会经济地位差异的机制”。需要加强这种了解，以澄清差异的根源，特别是与影响早期发展的社会或经济不利条件有关的具体风险。 要深入了解产生差异的发展机制，就需要更彻底地了解社会经济和种族/民族地位如何影响从孕育开始的发展决定因素。为了做到这一点，需要从更多样化的样本开始， 在生命过程的早期，需要比目前现有的研究。

Health disparities in the United States have their origins as early as the prenatal period. Early life conditions including poverty and discrimination generate disparities in health over the life course that become further entrenched in the population through their transmission across generations. Parental mental health, which is strongly linked with social and economic disadvantage as well as child development, may play a key mediating role in the transmission of disparities across generation, but a persistent gap in the disparities literature is that both maternal and paternal psychopathology have not been fully considered as mechanisms nor measured using phenotypically validated approaches. As a result, though disparities in health are well documented, the developmental mechanisms that impact disparities at the very beginning of life are not, particularly those which lead to developmental deficits that emerge long before disease states. The National Institutes of Health (NIH) strategic plan (2016-2020) highlights the need for research to improve “understanding mechanisms that lead to disparities by race/ethnicity and socioeconomic status.” Such enhanced understanding is needed to clarify the etiology of disparities – particularly the specific exposures linked with social or economic disadvantage that impact early development. Advancing knowledge of the developmental mechanisms that generate disparities requires a more thorough understanding of how socioeconomic and race/ethnic status influence the determinants of development from gestation onward. To accomplish this, more in-depth measurement of potential causes of disparities is needed from more diverse samples starting earlier in the life course are needed than is currently available from existing studies.