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胎儿期就有了。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差距，并通过代代相传在人口中变得更加根深蒂固。 父母的心理健康与社会和经济劣势以及儿童发展密切相关，可能在代际传播差异方面发挥关键的中介作用，但差异文献中持续存在的差距是，母亲和父亲的精神病理都没有被充分考虑为机制，也没有使用表型验证的方法进行衡量。 因此，尽管健康方面的差异得到了很好的记录，但在生命之初影响差异的发展机制却没有，特别是那些导致发育缺陷的机制，这些缺陷在疾病出现之前很久就出现了。美国国立卫生研究院(NIH)的战略计划(2016-2020年)强调了研究的必要性，以改进“了解导致种族/民族和社会经济地位差异的机制”。需要这种加强了解，以澄清差异的原因--特别是与影响早期发展的社会或经济劣势有关的具体风险。 要增进对造成差异的发展机制的了解，就必须更彻底地了解社会经济和种族/族裔状况如何从孕育开始影响发展的决定因素。要做到这一点，需要从更多样化的样本开始，对差异的潜在原因进行更深入的测量 在生命过程的早期需要的是比目前现有研究所能获得的。

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.