Social Inequality and Children's Mental Health

社会不平等与儿童心理健康

• 批准号: 7911834
• 负责人: AVSHALOM CASPI
• 金额: $ 12.21万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7911834
• 关键词: 12 year old; 2 year old; Academy; Accounting; Achievement; Address; Adolescent; Adopted; Adult; Adverse effects; Affect; Age; Agriculture; Alcohol or Other Drugs use; American; Anxiety; Area; Attention; Behavioral; Biological; Biological Markers; Biological Testing; Birth; Buffers; Characteristics; Charities; Child; Child Abuse and Neglect; Child Development; Child Mental Health; Child health care; Childhood; Cognitive; Collaborations; Collection; Communities; Conduct Disorder; Country; Data; Data Analyses; Data Collection; Data Set; Developed Countries; Development; Disease; Disease Attributes; Domestic Violence; Ecology; Economic Conditions; Economic Inflation; Emotional; England; Environment; Environmental Exposure; Environmental Risk Factor; Epidemiology; Evaluation; Event; Exposure to; Family; Family Process; Family Violence; Fetal Development; Food; Future; Genetic; Goals; Health; Health Status; Home environment; Home visitation; House Call; Income; Individual; Inequality; Inflammation; Inflammatory; International; Intervention; Joints; Lead; Life; Life Cycle Stages; Life Experience; Life Stress; Link; Location; Longitudinal Studies; Low income; Measures; Mediating; Mental Depression; Mental Health; Mental disorders; Methods; Molecular Genetics; Monitor; Neighborhoods; Nutritional; Outcome; Parents; Participant; Pediatrics; Perception; Play; Population; Positioning Attribute; Poverty; Prevention; Preventive; Process; Property; Psyche structure; Public Health; Questionnaires; Records; Registries; Relative (related person); Reporting; Research; Resources; Risk; Risk Factors; Role; Sampling; Science; Scientist; Series; Shapes; Siblings; Signal Transduction; Skin; Social Conditions; Social Mobility; Social status; Socioeconomic Status; Source; Stratification; Stress; Structure; Substance Use Disorder; Surveys; Symptoms; System; Testing; Time; Trust; Twin Multiple Birth; Twin Studies; United Nations; Variant; Victimization; Violence; Visit; Wales; Work; adolescent substance use; base; burden of illness; child poverty; cost effective; deprivation; design; early adolescence; early onset substance use; empowered; experience; family influence; family structure; grasp; health inequalities; innovation; longitudinal design; meetings; novel; physical conditioning; preference; prevent; psychosocial; public health relevance; social; social inequality; socioeconomics; statistics; theories

DESCRIPTION (provided by applicant): The social gradient in children's mental health is well documented. What is less clear is how social inequalities influence children's development. We propose to examine this question at three levels of analysis. At the neighborhood level, we will assess ecometric properties of the local areas in which children reside and test whether neighborhood-level social processes, such as collective efficacy, mediate the effects of neighborhood poverty on children's mental health. At the family level, we will trace the effects of socioeconomic deprivation on proximal family processes (exposure to violence, food insecurity) and test how stressful early life events may become biologically embedded. At the individual level, we will use a genetically-informative longitudinal design to test the hypothesis that children's perceptions of their social position can help to explain why some children growing up in poverty do versus do not develop health problems. METHOD: We will conduct this research using data from the Environmental Risk (E-Risk) Study. E-Risk is a longitudinal study (from birth to age 12) of a nationally-representative sample of twins born in England and Wales in 1994-1995 (N=2232), selected from a registry created with the UK Office of National Statistics (ONS). We have tracked the children over the first 12 years of their lives, monitoring their development and their environmental exposures, including multiple forms of social inequality. We have gathered data about the children and their families at 6 time points (birth, ages 2, 5, 7, 10, and 12 years). We have also conducted two independent ecometric assessments of the neighborhoods in which the children are growing up, enabling us to study inequalities in children's lives at both the community and family level. INNOVATION AND SIGNIFICANCE: The proposed research has implications both for understanding and reducing health inequalities. At each level of analysis, we adopt a process approach to test how social inequalities influence children's development. At the neighborhood level, we will identify malleable factors for community-level interventions which may be more cost effective and pragmatic than individual-level interventions. At the family level, we will test the direct and indirect contributions of family socio-economic conditions to children's development and identify specific intervention targets for reducing social inequalities in children's mental health. At the individual level, if we discover environmentally-mediated effects between children's subjective social status and their health, the implications would point to children's perceptions of social status as malleable intervention targets and open up a realm of intervention possibilities for empowering children. PUBLIC HEALTH RELEVANCE: About half of the population variation in children's mental health problems is accounted for by environmental factors, and social inequalities stand out as the most prominent determinants of health in the first decade of life. However, the hope of preventing early- emerging mental health problems requires research to identify the underlying mechanisms by which inequalities affect health. Our proposed research tests how social inequalities affect children's health, aiming to identify malleable intervention targets at the community, family, and individual levels.

描述（由申请人提供）：儿童心理健康的社会梯度有据可查。不太清楚的是，社会不平等如何影响儿童的发展。我们建议在三个分析层次上研究这个问题。在邻里层面，我们将评估当地儿童居住的生态计量属性，并测试邻里层面的社会过程，如集体效能，介导邻里贫困对儿童心理健康的影响。在家庭层面，我们将追踪社会经济剥夺对近端家庭过程（暴露于暴力，粮食不安全）的影响，并测试压力的早期生活事件如何可能成为生物嵌入。在个人层面上，我们将使用一个遗传信息的纵向设计来测试的假设，儿童的看法，他们的社会地位，可以帮助解释为什么有些孩子在贫困中长大，与不发展健康问题。方法：我们将使用环境风险（E风险）研究的数据进行这项研究。E-Risk是一项纵向研究（从出生到12岁），研究对象是1994-1995年在英格兰和威尔士出生的具有全国代表性的双胞胎样本（N=2232），选自英国国家统计局（ONS）创建的登记处。我们在孩子们生命的头12年里跟踪他们，监测他们的发展和环境暴露，包括多种形式的社会不平等。我们收集了6个时间点（出生、2岁、5岁、7岁、10岁和12岁）的儿童及其家庭的数据。我们还对儿童成长的社区进行了两次独立的生态计量评估，使我们能够在社区和家庭层面研究儿童生活中的不平等。创新和意义：拟议的研究对理解和减少健康不平等都有意义。在每一层次的分析中，我们采用过程方法来测试社会不平等如何影响儿童的发展。在社区层面，我们将确定社区层面干预的可塑性因素，这可能比个人层面的干预更具成本效益和实用性。在家庭层面，我们将测试家庭社会经济条件对儿童发展的直接和间接贡献，并确定具体的干预目标，以减少儿童心理健康方面的社会不平等。在个人层面上，如果我们发现儿童的主观社会地位和他们的健康之间的环境介导的影响，其影响将指向儿童的社会地位的可塑性干预目标的看法，并开辟了一个领域的干预可能性，赋予儿童。公共卫生关系：儿童心理健康问题的人口差异约有一半是由环境因素造成的，社会不平等是生命头十年健康的最突出决定因素。但是，预防早期出现的心理健康问题的希望需要进行研究，以确定不平等影响健康的潜在机制。我们提出的研究测试社会不平等如何影响儿童的健康，旨在确定在社区，家庭和个人层面的可塑性干预目标。