Childhood Antecedents of Adult Cardiometabolic health: A Prospective Study of Low-Income Men

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Project Summary/Abstract Cardiovascular disease (CVD) and diabetes are leading causes of death among adults in the US, with incident disease following years of accumulating risk conferred through various metabolic pathways (obesity, dyslipidemia, insulin resistance), immune factors (e.g., systemic inflammation), and rising blood pressure. The pathogenesis of CVD and cardiometabolic health begins in childhood, thus it is imperative to identify factors that contribute to emerging cardiometabolic health disparities. Like other chronic diseases, CVD and diabetes track a socioeconomic gradient, with greater lifelong health risk among individuals born into disadvantaged circumstances. However, no prospective studies have carefully characterized links between early socioeconomic disadvantage and adult health, addressing whether poverty during particular developmental stages is especially harmful and delineating developmentally salient risk factors that may link economic disadvantage to cardiometabolic disease (CMD) risk. Guided by the family stress framework, we propose that family-, school- and community-level factors during critical phases of development are pathways through which socioeconomic disadvantage in childhood shapes cardiometabolic health. We also consider the role of child- based protective factors that might buffer the effects of poverty on adult health outcomes. Finally, we explore how race and SES intersect to shape risk for CMD in adulthood and whether adult health behaviors are pathways through which economic disadvantage gives rise to greater propensity for CMD. The project will assess the cardiovascular health of a diverse sample of 248 adult men (aged 31-33 years) who participated in the Pittsburgh Mother & Child Project (PMCP). The parent project recruited a sample of 310 toddlers from low income families and has followed them closely to early adulthood, permitting a comprehensive assessment of risk and protective factors. We will consider whether these factors relate to biomarkers of cardiometabolic health risk and preclinical markers of CVD – carotid intima media thickness and pulse wave velocity. By testing novel contextual pathways at the family, school, and neighborhood levels this investigation will help to identify contexts that can be targeted by programs and policies aimed at reducing socioeconomic disparities in adult health.