ASSESSING THE EVOLVING IMPACT OF EARLY LIFE EXPOSURES ON CHILD PHYSICAL HEALTH AND NEURODEVELOPMENT

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PROJECT SUMMARY / DESCRIPTION How does a healthy child grow? Asked by every parent, the simplicity of this question masks the complex nature of child development and makes light of the diverse environmental factors and variables that shape a child’s emerging physical health and neurodevelopment. Beginning at conception and accelerating throughout childhood and adolescence, our unique environmental exposures and social experiences shape our behaviors, impact our health, and influence our developing cognitive skills and abilities. Far from being distinct entities, aspects of physical health and neurodevelopment evolve dynamically together in a bi-directional feedback cycle that promotes healthy or rapidly worsening outcomes. At every stage of this cycle, factors that affect the child (e.g., sleep, chemical exposures, discrimination), their family (e.g., family sociodemographic characteristics), and their neighborhood (e.g., neighborhood safety, school quality) can improve health or accelerate decline. Over the past two years, the COVID-19 pandemic has ushered in widespread disruptions to almost every aspect of a child and family’s life, with disproportionate impacts on lower-income, and racial and ethnic minority families. Differences in public health responses across the ECHO Cohort offer an important opportunity to understand how these multi-level factors, including social determinants of health (SDoH), have moderated child physical health and neurodevelopment. Leveraging the ECHO Cohort and taking a team science approach, this proposal aims to understand the dynamic relationships that link child neurodevelopment and two pressing public health challenges: pediatric asthma and obesity; and the influence of specific multi-level moderators (chemical exposures, child sleep, physical activity, and key SDoH factors). We will examine: 1. How child neurodevelopment and physical health outcomes, specifically asthma, and obesity are shaped by chemical, biological, and social environmental exposures; 2. How physical health and neurodevelopment co-develop and reinforce each other throughout childhood; 3. How lived experiences across the child, family, and neighborhood contexts, including SDoH, moderate neurodevelopmental outcomes; and 4. How these relationships have been changed by the COVID-19 pandemic and varied across racial, ethnic, and socioeconomic dimensions. Through a comprehensive Plan for Enhancing Diverse Perspectives (PEDP), we take an intentional approach to include the social, psychosocial, and economic inequalities, constraints, and behavioral norms that underlie disparities in neurodevelopment and child physical health outcomes. With core tenets of access and inclusion, we will re- enroll our Cohort Study Site (RESONANCE) comprising >1650 well-characterized family-child dyads from diverse sociodemographic backgrounds across Rhode Island. Using novel remote data collection and mobile labs, we will address traditional barriers to research participation and access while ensuring adherence and high data quality across all core elements and biospecimens. Outcomes from our solutions-oriented research will have a direct and meaningful impact on health interventions and public policy guidance.