Effects of Neighborhood Environment on Child Behavioral Health

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ABSTRACT. Healthy child development is essential to long-term wellness because it enables human capacity to participate in economic, social, and civic life; however, not all children experience healthy development. Many children are affected by social determinants of health (SDOH) including structural inequities resulting from their neighborhood environment. Neighborhood environment, a powerful SDOH, profoundly shapes children's physical, mental, and emotional health, and influences opportunities for children to achieve long-term health. Parents who reside in poorer neighborhoods also tend to experience ineffective coping, parenting challenges, and suboptimal family cohesion, which may influence behavioral dysregulation and academic performance in early childhood. Behavioral dysregulation – an impairment in ability to self-regulate behaviors characterized by reflexive, automatic, and emotional reaction of acting out – is associated with the development of common childhood psychopathologies. In addition, behavioral dysregulation is associated with poor academic performance, another important indicator of long-term child health. Studying these outcomes in early childhood provides windows of opportunity to find solutions to promote life-long health and close the gap on health disparities later in life. Parenting behavior and family cohesion (positive relationships between family members and the level of closeness, emotional bonding, and support) are modifiable indicators of family relationships that can be targeted to mitigate the effect of neighborhood environment on child behavioral dysregulation. In this NRSA F31 proposal, using rich publicly available data from the Environmental Influences on Child Health Outcomes (ECHO) Program, I will adopt the Creating Nurturing Environments framework to address the following specific aims: 1) Identify the effect of neighborhood environment on behavioral dysregulation and academic performance in early childhood (1-6 years); 2) Determine the degree to which family relationships mediate the effect of neighborhood environment on behavioral dysregulation and academic performance. The accompanying career development plan will build the foundation for me to a) Build expertise in child development with emphasis on behavioral health and academic performance; b) Build expertise in neighborhood environment and its effect on child health; c) Advance skills in quantitative research methods for data analysis such as structural equation modeling; d) Gain experience in team science skills and accomplish professional development goals. I have a strong mentorship team who are influential in their respective fields with robust NIH-funding and publications, dedicated to my growth and development throughout this F31 award and my career. The career development and research plan will guide me to achieve my ultimate career goal of becoming an independent nurse scientist who advances the science in addressing SDOH and promoting child health. This proposal aligns with the new NINR Strategic Plan with its focus to understand SDOH to promote health equity in neighborhoods with shared characteristics of strengths and vulnerabilities.