RHODE ISLAND CHILDREN'S EQUITY AND DEVELOPMENT STUDY (ENRICHED) - PHASES 1 AND 2

完成第一阶段的评估和第二阶段的征聘和评估 尤尼斯·肯尼迪·施莱弗国家儿童健康和人类发展研究所人口健康研究部开展以儿童健康和人类发展为重点的研究。作为DiPHR使命的一部分，一个令人感兴趣的领域是调查健康差距的发展根源--即社会优势群体和弱势群体之间发展成果的差异。在这里，我们指的是社会经济和种族/族裔群体之间不平等的健康结果，尽管在包括智力残疾和性少数地位在内的其他社会不利地位的背景下也可能存在差异。 美国的健康差距--预期寿命和慢性病--早在产前就有了根源。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。父母的心理健康问题与社会和经济劣势以及儿童发展密切相关，可能在代际传播差距方面发挥关键的中介作用。然而，母亲和父亲的精神病理并没有被完全视为造成差异的机制，也没有使用表型验证的方法(例如，通过结构化的诊断性访谈)来衡量。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。NICHD 2020战略计划强调健康差距是一个影响产妇健康、生育结果和儿童发展的跨领域问题；它强调“了解社会、经济、结构和区域因素的贡献对于推进预防、诊断和干预工作至关重要”，旨在缓解健康差距。 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地位和种族/族裔如何影响孕期健康和儿童发育的决定因素。

Completion of Assessments for Phase 1 and Recruitment and Assessments for Phase 2 The Division of Population Health Research (DiPHR) at the Eunice Kennedy Shriver National Institute of Child Health and Human Development conducts studies focusing on child health and human development. As part of DiPHR's mission, one area of interest is the investigation of the developmental origins of health disparities - i.e., differences in developmental outcomes between socially advantaged and disadvantaged groups. Here, we refer to unequal health outcomes between socioeconomic and race/ethnic groups, although disparities may also exist in the context of other socially disadvantaged statuses including intellectual disability and sexual minority status. Health disparities in the United States - in life expectancy and chronic disease - 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 problems, which are strongly linked with social and economic disadvantage as well as child development, may play a key mediating role in the transmission of disparities across generations. However, maternal and paternal psychopathology have not been fully considered as mechanisms contributing to disparities nor have been measured using phenotypically validated approaches (e.g. through structured diagnostic interviews). 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 NICHD 2020 strategic plan highlights health disparities as a cross-cutting problem impacting the advancement of maternal health, birth outcomes, and child development; it emphasizes that “understanding the contribution of social, economic, structural, and regional factors is vital to advancing preventive, diagnostic, and intervention efforts” designed to mitigate health disparities. Advancing knowledge of the developmental mechanisms that generate disparities requires a more thorough understanding of how socioeconomic status and race/ethnicity influence the determinants of prenatal health and child development from gestation onward.