THE PRENATAL AND CHILDHOOD MECHANISMS OF HEALTH DISPARITIES; INITIAL RECRUITMENT AND RETENTION

产前和儿童期健康差异的机制；

• 批准号: 10936045
• 负责人: Lina Mu
• 金额: $ 141.63万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-07-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10936045
• 关键词: Address; Adherence; African American; Age Months; Area; Beginning of Life; Biological; Birth; Black American; Blood; Child; Child Development; Child Health; Childhood; Chronic Disease; Consent; Data; Data Coordinating Center; Data Security; Development; Diagnostic; Discrimination; Disease; Disparity; Disparity population; Economics; Enrollment; Ethnic Origin; Ethnic Population; Family; Fathers; Generations; Hair; Health; Health behavior; Hispanic; Human Development; Immune; Infant; Intellectual functioning disability; Intervention; Interview; Interviewer; Investigation; Knowledge; Latina; Life; Life Cycle Stages; Life Expectancy; Link; Maternal Health; Measurement; Measures; Mediating; Mental Health; Metabolic; Mission; Modernization; Mothers; National Institute of Child Health and Human Development; Neighborhoods; Neurosecretory Systems; Newborn Infant; Not Hispanic or Latino; Outcome; Parents; Participant; Phenotype; Play; Population; Poverty; Pregnancy; Pregnant Women; Preventive; Protocols documentation; Psychopathology; Questionnaires; Race; Reduce health disparities; Regulation; Research; Role; Sampling; Schedule; Self Administration; Site; Socioeconomic Status; Strategic Planning; Structure; System; Time; Umbilical Cord Blood; United States; Urine; Visit; Woman; Work; design; economic disparity; ethnic disparity; follow-up; health disparity; health outcome disparity; interest; neurobehavioral; outcome disparities; participant enrollment; participant retention; population health; prenatal; prenatal health; psychologic; racial disparity; racial population; recruit; response; sexual minority; social; social disparities; socioeconomic disparity; socioeconomics; transmission process

The Division of Population Health Research (DiPHR) 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 and 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 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 advancing 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. To accomplish this, more in-depth measurement of potential causes of disparities is needed from more diverse samples starting earlier in the life course than is currently available from existing studies. This work needs to measure how various domains of child development are influenced by multiple inputs at the biological, psychological, family, and neighborhood levels, and in which small differences early in child development are compounded over time resulting in large gaps in health later on.

人口健康研究部 (DiPHR) 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，其中一个感兴趣的领域是调查健康差异的发展根源，即社会之间发展结果的差异。在这里，我们指的是社会经济群体和种族/族裔群体之间的不平等健康结果，尽管在其他社会弱势群体中也可能存在差异，包括智力障碍和性少数群体的健康差异。美国的预期寿命和慢性疾病早在产前就已存在，包括贫困和歧视在内的早期生活条件造成了生命过程中的健康差异，并通过父母的代代相传而在人口中进一步根深蒂固。心理健康问题与社会和经济劣势以及儿童发展密切相关，可能在代代相传的差异中发挥关键的中介作用，然而，母亲和父亲的精神病理学尚未被充分视为造成差异的机制，也没有被充分考虑。测量使用表型验证的方法（例如，通过结构化诊断访谈）因此，尽管健康方面的差异已有充分记录，但在生命之初影响差异的发育机制却没有，特别是那些导致早年出现发育缺陷的机制。 NICHD 2020 战略计划强调健康差异是一个影响促进孕产妇健康、出生结果和儿童发展的跨领域问题；它强调“了解社会、经济、结构和发展的贡献；区域因素对于推进预防、诊断和干预工作至关重要”，旨在减少健康差异，增进对造成差异的发育机制的了解，需要更全面地了解社会经济地位和种族/民族如何影响产前健康和儿童的决定因素。为了实现这一目标，需要从生命历程早期开始更深入地测量差异的潜在原因，这项工作需要测量儿童发育的各个领域。受到影响生物、心理、家庭和邻里层面的多重投入，儿童发展早期的微小差异随着时间的推移而加剧，导致后来的健康差距巨大。