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Adolescents / Chronic Illnesses / Publications / Socioeconomic Status — No Comments
15
Sep 15

Resilience in low socioeconomic status children with asthma: adaptations to stress

Background: Low socioeconomic status (SES) is a strong predictor of many health problems, including asthma impairment; however, little is understood about why some patients defy this trend by exhibiting good asthma control despite living in adverse environments. Objective: This study sought to test whether a psychological characteristic, the shift-and-persist strategy (dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future), protects low-SES children with asthma. Methods: One hundred twenty-one children aged 9 to 18 years with a physician’s diagnosis of asthma were recruited from medical practices and community advertisements (mean age, 12.6 years; 67% male; 61% white). Shift-and-persist scores and asthma inflammation (eosinophil counts and stimulated IL-4 cytokine production) were assessed at baseline, and asthma impairment (daily diary measures of rescue inhaler use and school absences) and daily peak flow were monitored at baseline and at a 6-month follow-up. Results: Children who came from low-SES backgrounds but who engaged in shift-and-persist strategies displayed less asthma inflammation at baseline (β = 0.19, P < .05), as well as less asthma impairment (reduced rescue inhaler use and fewer school absences; β = 0.32, P < .01) prospectively at the 6-month follow-up period. In contrast, shift-and-persist strategies were not beneficial among high-SES children with asthma. Conclusion: An approach that focuses on the psychological qualities that low-SES children develop to adapt to stressors might represent a practical and effective starting point for reducing health disparities. Moreover, the approaches that are effective in low-SES communities might be different from those that are optimal in a high-SES context.

CITATION: Chen, E., Strunk, R. C., Threthewey, A., Schreier, H. M. C., Maharaj, N., & Miller, G. E. (2011). Resilience in low socioeconomic status children with asthma: adaptations to stress. Journal of Asthma and Clinical Immunology, 128(5), 970-976.

Adolescents / Chronic Illnesses / Publications / Socioeconomic Status — No Comments
15
Sep 15

Socioeconomic status in one’s childhood predicts offspring cardiovascular risk

Objective: To test whether effects of socioeconomic environments can persist across generations, we examined whether parents’ childhood socioeconomic status (SES) could predict blood pressure (BP) trajectories in their youth across a 12-month study period and C-reactive protein (CRP) levels at one year follow-up. Methods: BP was assessed in 88 healthy youth (M age = 13 ± 2.4) at three study visits, each 6 months apart. CRP was also assessed in youth at baseline and one year follow-up. Parents reported on current and their own childhood SES (education and crowding). Results: If parents’ childhood SES was lower, their children displayed increasing SBP and CRP over the 12-month period, or conversely, the higher parents’ childhood SES, the greater the decrease in SBP and CRP in their youth over time. These effects persisted even after controlling for current SES. A number of other factors, including child health behaviors, parent psychosocial characteristics, general family functioning, and parent physiology could not explain these effects. Conclusion: Our study suggests that the SES environment parents grow up in may influence physical health across generations, here, SBP and CRP in their children, and hence that intergenerational histories are important to consider in predicting cardiovascular health in youth.

CITATION: Schreier, H. M. C. & Chen, E. (2010). Socioeconomic status in one’s childhood predicts offspring cardiovascular risk. Brain, Behavior, & Immunity, 24, 1324-1331.

Adolescents / Family Influences / Inflammation / Publications / Socioeconomic Status — 1 Comment
09
Sep 15

Family chaos and adolescent inflammatory profiles: the moderating role of socioeconomic status

Objective: To test whether family chaos influences adolescents’ inflammatory profiles and whether adolescents from low socio- economic status (SES) environments are at higher risk for experiencing adverse inflammatory profiles from living in chaotic family environments. Methods: A total of 244 families with an adolescent aged 13 to 16 years participated. Parents completed measures of family SES and family chaos. Both systemic inflammation and stimulated proinflammatory cytokine production in response to bacterial challenge were assessed in adolescents. Results: Our results suggest that SES moderates the detrimental effect of family chaos on systemic inflammation and interleukin-6 (B = -0.010, standard error [SE] = 0.004, p = .026), but not C-reactive protein (B = 0.009, SE = 0.006, p = .11), and on stimulated proinflammatory cytokine production (B = -0.098, SE = 0.044, p = .026) in adolescents, such that a chaotic family environment is positively associated with greater systemic inflammation and greater stimulated proinflammatory cytokine production in adolescents as family SES declines. Conclusions: These findings indicate that living in chaotic family environments places youth who may be vulnerable based on socioeconomic factors at a potentially higher risk for inflammation-related diseases. Key words: inflammation, family chaos, adolescents, socioeconomic status.

CITATION: Schreier, H. M. C., Roy, L. B., Frimer, L., & Chen, E. (2014). Family chaos and adolescent inflammatory profiles: the moderating role of socioeconomic status. Psychosomatic Medicine, 76(6), 460-467.

Chronic Illnesses / Publications / Socioeconomic Status — No Comments
09
Sep 15

Socioeconomic status and the health of youth: A multi-level, multi-domain approach to conceptualizing pathways

Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on 2 prevalent chronic health problems in youth today, asthma and obesity. We review and propose a model that encompasses (a) multiple levels of influence, including the neighborhood, family and person level; (b) both social and physical domains in the environment; and finally (c) dynamic relationships between these factors. A synthesis of existing research and our proposed model draw attention to the notion of adverse physical and social exposures in youth’s neighborhood environments altering family characteristics and youth psychosocial and behavioral profiles, thereby increasing youth’s risk for health problems. We also note the importance of acknowledging reciprocal influences across levels and domains (e.g., between family and child) that create self-perpetuating patterns of influence that further accentuate the impact of these factors on youth health. Finally, we document that factors across levels can interact (e.g., environmental pollution levels with child stress) to create unique, synergistic effects on youth health. Our model stresses the importance of evaluating influences on youth’s physical health not in isolation but in the context of the broader social and physical environments in which youth live. Understanding the complex relationships between the factors that link low SES to youth’s long-term health trajectories is necessary for the creation and implementation of successful interventions and policies to ultimately reduce health disparities.

CITATION: Schreier, H. M. C. & Chen, E. (2013). Socioeconomic status and the health of youth: A multi-level, multi-domain approach to conceptualizing pathways. Psychological Bulletin, 139(3), 606-654.

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