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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.07.045 Byline: W. Thomas Boyce (a), Pamela K. Den Besten (b), Juliet Stamperdahl (c), Ling Zhan (b), Yebin Jiang (d), Nancy E. Adler (b), John D. Featherstone (b) Abstract: The studies reported here examines stress-related psychobiological processes that might account for the high, disproportionate rates of dental caries, the most common chronic disease of childhood, among children growing up in low socioeconomic status (SES) families. In two 2004-2006 studies of kindergarten children from varying socioeconomic backgrounds in the San Francisco Bay Area of California (Ns = 94 and 38), we performed detailed dental examinations to count decayed, missing or filled dental surfaces and microtomography to assess the thickness and density of microanatomic dental compartments in exfoliated, deciduous teeth (i.e., the shed, primary dentition). Cross-sectional, multivariate associations were examined between these measures and SES-related risk factors, including household education, financial stressors, basal and reactive salivary cortisol secretion, and the number of oral cariogenic bacteria. We hypothesized that family stressors and stress-related changes in oral biology might explain, fully or in part, the known socioeconomic disparities in dental health. We found that nearly half of the five-year-old children studied had dental caries. Low SES, higher basal salivary cortisol secretion, and larger numbers of cariogenic bacteria were each significantly and independently associated with caries, and higher salivary cortisol reactivity was associated with thinner, softer enamel surfaces in exfoliated teeth. The highest rates of dental pathology were found among children with the combination of elevated salivary cortisol expression and high counts of cariogenic bacteria. The socioeconomic partitioning of childhood dental caries may thus involve social and psychobiological pathways through which lower SES is associated with higher numbers of cariogenic bacteria and higher levels of stress-associated salivary cortisol. This convergence of psychosocial, infectious and stress-related biological processes appears to be implicated in the production of greater cariogenic bacterial growth and in the conferral of an increased physical vulnerability of the developing dentition. Author Affiliation: (a) University of British Columbia, Vancouver, BC, Canada (b) University of California, San Francisco, USA (c) University of California, Berkeley, USA (d) University of Michigan, USA

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.12.006 Byline: Patrick West (a), Helen Sweeting (a), Robert Young (a), Shona Kelly (b) Abstract: This paper examines the relative importance of family socioeconomic status (SES) and school-based peer hierarchies for young people's psychoneuroendocrine response, represented by cortisol level. Data are drawn from a study of 2824, 15-year-olds in 22 Scottish secondary schools in 2006 who provided information on family SES (parental occupation, material deprivation and family affluence) and social position in school hierarchies, together with two morning salivary cortisol samples. School social position was assessed by participants placing themselves on seven 'ladders', from which three factors were derived, termed scholastic, peer and sports hierarchies. Controlling for confounds, there was little or no variation in cortisol by any SES measure. By contrast, each school hierarchy was independently associated with cortisol, but in different ways. For the scholastic hierarchy, an inverse linear relationship was found for females, cortisol increasing with lower position. For peer hierarchy, an opposite (direct) linear relationship occurred for males, while for females elevated cortisol was associated only with 'top' position. For sports, elevated cortisol among males was associated with 'bottom' position, among females with all except the 'top'. These results are interpreted in the context of Sapolsky's () predictions for stress responses to hierarchical position in stable and unstable social systems, the former represented by the scholastic hierarchy involving elevated cortisol in lower positions, the latter by peer hierarchy with elevated cortisol in higher positions. Overall, the results highlight the greater importance of school-based peer groups than family SES for young people's psychoneuroendocrine response. Author Affiliation: (a) MRC Social & Public Health Sciences Unit, 4, Lilybank Gardens, Glasgow G12 8RZ, UK (b) Centre for Intergenerational Health Research, University of South Australia, Division of Health Sciences, Social Epidemiology Unit, P4-18, City East Campus, North Terrace, Adelaide, SA 5001, Australia