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Background: Exposure to racism and associated adversities, such as poverty, is hypothesized to contribute to racial inequities in health via stress and immune pathways. Furthermore, the effects of adversity may be more salient during sensitive developmental periods. Our study examined racial differences in stress and immune biomarkers during adolescence and the effects of exposure to economic adversity at distinct developmental time periods and cumulatively in accounting for potential racial differences. Methods: Secondary analysis of the Adolescent Health and Development in Context study was conducted. Data were derived from self-administered surveys; interviews; smartphone-based, geographic-explicit ecological momentary assessment; stress biomarkers (evening salivary cortisol over six nights and hair cortisol); and immune biomarkers (salivary shedding of Epstein-Barr virus [EBV] DNA among EBV-positive adolescents). Current socioeconomic status measures included annual household income and caregiver education. Caregivers also reported experiences of bankruptcy, difficulty paying bills, receipt of food stamps/Supplemental Nutrition Assistance Program/electronic benefit transfer, and job loss when the child was of ages birth-5 years, 6-10 years, and 11 years or older. An affirmative response to any item was defined as exposure to economic adversity for that developmental time period (yes/no). A cumulative economic adversity measure was calculated as the sum of exposures across developmental periods (0 = never exposed to 3 = exposed across all time periods). Descriptive and multivariable regression analyses were conducted, accounting for covariates. Results: Black/African American adolescents had higher salivary cortisol concentration, higher hair cortisol concentration, and an increased odd of salivary shedding of EBV DNA compared to White adolescents. Racial differences were not attenuated by the current socioeconomic status or economic adversity (developmental period or cumulatively). Discussion: Our study provides evidence that stress and immune biomarkers differ by race as early as adolescence and may be one pathway through which racism and associated adversities contribute to racial health inequities. Further research on the contribution of multiple adversities beyond poverty to racial inequities in physiological stress and health is critical for informing effective prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Background: Mass incarceration of Black fathers and mothers in the United States has had an undeniably negative effect on the health and well-being of their children, families, and communities. Nearly 1 in every 9 Black youth in the United States has had an incarcerated parent compared to 1 in every 17 White youth. To mitigate the consequences of such historical and structural racism, family and community protective factors that promote health and flourishing in Black youth need exploration. Objectives: The aim of this study was to understand the associations of protective family, school, and neighborhood factors of overall health and flourishing in Black youth ever exposed to parental incarceration. Methods: Using the 2016-2019 National Survey of Children's Health, secondary data analyses were conducted of Black youth ages 6-17 years exposed to parental incarceration (n = 839). Multivariable logistic regression models predicted the associations among protective family and community factors and two child outcomes of interest: overall good health status and flourishing. Overall good health status was measured dichotomously comparing children in "good, very good, or excellent" health to children in "fair or poor" health. Flourishing was measured as a count score using three survey questions designed to assess the child's curiosity and discovery about learning, resilience, and self-regulation. Protective factors of interest included family resilience and connectedness, neighborhood support and safety, and school safety. Other child and caregiver demographics and health characteristics were also included as covariates. Results: Across all models, higher levels of family connectedness were associated with greater odds of having overall good health and flourishing in Black youth exposed to parental incarceration after adjusting for covariates and neighborhood and school protective characteristics. No significant associations were found between neighborhood or school protective factors and either outcome. Discussion: To achieve health equity and maximize opportunities for all youth, we must remove the obstacles and consequences of mass incarceration. Improving the health and flourishing of Black youth who have had incarcerated parents requires greater investment in structural supports to bolster family connectedness and better evidence on how to support families affected by mass incarceration and structural racism. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Background: Despite strong prevention efforts and advances in neonatal care in recent decades, low birth weight remains a serious public health problem in the United States, and survivors remain at increased risk for lifelong problems including cognitive deficits. Current regional and local strategies for referral often rely on variable thresholds for birth weight and gestational age that may be poor analogues to cognitive risk. Improving early referral criteria offers many benefits, including improved cognitive outcomes for children and improved cost-effectiveness and resource utilization in resource-limited communities. Objectives: We hypothesized that social determinants measurable at birth or at birth hospital discharge, when combined with birth weight and gestational age, would offer an improvement over birth weight and gestational age alone in predicting cognitive test scores in school-aged children with low birth weight. Methods: We conducted a secondary analysis using a birth cohort of children from the Fragile Families and Child Wellbeing Study. We created a panel of maternal, familial, and community-level social determinant indicators from the data and examined associations with cognitive measures assessed at age of 9 years. Results: The final social determinant model was statistically significant and explained 35% of the total variance in composite test scores. The "standard care" model (birth weight and gestational age) only explained 9% of the variance. Discussion: Assessment of social determinants may offer improvement over traditional referral criteria to identify children most at risk of cognitive deficits after low birth weight. [ABSTRACT FROM AUTHOR]

Low birth weight is an ongoing public health problem with severe consequences for those affected, including early morbidity and mortality and elevated risk for lifelong deficits in cognitive function. These deficits can be ameliorated by early intervention in many cases. To contribute to criteria for earlier identification of at-risk children prior to the onset of delays or deficits, we examined relationships between three gene candidates— SLC6A4, BDNF, COMT— and cognitive outcomes at school age in a secondary analysis of existing data from a nationally representative cohort. Single nucleotide polymorphism rs4074134, a variant of BDNF, and a rare insertion/deletion in the intron region of SLC6A4 were significant predictors of cognitive performance. Our final model predicted 17% of the variance in composite cognitive test scores among children with low birth weight at school age (F = 96.36, p <.001, R 2 =.17). Specifically, children homozygous for cytosine at rs4074134 scored.62 standard deviations higher on a measure of global cognition than children with one or more thymine. Similarly, children with an extra-long copy number variant of SLC6A4 scored.88 standard deviations higher than children who had one or more short forms of the gene. These findings support the potential for an approach to identifying children with low birth weights who are most at need of early intervention services. Future research should focus on validation of these findings in an independent sample and confirmation of the biological mechanisms through which these genes influence cognitive development. [ABSTRACT FROM AUTHOR]

The effects of place on human health and development have been extensively studied in recent years in the adult and adolescent populations, but minimal research has addressed neighborhood effects in early childhood. This analysis of the National Survey of Children's Health 2011/2012 cross-sectional survey examined relationships between risk for developmental disability in early childhood and neighborhood characteristics in a nationally-representative sample of children ages 0–5 years. Parents reported on their child's development using a well-validated parent report screening tool for developmental problems (the Parent's Evaluation of Developmental Status tool), and neighborhood and family characteristics. Multinomial logistic regression analyses were conducted for each of three neighborhood variables: physical disorder, safety, and isolation. After controlling for parental and child characteristics, the three neighborhood variables were each significantly associated with moderate (but not severe) risk versus low to no risk for developmental disabilities. When all neighborhood characteristics were included simultaneously in the same model, only physical disorder remained statistically significant [OR 1.44 (95% CI 1.09–1.91)], though modestly attenuated. These results suggest that neighborhoods may have effects on early childhood development, after controlling for individual child, parental, and family characteristics. [ABSTRACT FROM AUTHOR]

Objective To examine the associations between parental perceptions of the neighborhood context and adolescent depression including potential gender differences in outcomes. Design and Sample Descriptive correlational study. A total of 32,499 parents of adolescents aged 12-17 years. Measures Descriptive and multivariate logistic and linear regression analyses of the 2007 National Survey of Children's Health. Neighborhood context was operationalized as physical disorder, social isolation, and lack of safety. Two depression outcomes (current depression diagnosis and current depression symptoms) were analyzed. Results Parental perceptions of neighborhood physical disorder were positively associated with adolescent depression diagnosis ( AOR = 1.73, 95% CI = 1.07, 2.80) and an increase in depression symptoms (0.186, p < 0.001). In addition, parental perceptions of neighborhood social isolation (0.061, p < 0.001) and lack of safety (0.037, p < 0.01) were associated with adolescent depression symptoms, and the measures modestly attenuated the relationship between neighborhood physical disorder and adolescent depression symptoms (0.117, p < 0.05). No significant gender differences were found. Conclusions Public health interventions to reduce neighborhood physical disorder, social isolation, and lack of safety should be considered in efforts to promote adolescent mental health. Further research exploring other mechanisms through which neighborhood physical disorder may contribute to adolescent depression also is needed, including potential gender differences. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To examine racial and ethnic disparities in human papillomavirus (HPV) awareness and vaccination among young adult females aged 18-24 years. Design and Sample: Descriptive correlational study. One thousand nineteen women aged 18-24 years who self-identified as Hispanic, non-Hispanic Black, or non-Hispanic White. Measures: Descriptive and multivariate logistic regression analyses using data from the 2007-2008 National Survey of Family Growth. Results: Approximately 90% of non-Hispanic White women, 80% of non-Hispanic Black women, and 56-60% of Hispanic women reported an awareness of HPV infection and vaccination, and yet, vaccine receipt across racial and ethnic groups was 23%, 8%, and 6%, respectively. In multivariate analyses, Hispanic and non-Hispanic Black women were less aware than non-Hispanic White women of HPV infection (OR=0.10, 95% CI=0.05, 0.19; OR=0.23, 95% CI=0.13, 0.40) and vaccination (OR=0.13, 95% CI=0.07, 0.27; OR=0.27, 95% CI=0.14, 0.52) and also less likely to report vaccine receipt (OR=0.44, 95% CI=0.21, 0.90; OR=0.16, 95% CI=0.07, 0.35). Conclusions: Despite moderate to high levels of awareness, HPV vaccination rates were low among this national population of young adult women. Continued surveillance is imperative to monitor vaccine uptake, including racial and ethnic disparities. Further research exploring HPV knowledge and vaccination barriers across diverse cultural groups is needed to inform the development of more effective public health interventions. [ABSTRACT FROM AUTHOR]

Objectives. We examined relationships between neighborhood social disorganization and trichomoniasis among young US adults. Methods. We employed multilevel logistic regression modeling with secondary data from wave III of the National Longitudinal Study of Adolescent Health (2001-2002). The dependent variable-trichomoniasis-was measured via urine testing. The measures for neighborhood social disorganization were derived from the 2000 US Census-racial and ethnic composition, concentrated poverty, and residential instability. The sample comprised 11370 individuals across 4912 neighborhoods. Results. Trichomoniasis was more likely in neighborhoods with higher concentrations of Black residents (adjusted odds ratio [AOR]=1.16; 95% confidence interval [CI]=1.03, 1.30). However, this association was mediated by neighborhood concentrated poverty. Furthermore, young adults who lived in neighborhoods with higher concentrations of poverty were significantly more likely to have trichomoniasis (AOR=1.25; 95% CI=1.07, 1.46). Neither immigrant concentration nor residential instability was significantly associated with trichomoniasis. Conclusions. These findings strengthen the evidence that neighborhood structural conditions are associated with individual sexually transmitted infection (STI) acquisition. Research is needed to explore the mechanisms through which these conditions influence STI. In addition, STI-prevention programs that include structural interventions targeting neighborhood disadvantage are needed. [ABSTRACT FROM AUTHOR]