Childhood and Adult Psychosocial Stress and the Association with Disparities in Adult Cardiometabolic Health

Harvard School Of Public Health, Boston MA

Investigators

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Abstract

PROJECT SUMMARY Life-course epidemiology directs attention to the connection between childhood experiences and adult health, and increasing research indicates that many of the most burdensome chronic diseases globally are rooted in childhood. Research shows adults who experience four or more types of adverse childhood experiences (ACEs) (i.e., potentially traumatic events or aspects of a child’s environment that undermine their sense of safety and stability) have roughly twice the odds of obesity and cardiovascular disease — and even greater odds for high-risk health behaviors—relative to adults who did not experience adversity in childhood. This relation is burgeoning and remains under- explored among different age groups, socio-economic status (SES), and race/ethnicities. In addition to ACEs, stressors experienced as an adult have been linked to increased risk of poor health outcomes. Also, SES and non-white race have been associated with higher ACE prevalence as well as increased presence of risk factors for cardiometabolic disease. However, less is known about how cumulative stress (i.e., the combination of adult, acute, and chronic stressors) influences cardiometabolic disease risk over a period of time. The “Integrating Lifecourse Approaches, Biological, and Digital Phenotyping in Support of Heart and Lung Disease Epidemiologic Research” parent grant focuses on strengthening infrastructure necessary to collect data on traditional and emerging risk factors for heart and lung diseases. The goal of the proposed supplemental research is to translate the activities of the parent grant and identify early life risk factors – and their interplay with other psychosocial stressors experienced in adulthood -- in multiple generations for cardiometabolic disease, ultimately supporting work towards reducing these risk factors among high-risk populations. As such, the research aims are as follows: (Aim1) To Investigate racial/ethnic and geographic/demographic predictors of childhood psychosocial stress – and their interactions with socio-economic status (SES) – among adult women; (Aim2) To identify how ACEs combine with adult experiences of stress to predict cardiometabolic disease and examine the extent to which cumulative stress contributes to racial disparities in the risk factors of cardiometabolic disease; and (Aim3) To understand contextual factors that might reduce or exacerbate the association between psychosocial stressors and cardiometabolic outcomes, through smartphone digital phenotyping and the collection and analysis of geospatial datasets. The proposed supplemental research has important public health implications.