Research Review

Childhood Health Disparities Can Have Life-Long Health Effects

Research indicates that physical and mental stress in childhood may have life-long adverse health effects and policy initiatives are needed to emphasize the importance of starting health promotion and disease prevention early in life, according to an article in The Journal of the American Medical Association.

The authors assert that the promotion of health and prevention of disease in adults should begin in the early years of life. “Investigators have postulated that early experience can affect adult health in at least 2 ways—by accumulating damage over time or by the biological embedding of adversities during sensitive developmental periods. In both cases, there can be a lag of many years, even decades, before early adverse experiences are expressed in the form of illness.”

If health damage occurs through a cumulative process, chronic diseases can be seen as the products of repeated encounters with both psychologically and physically stressful experiences. In some cases, the cumulative burden of multiple risk factors early in life may limit the effectiveness of interventions later in life, thereby making it impossible to completely reverse the neurobiological and health consequences of certain risk factors, such as growing up in poverty, they wrote.

A considerable body of research also suggests that adult disease and risk factors for poor health can be embedded biologically during sensitive periods in which the developing brain is more receptive to various environmental signals, whether positive or negative. “Early experiences of child maltreatment and poverty have been associated with heightened immune responses in adulthood that are known risk factors for the development of cardiovascular disease, diabetes, asthma, and chronic lung disease.”

Despite increasing evidence of the long-term effects of early adversity on lifelong health, little attention has been paid to the development of health promotion and disease prevention strategies based on the reduction of significant stressors affecting everyday life for vulnerable young children and their parents.

The authors say areas worth consideration for health promotion and policy include the design and implementation of new approaches for both the prevention and treatment of toxic stress (e.g., extreme poverty, recurrent physical and/or emotional abuse) and its consequences, beginning in the early childhood years; using high-quality early childhood programs to address the stress-related roots of social class disparities in health; and having child welfare services implement health promotion practices.

— Source: American Medical Association