Early origins of health disparities: Burden of infection, health, and socioeconomic status in U.S. children

Abstract

Recent work in biodemography has suggested that life-time exposure to infection and inflammation may be important determinants of later-life morbidity and mortality. Early exposure to infections during critical periods can predispose individuals to chronic disease, in part through the reallocation of energy away from development needed for immune and inflammatory responses. Furthermore, markers of inflammation are known to vary by socioeconomic status in adults and may contribute to overall socioeconomic health inequalities, but little is known about how the sources of this inflammation over the life course. This paper uses novel biomarker data from the Third National Health and Nutrition Examination Survey (NHANES III) to test the association of the burden of common chronic infections (Helicobacter pylori (H. pylori), cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), hepatitis A and hepatitis B) with height-for-age and asthma/chronic respiratory conditions in U.S. children ages 6 and older, and the association of these chronic infections to children’s socioeconomic status. A higher burden of infection is found to be associated with lower height-for-age as well as an increased likelihood of asthma net of race/ethnicity, family income, and parental education. Children with lower family income, lower parental education, and non-white race/ethnicity have a higher likelihood of infection with several individual pathogens as well as the overall burden of infection. Differential exposure and/or susceptibility to infections may be one mechanism through which early social factors get embodied and shape later life health outcomes.

Early childhood poverty, immune-mediated disease processes, and adult productivity

“…Such sustained capacity for work may, in turn, be related to the presence or absence of chronic health conditions, which impair the physical and mental abilities required to achieve and maintain gainful employment. Commonalities among many of these prevalent, chronic conditions, such as hypertension and arthritis, include their propensities to disrupt activities of daily living (ADLs), their known linkages to socioeconomic status in both childhood and adult life (2,3), and their plausible partial mediation by neuroimmunological processes (4)(5)(6)(7). Whether immune-mediated chronic diseases play a role in associations between early socioeconomic conditions and adult productivity is, therefore, an important and understudied question (8).…”

Social stratification, classroom climate, and the behavioral adaptation of kindergarten children

“…These differences exert powerful constraints on human health, well being, and development, rendering SES the single most potent determinant of health within human populations (21,22). Beginning even early in life, disadvantaged, subordinate groups bear disproportionate burdens of disease and disorder, with poorer children sustaining higher rates of low birth weight (23), traumatic injury (24), infectious diseases (25), dental caries (26), psychiatric and developmental-behavioral disorders (27), and poor academic performance (28). Growing evidence suggests, moreover, that childhood exposures to socioeconomic inequalities establish enduring developmental trajectories, leading to lifelong differences in the rates and severities of medical conditions, disorders of mental health, and educational and occupational underachievement (29)(30)(31)(32).…”

Social Dominance in Childhood and Its Evolutionary Underpinnings: Why It Matters and What We Can Do

“…For example, chronic loss on a wider economic scale (ie, relative inequity in income) has a profound impact on health and wellbeing across the life span in domains as diverse as oral health, 16 birth weight, 17 hypertension and arthritis, 18 and infectious disease. 19 Moreover, inequity undermines trust, enhances social anxiety, and weakens the status of women. 20 Within even smaller social groups, power differentials and social stress have measurable effects on endocrine functioning, including hyperactivation of the glucocorticoid system (eg, cortisol and hydrocortisone) and catecholamine hormones (eg, epinephrine and norepinephrine).…”