In recent decades there has been a marked decline in morbidity and mortality from coronary heart disease (CHD) in the US. But the strength of this trend varies across demographic groups. Those of low socioeconomic status (SES) continue to develop, and die from, CHD at rates more typical of the 1970's. Most research on the origins of these disparities focuses on middle stages of the lifespan, when CHD manifests clinically. While this research has been fruitful, shifting the focus towards earlier life stages could yield valuabl insights. Many pathogenic mechanisms that give rise to CHD begin in childhood, and by adolescence increasing numbers of American youth display risk factors for and preclinical signs of CHD, which themselves pattern by SES. Despite these findings, relatively little attention has been directed towards early CHD disparities. We know little about why they emerge and how they unfold developmentally. To address these questions, we propose a prospective, multilevel study of 250 youth from economically diverse backgrounds. Subjects will be enrolled during eighth grade and reassessed in tenth grade. Drawing on hypotheses from a recently developed conceptual framework, the study poses three questions about SES disparities in immunologic, neural, and psychosocial development, and the implications for early CHD risk. First, we ask whether SES relates to maturation patterns in the immune system, with a focus on inflammatory processes that underlie CHD. We expect low-SES youth to display a multilayer inflammatory phenotype, which manifests at the genomic, cellular, and systemic levels of analyses. Second, we ask whether SES relates to maturation patterns in the brain's corticolimbic and corticostriatal circuitries, and thereby give rise to behavioral proclivities that heighten CHD risk. Using high-dimensional structural imaging and diffusion tensor imaging, we expect low SES to be associated with disparities in grey- and white-matter development in these circuitries. These disparities should, in turn, presage CHD-relevant behavioral proclivities, including threat vigilance, social turmoil, poor self-regulation, and unhealthy lifestyles. Finally, noting that som low-SES youth have positive health outcomes, we explore characteristics and experiences that bend the normative demographic curve. We expect that lower-SES youth who encounter positive social influences - specifically role models and high maternal warmth - will develop a suite of personal resources - trust, emotion regulation skills, and self-esteem - that help them navigate the challenges of high school and low-SES life more broadly. Those resources will shift low-SES youth off their expected risk trajectory, resulting in immune and neural patterns similar to higher-SES youth.

Public Health Relevance

People who spend the early years of their lives in poverty are more likely to develop heart disease when they reach adulthood. This project attempts to identify the mechanisms that underlie this process. We study teenagers over a two-year period, asking whether brain development, immune functioning, and heart disease risk depend on their family's economic situation. By studying these processes, we may be able to identify targets for early prevention.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL122328-03
Application #
9181446
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Campo, Rebecca A
Project Start
2014-12-01
Project End
2018-11-30
Budget Start
2016-12-01
Budget End
2017-11-30
Support Year
3
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Northwestern University at Chicago
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
160079455
City
Evanston
State
IL
Country
United States
Zip Code
60201
Chiang, Jessica J; Turiano, Nicholas A; Mroczek, Daniel K et al. (2018) Affective reactivity to daily stress and 20-year mortality risk in adults with chronic illness: Findings from the National Study of Daily Experiences. Health Psychol 37:170-178
Miller, Gregory E; Chen, Edith; Shalowitz, Madeleine U et al. (2018) Divergent transcriptional profiles in pediatric asthma patients of low and high socioeconomic status. Pediatr Pulmonol 53:710-719
Hostinar, Camelia E; Nusslock, Robin; Miller, Gregory E (2018) Future Directions in the Study of Early-Life Stress and Physical and Emotional Health: Implications of the Neuroimmune Network Hypothesis. J Clin Child Adolesc Psychol 47:142-156
Chiang, Jessica J; Chen, Edith; Miller, Gregory E (2018) Midlife Self-Reported Social Support as a Buffer Against Premature Mortality Risks Associated with Childhood Abuse. Nat Hum Behav 2:261-268
Chen, Edith; Brody, Gene H; Miller, Gregory E (2017) Childhood close family relationships and health. Am Psychol 72:555-566
Miller, Gregory E; Culhane, Jennifer; Grobman, William et al. (2017) Mothers' childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways. Brain Behav Immun 65:11-19
Hostinar, Camelia E; Ross, Kharah M; Chen, Edith et al. (2017) Early-Life Socioeconomic Disadvantage and Metabolic Health Disparities. Psychosom Med 79:514-523
Miller, Gregory E; Borders, Ann E; Crockett, Amy H et al. (2017) Maternal socioeconomic disadvantage is associated with transcriptional indications of greater immune activation and slower tissue maturation in placental biopsies and newborn cord blood. Brain Behav Immun 64:276-284
Brody, Gene H; Yu, Tianyi; Chen, Edith et al. (2017) Family-centered prevention ameliorates the association between adverse childhood experiences and prediabetes status in young black adults. Prev Med 100:117-122
Chen, Edith; Turiano, Nicholas A; Mroczek, Daniel K et al. (2016) Association of Reports of Childhood Abuse and All-Cause Mortality Rates in Women. JAMA Psychiatry 73:920-7

Showing the most recent 10 out of 15 publications