Health disparities between African-American and white girls are evident early in life and continue over the life course. In adulthood, African-American females bear a disproportionate burden of poor health, give birth to sicker babies, and die at younger ages than white females. The persistence and depth of these disparities is recognized as a major public health problem and the elimination of these health disparities has been identified as one of the two major goals of the decade within Healthy People 2010. Despite the high national priority given to eliminating health disparities, progress towards this goal has been slow. Research has focused primarily on understanding the extent and depth of the problem and in establishing links between broad measures of social and economic factors and health disparities. Much of the research has used cross- sectional data--a design that cannot adequately examine associations between a health outcome and risk exposures that temporally preceded the observation window. Despite rapid developments in the biological sciences suggesting strong influences of early life exposures on the shaping of biological processes, few studies have investigated health disparities in light of early childhood contextual experiences. In this study, we investigate the impact of early childhood contexts on adolescent physical health using the Life Course Health Development Theory which posits that health variability is tied to the interaction of multiple contextual factors at sensitive life periods and that extraorganismic influences """"""""get under one's skin"""""""" through biological processes designed to adapt to acute stress. In this theory the early contextual period starts with the mother's prepregnancy health and continues through the intrauterine and early childhood years. This is the time period that is the focus of our study. We will examine early childhood contextual factors from 4 domains using a multigenerational data base (NLSY79 Mother, Child, and Young Adult files) that has great strength in the depth and richness of contextual variables. We will examine how these contextual factors differentially impact the physical health (somatic growth, age of menarche, and self-reported general health status) of African-American and white girls in adolescence. The overall aim of this project is to determine how early life contexts differentially influence the physical health of African-American and white adolescent girls.
The specific aims are: 1)To quantify and describe race differences in early childhood environmental contexts;2)To test whether there are racial disparities in adolescent physical health in African-American and white girls matched on early childhood contextual factors. 3) To model race differences in adolescent physical health as a function of the early childhood environment and to investigate the extent to which race differences in adolescent physical health are attributable to: a) Differences in the level of available resources within contexts key to young children, b) Differences in children's health response to early environmental contexts.

Public Health Relevance

The major thrust of this proposal is to understand how early childhood environments differentially influence the health of white and African-American adolescent females. The knowledge gained from this research will aid with the development of prevention and/or early intervention strategies aimed at improving the health of African-American females. The results of this study will inform practice at the individual and aggregate level, and should assist with achieving Healthy People 2010 goals to reduce the level of health disparities in minorities in this country.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
Project #
Application #
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Hardy, Lynda R
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Ohio State University
Schools of Nursing
United States
Zip Code
Reagan, Patricia B; Salsberry, Pamela J (2014) Cross race comparisons between SES health gradients among African-American and white women at mid-life. Soc Sci Med 108:81-8
Salsberry, Pamela J; Reagan, Patricia B; Fang, Muriel Z (2013) Disparities in women's health across a generation: a mother-daughter comparison. J Womens Health (Larchmt) 22:617-24
Reagan, Patricia B; Salsberry, Pamela J; Fang, Muriel Z et al. (2012) African-American/white differences in the age of menarche: accounting for the difference. Soc Sci Med 75:1263-70
Reagan, Patricia B; Salsberry, Pamela J (2010) Pathways to adolescent overweight: Body mass index and height percentile change in childhood. Int J Pediatr Obes 5:80-7
Salsberry, Pamela J; Reagan, Patricia B (2009) Comparing the influence of childhood and adult economic status on midlife obesity in Mexican American, white, and African American women. Public Health Nurs 26:14-22
Salsberry, Pamela J; Reagan, Patricia B; Pajer, Kathleen (2009) Growth differences by age of menarche in African American and White girls. Nurs Res 58:382-90