Sensitive Periods: Prospective Associations of Childhood and Adulthood Neighborhoods with Life Course Obesity and Blood Presure Trajectories

Pescador Jimenez, Marcia

Abstract

Compelling evidence has arisen on the role of neighborhood deprivation and childhood psychosocial adversity in cardiovascular health. Investigations into neighborhood health effects have identified two broad domains of neighborhood attributes that may be relevant to health: neighborhood physical environment and neighborhood social environment. Furthermore, early childhood is a critical stage in the life course during which inputs received can set health-related behaviors that may have long lasting impacts. Most of the current research has only investigated cross-sectional associations between neighborhood deprivation and cardiovascular disease (CVD) risk factors, which does not test the temporal assumption of causality. The proposed research will fill gaps in the literature using data from the New England Family Study (NEFS), a longitudinal investigation of risk factors for adult medical issues that may have early childhood developmental origins. Participants were followed since birth until adulthood in Providence, RI and Boston, MA, two of the most densely inhabited metropolitan areas in the Northeastern United States. Participants? lifetime residential history will be geocoded and linked to neighborhood factors across the life course. The resulting dataset will allow the research team to examine two aspects of neighborhood deprivation: neighborhood socioeconomic status (NSES), and accessibility to green space, using multilevel models. Outcomes will include two major CVD risk factors across the life course: high blood pressure (HBP) and body mass index (BMI). The proposed study will address three aims to evaluate: 1) Longitudinal associations of NSES with HBP and BMI; 2) Longitudinal associations of neighborhood accessibility to green space with HBP and BMI; and 3) The extent to which childhood adversity modifies the longitudinal association of neighborhood deprivation with HBP and BMI. We hypothesize that participants experiencing childhood adversity in households in deprived neighborhoods are a high-risk subset of the population that should be prioritized. In addition, this study will make available neighborhood data to pursue spatial questions at a level of detail and with methodologies not previously accessible in the NEFS; and not available in most longitudinal observational studies. Results from this longitudinal study may provide new evidence that during critical periods of susceptibility in life, greater access to neighborhood green space and higher NSES may slow the development of CVD in middle- aged adults. The

Public Health Relevance

This project will apply multilevel and spatial analytic methods to provide comprehensive answers about cumulative disadvantage resulting from neighborhood deprivation and childhood adversity on blood pressure and obesity, two major CVD risk factors posing substantial public health burdens. This study will be the first to longitudinally address fundamental questions regarding critical stages in the life course that can have severe life-long consequences on CVD risk. Analyses of this kind will provide insight into individual and community actions that can meaningfully improve public health and reduce environmental health disparities.