Child Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging

doi:10.1016/j.acap.2016.01.014

Academic Pediatrics

Volume 16, Issue 3, Supplement, April 2016, Pages S37-S45

https://doi.org/10.1016/j.acap.2016.01.014 Get rights and content

Abstract

The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This literature review focused on evidence of the influence of child poverty on the major contributors to adult morbidity and mortality in the United States, the mechanisms by which these associations operate, and the implications for reforming child health programs and policies. Strong and varied evidence base documents the effect of child poverty and related early life experiences and exposures on the major threats to adult health and healthy aging. Studies using a variety of methodologies, including longitudinal and cross-sectional strategies, have reported significant findings regarding cardiovascular disorders, obesity and diabetes, certain cancers, mental health conditions, osteoporosis and fractures, and possibly dementia. These relationships can operate through alterations in fetal and infant development, stress reactivity and inflammation, the development of adverse health behaviors, the conveyance of child chronic illness into adulthood, and inadequate access to effective interventions in childhood. Although the reviewed studies document meaningful relationships between child poverty and adult outcomes, they also reveal that poverty, experiences, and behaviors in adulthood make important contributions to adult health and aging. There is strong evidence that poverty in childhood contributes significantly to adult health. Changes in the content, financing, and advocacy of current child health programs will be required to address the childhood influences on adult health and disease. Policy reforms that reduce child poverty and mitigate its developmental effects must be integrated into broader initiatives and advocacy that also attend to the health and well-being of adults.

Section snippets

Poverty, Deprivation, and Capabilities

Poverty implies deprivation. However, deprivation of what remains a complex and often controversial issue. Absolute notions of poverty recognize that at some level material deprivation can be so severe that it can undermine physical efficiency and ultimately result in death. Such absolute definitions of poverty often rely on nutrition as a core requirement, as does the official poverty line in the United States. Relative definitions stress the minimum levels of resources required for social

The Effect of Childhood Exposures on Adult Health

Although several recent reviews have underscored the wide variation in the time frames, social settings, and analytic strategies used to assess the relationship between childhood socioeconomic status and adult outcomes, a large majority of studies have revealed strong inverse associations between childhood status and adult patterns of morbidity and mortality.5, 6, 7, 8 In addition, recent arguments have suggested that the development of adult health and disease should be integrated into a

Fetal/Infant Exposures and Epigenetics

Although the evidence supporting the association of child poverty and later adult health is strong, the precise mechanisms by which this association is generated continue to be the focus of intense investigation. In many ways, the recent dramatic growth in life-course research was set in motion by a series of epidemiological studies by Barker and colleagues relating altered fetal growth to the risk of cardiovascular disease in adults.64, 65 It has been postulated that these relationships are

Translating the Evidence Base into Practice and Policy

The diversity and complexity of early influences on lifelong health suggests that there are likely a multitude of ways programmatic interventions and policies could improve child well-being and consequently enhance the potential for a healthy adulthood. However, there are 4 opportunities that deserve special attention, because they represent particularly promising uses of the child health community's strategic expertise as well as arenas that have been inadequately addressed or purposefully

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Citation Excerpt :
Given the clear neurodevelopmental aspect of schizophrenia, susceptible neuronal maturation periods in a child’s life and adverse experiences during these periods play a crucial role in the etiology of the disorder [2,7,8]. Growing up under disadvantageous economic conditions poses a strong risk for affecting a child’s developmental trajectory and has been shown to affect health [91–93], brain development [94,95], educational and cognitive outcomes [93,96] and may promote problematic behaviors and affect socio-emotional functioning [93,96,97]. Here, we will explore the association between adverse, stress-inducing experiences during childhood and adolescence mediated by economic hardship, and the risk for developing schizophrenia.
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: The author reports no conflicts of interest.

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Child Poverty–Destruction of the Nation's Human CapitalChild Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging

Abstract

Section snippets

Poverty, Deprivation, and Capabilities

The Effect of Childhood Exposures on Adult Health

Fetal/Infant Exposures and Epigenetics

Translating the Evidence Base into Practice and Policy

Cell

Cell

Soc Sci Med

J Affect Disord

Psychoneuroendocrinology

J Affect Disord

J Affect Disord

Am J Geriatr Psychiatry

Lancet Respir Med

Ann Allergy Asthma Immunol

J Allergy Clin Immunol

Lancet

Lancet

Int J Gynaecol Obstet

Lancet Neurol

Semin Cell Dev Biol

Adv Chronic Kidney Dis

Lancet

Soc Sci Med

Neuron

Soc Sci Med

Neuron

Psychoneuroendocrinology

Commondities and Capabilities

A sociological approach to the measurement of poverty: a reply

Oxf Econ Pap

An Inquiry into Nature and Causes of the Wealth of Nations

The development of capability indicators

J Hum Dev Capab

Childhood socioeconomic circumstances and cause-specific mortality in adulthood: systematic review and interpretation

Epidemiol Rev

Is the association between childhood socioeconomic circumstances and cause-specific mortality established? Update of a systematic review

J Epidemiol Community Health

From developmental origins of adult disease to life course research on adult disease and aging: insights from birth cohort studies

Annu Rev Public Health

Life course health development: an integrated framework for developing health, policy, and research

Millbank Q

The State of US Health, 1990-2010

JAMA

A life course approach to cardiovascular aging

Future Cardiol

Social determinants of risk and outcomes for cardiovascular disease a scientific statement from the American Heart Association

Circulation

Childhood abuse, parental warmth, and adult multisystem biological risk in the Coronary Artery Risk Development in Young Adults study

Proc Natl Acad Sci U S A

Childhood maltreatment and BMI trajectories to mid-adult life: follow-up to age 50y in a British birth cohort

PLoS One

Bullying victimization in childhood predicts inflammation and obesity at mid-life: a five-decade birth cohort study

Psychol Med

Life course trajectories of systolic blood pressure using longitudinal data from eight UK cohorts

PLoS Med

Adverse childhood experiences and blood pressure trajectories from childhood to young adulthood: the Georgia Stress and Heart Study

Circulation

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

Proc Natl Acad Sci U S A

Early-life determinants of overweight and obesity: a review of systematic reviews

Obes Rev

Early markers of adult obesity: a review

Obes Rev

Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

BMC Public Health

Birth weight and risk of type 2 diabetes: a systematic review

JAMA

Development of symptoms of tobacco dependence in youth: 30 month follow up data from the DANDY study

Tob Control

Developmental origins of the metabolic syndrome: prediction, plasticity, and programming

Physiol Rev

Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood

Int J Epidemiol

Adverse childhood experiences: retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population

J Public Health (Oxf)

Childhood obesity and adult cardiovascular disease risk: a systematic review

Int J Obes

Child Poverty–Destruction of the Nation's Human Capital
Child Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging