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Pathways Linking Community-Level Social Determinants of Health to Infant Biological Markers and Early Childhood
Viviane Valdes1,2, Ellen Jopling1,2, Georgia F Celestin1
1Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Insights
Community social factors like poverty impact children's biological stress markers, including telomere length (TL) and frontal alpha asymmetry (FAA), potentially influencing later psychopathology. Early environmental interventions addressing these social determinants are crucial.
Area of Science:
- Developmental psychology
- Molecular biology
- Public health
Background:
- Community-level social determinants of health (SDOH) are increasingly recognized as critical factors influencing child development.
- Biological markers such as frontal alpha asymmetry (FAA) and telomere length (TL) offer objective measures of early life stress.
- Understanding the interplay between SDOH, biological markers, and psychopathology is essential for targeted interventions.
Purpose of the Study:
- To examine associations between community-level SDOH and biological markers (FAA and TL) in early childhood.
- To investigate the pathways from SDOH to biological markers and subsequent child psychopathology symptoms.
- To identify specific SDOH that influence biological stress markers at distinct developmental time points.
Main Methods:
- Longitudinal study following 211 families for the first two years of life.
- Assessment of SDOH using US Census data.
- Measurement of FAA via resting-state electroencephalogram and TL from infant saliva samples.
- Evaluation of child psychopathology symptoms using the ITSEA.
- Statistical analyses including bivariate correlations and structural equation modeling (SEM).
Main Results:
- Community poverty levels were significantly associated with shorter telomere length (TL) at 9 months.
- Higher rates of healthcare uninsurance and food insecurity showed preliminary associations with frontal alpha asymmetry (FAA) at 2 and 9 months, respectively, though not significant after multiple comparison adjustments.
- SEM analyses indicated that community poverty influenced psychopathology through TL, and SDOH influenced FAA, which in turn predicted psychopathology symptoms at 2 years.
Conclusions:
- Distinct social determinant domains impact biological stress markers at specific early developmental stages.
- Community-level factors, particularly poverty, play a significant role in shaping biological stress and subsequent child mental health.
- Findings highlight the need for structural-level policies and early interventions to mitigate the impact of adverse social environments on child development.
Abstract:
We aimed to examine associations between multiple community-level social determinants of health and two biological markers: frontal alpha asymmetry (FAA) and telomere length (TL) in early childhood. We also probed pathways from community-level social determinants to biological markers and subsequent psychopathology symptoms. Using a longitudinal design, 211 families were followed during the first 2 years of life. Social determinants were assessed using US Census data, FAA using resting-state electroencephalogram, TL from infant saliva samples, and child psychopathology symptoms using the ITSEA. Statistical analyses included bivariate correlations (unadjusted and with false discovery rate adjustment for multiple comparisons) and SEM. For FAA, higher rates of uninsurance (healthcare) were associated with greater right lateralization at 2 months (r = -0.233, p = 0.028), and higher rates of food insecurity were also associated with greater right lateralization at 9 months (r = -0.250, p = 0.036); however, these associations were not significant after adjustment for multiple comparisons. In our SEM model, we found that both social determinants had paths to FAA (i.e., healthcare uninsurance rates to FAA at 2 months; food insecurity rates to FAA at 9 months), which had paths to child psychopathology symptoms at 2 years. Two community-level social determinants (greater poverty levels/lower home ownership rates) were significantly associated with shorter TL at 9 months (r = -0.395, p = 0.007; r = 0.293, p = 0.048), although only community poverty levels remained significant after adjustment for multiple comparisons. In the SEM model, community poverty levels had paths through TL at 9 months to child psychopathology symptoms at 2 years; home ownership rates only covaried with poverty levels. Distinct social determinant domains may influence markers of biological stress at specific time points. These findings underscore the importance of structural-level policies and early interventions addressing multiple aspects of the environment.
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