Abstract
The influence of childhood contexts on adult blood pressure is an important yet understudied topic. Using a developmental perspective, this study examines the association between neighborhood socioeconomic disadvantage in early childhood (0–5 yrs), middle childhood (6–12 yrs) and adolescence (13–18 yrs) on subsequent blood pressure in young adulthood. Data were from 263 college students (52% Black; Mage = 19.21 years) and neighborhood socioeconomic disadvantage was measured using a tract-level Area Deprivation Index. Neighborhood disadvantage in early childhood was significantly associated with diastolic blood pressure and explained 22% of the race difference between Black and White adults. The findings are consistent with the notion that early childhood may be a sensitive period for the effects of neighborhood disadvantage on blood pressure.
Similar content being viewed by others
References
Abercrombie, L., Sallis, J., Conway, T., Frank, L., Saelens, B., & Chapman, J. (2008). Income and racial disparities in access to public parks and private recreation facilities. American Journal of Preventive Medicine, 34(1), 9–15.
Allison, P. (1999). Multiple regression: a primer. Thousand Oaks: Pine Forge Press.
Alvarado, S. E. (2019). The indelible weight of place: childhood neighborhood disadvantage, timing of exposure, and obesity across adulthood. Health & Place, 58, 102159.
Bailey, Z. D., Feldman, J. M., & Bassett, M. T. (2021). How structural racism works—racist policies as a root cause of U.S. racial health inequities. New England Journal of Medicine, 384(8), 768–773.
Balfour, P., Rodriguez, C., & Ferdinand, K. (2015). The role of hypertension in race-ethnic disparities in cardiovascular disease. Current Cardiovascular Risk Reports, 9(4), 18.
Barker, D. (2004). The developmental origins of adult disease. Journal of the American College of Nutrition, 23(sup6), 588S–595S.
Berney, L. R., & Blane, D. B. (1997). Collecting retrospective data: accuracy of recall after 50 years judged against historical records. Social Science & Medicine, 45(10), 1519–1525. https://doi.org/10.1016/S0277-9536(97)00088-9.
Ben-Shlomo, Y., & Kuh, D. (2002). A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. International Journal of Epidemiology, 31(2), 285–293. https://doi.org/10.1093/ije/31.2.285.
Bishop, A. S., Walker, S. C., Herting, J. R., & Hill, K. G. (2020). Neighborhoods and health during the transition to adulthood: a scoping review. Health & Place, 63, 102336.
Boylan, J. M., & Robert, S. A. (2017). Neighborhood SES is particularly important to the cardiovascular health of low SES individuals. Social Science & Medicine, 188, 60–68. https://doi.org/10.1016/j.socscimed.2017.07.005.
Braveman, P., & Barclay, C. (2009). Health disparities beginning in childhood: a life-course perspective. Pediatrics, 124(3), S163–S175.
Bunea, I. M., Szentágotai-Tătar, A., & Miu, A. C. (2017). Early-life adversity and cortisol response to social stress: a meta-analysis. Translational Psychiatry, 7, 1274 https://doi.org/10.1038/s41398-017-0032-3.
Carnethon, M., Pu, J., Howard, G., Albert, M., Anderson, C., Bertoni, A., Mujahid, M., Palaniappan, L., Taylor, H., Willis, M., & Yancy, C. (2017). Cardiovascular health in African Americans: a scientific statement from the American Heart Association. Circulation, 136(21), e393–423.
Center of Disease Control. (2021). Facts about hypertension. https://www.cdc.gov/bloodpressure/facts.html.
Charles, C. (2003). The dynamics of racial residential segregation. Annual Review of Sociology, 29(1), 167–207. https://doi.org/10.1146/annurev.soc.29.010202.100002.
Chen, E., & Paterson, L. Q. (2006). Neighborhood, family, and subjective socioeconomic status: how do they relate to adolescent health. Health Psychology, 25(6), 704–714. https://doi.org/10.1037/0278-6133.25.6.704.
Chen, L., Simonsen, N., & Liu, L. (2015). Racial differences of pediatric hypertension in relation to birth weight and body size in the United States. PLoS One, 10(7), e0132606 https://doi.org/10.1371/journal.pone.0132606.
Chen, X., & Wang, Y. (2008). Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation, 117(25), 3171–3180.
Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Joseph, L., Izzo, J., Jones, D. W., Materson, B., Oparil, S., Jackson, T., Wright, J., & Roccella, E. (2003). The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 Report. JAMA, 289(19), 2560–2571.
Cooper, R., Wolf-Maier, K., Luke, A., Adeyemo, A., Banegas, J. R., Forrester, T., Giampaoli, S., Joffres, M., Kastarinen, M., Primatesta, P., Stegmayr, B., & Thamm, M. (2005). An international comparative study of blood pressure in populations of European vs. African descent. BMC Medicine, 3(1), 2 https://doi.org/10.1186/1741-7015-3-2.
Diez Roux, A. (2001). Investigating neighborhood and area effects on health. American Journal of Public Health, 91(11), 1783–1789. https://doi.org/10.2105/AJPH.91.11.1783.
Diez Roux, A. V., Mujahid, M. S., Hirsch, J. A., Moore, K., & Moore, L. V. (2016). The impact of neighborhoods on CV risk. Global Heart, 11(3), 353–363. https://doi.org/10.1016/j.gheart.2016.08.002.
Durfey, S., Kind, A., Buckingham, W., DuGoff, E., & Trivedi, A. (2019). Neighborhood disadvantage and chronic disease management. Health Services Research, 54, 206–216.
Ferraro, K., Schafer, M., & Wilkinson, L. (2016). Childhood disadvantage and health problems in middle and later life: early imprints on physical health? American Sociological Review, 81(1), 107–133.
Francis, H., & Stevenson, R. (2013). Validity and test–retest reliability of a short dietary questionnaire to assess intake of saturated fat and free sugars: a preliminary study. Journal of Human Nutrition and Dietetics, 26(3), 234–242.
Franzini, L., Taylor, W., Elliott, M. N., Cuccaro, P., Tortolero, S. R., Janice Gilliland, M., Grunbaum, J., & Schuster, M. A. (2010). Neighborhood characteristics favorable to outdoor physical activity: disparities by socioeconomic and racial/ethnic composition. Health & Place, 16(2), 267–274.
Fuller-Rowell, T., Curtis, D., El-Sheikh, M., Chae, D., Boylan, J., & Ryff, C. (2016). Racial disparities in sleep: the role of neighborhood disadvantage. Sleep Medicine, 27–28, 1–8.
Fuller-Rowell, T. E., Nichols, O. I., Robinson, A. T., Boylan, J. M., Chae, D. H., & El-Sheikh, M. (2021a). Racial disparities in sleep health between Black and White young adults: the role of neighborhood safety in childhood. Sleep Medicine, 81, 341–349.
Fuller-Rowell, T. E., Nichols, O. I., Jokela, M., Kim, E. S., Yildirim, E. D., & Ryff, C. D. (2021b). A changing landscape of health opportunity in the United States: increases in the strength of association between childhood socioeconomic disadvantage and adult health between the 1990s and the 2010s. American Journal of Epidemiology, 190, 2284–2293.
Gaskin, D., Dinwiddie, G., Chan, K., & McCleary, R. (2012). Residential segregation and the availability of primary care physicians. Health Services Research, 47(6), 2353–2376.
Gaydosh, L., Schorpp, K. M., Chen, E., Miller, G. E., & Harris, K. M. (2018). College completion predicts lower depression but higher metabolic syndrome among disadvantaged minorities in young adulthood. Proceedings of the National Academy of Sciences, 115(1), 109–114. https://doi.org/10.1073/pnas.1714616114.
Gaydosh, L., & McLanahan, S. (2021). Youth academic achievement, social context, and body mass index. SSM Population Health, 13, 100708.
Gilman, S., Huang, Y., Jimenez, M., Agha, G., Chu, S., Eaton, C., Goldstein, R., Kelsey, K., Buka, S., & Loucks, E. (2019). Early life disadvantage and adult adiposity: tests of sensitive periods during childhood and behavioral mediation in adulthood. International Journal of Epidemiology, 48(1), 98–107.
Gray, L., Lee, I.-M., Sesso, H. D., & Batty, G. D. (2011). Blood pressure in early adulthood, hypertension in middle age, and future cardiovascular disease mortality: HAHS (Harvard Alumni Health Study). Journal of the American College of Cardiology, 58(23), 2396–2403. https://doi.org/10.1016/j.jacc.2011.07.045.
Greenberg, D., Gershenson, C., & Desmond, M. (2016). Discrimination in evictions: empirical evidence and legal challenges. Harvard Civil Rights-Civil Liberties Law Review, 51(1), 115–158.
Guadamuz, J. S., Wilder, J. R., Mouslim, M. C., Zenk, S. N., Alexander, G. C., & Qato, D. M. (2021). Fewer pharmacies in black and hispanic/latino neighborhoods compared with white or diverse neighborhoods, 2007–15. Health Affairs, 40(5), 802–811. https://doi.org/10.1377/hlthaff.2020.01699.
Harding, D. J. (2009). Collateral consequences of violence in disadvantaged neighborhoods. Social Forces, 88(2), 757–784. https://doi.org/10.1353/sof.0.0281.
Harris, K. M. (2010). An integrative approach to health. Demography, 47(1), 1–22.
Huang, Y., Edwards, J., & Laurel-Wilson, M. (2020). The shadow of context: neighborhood and school socioeconomic disadvantage, perceived social integration, and the mental and behavioral health of adolescents. Health & Place, 66, 102425 https://doi.org/10.1016/j.healthplace.2020.102425.
James, G., Witten, D., Hastie, T., & Tibshirani, R. (2013). An introduction to statistical learning (Vol. 103). New York, NY: Springer. https://doi.org/10.1007/978-1-4614-7138-7.
Jimenez, M., Wellenius, G., Subramanian, S., Buka, S., Eaton, C., Gilman, S., & Loucks, E. (2019). Longitudinal associations of neighborhood socioeconomic status with cardiovascular risk factors: a 46-year follow-up study. Social Science & Medicine, 241, 112574.
Johnston, R., Jones, K., & Manley, D. (2018). Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Quality & Quantity, 52(4), 1957–1976. https://doi.org/10.1007/s11135-017-0584-6.
Jones, C., Taylor, K., Poston, L., & Shennan, A. (2001). Validation of the Welch Allyn ‘Vital Signs’ oscillometric blood pressure monitor. Journal of Human Hypertension, 15, 191–195.
Jones, N., Gilman, S., Cheng, T., Drury, S., Hill, C., & Geronimus, A. (2019). Life course approaches to the causes of health disparities. American Journal of Public Health, 109(S1), S48–S55.
Keita, A. D., Casazza, K., Thomas, O., & Fernandez, J. R. (2009). Neighborhood-level disadvantage is associated with reduced dietary quality in children. Journal of the American Dietetic Association, 109(9), 1612–1616. https://doi.org/10.1016/j.jada.2009.06.373.
Kind, A., Jencks, S., Brock, J., Yu, M., Bartels, C., Ehlenbach, W., Greenberg, C., & Smith, M. (2014). Neighborhood socioeconomic disadvantage and 30 day rehospitalizations: an analysis of medicare data. Annals of Internal Medicine, 161(11), 765–774.
Kohen, D. E., Leventhal, T., Dahinten, V. S., & McIntosh, C. N. (2008). Neighborhood disadvantage: pathways of effects for young children. Child Development, 79(1), 156–169.
Kravitz-Wirtz, N. (2016). Temporal effects of child and adolescent exposure to neighborhood disadvantage on black/white disparities in young adult obesity. Journal of Adolescent Health, 58(5), 551–557. https://doi.org/10.1016/j.jadohealth.2016.01.004.
Kuh, D., Ben-Shlomo, Y., Lynch, J., Hallqvist, J., & Power, C. (2003). Life course epidemiology. Journal of Epidemiology and Community Health, 57(10), 778–783.
Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, 863 https://doi.org/10.3389/fpsyg.2013.00863.
Landi, F., Calvani, R., Picca, A., Tosato, M., Martone, A. M., Ortolani, E., Sisto, A., D’Angelo, E., Serafini, E., Desideri, G., Fuga, M. T., & Marzetti, E. (2018). Body mass index is strongly associated with hypertension: results from the longevity check-up 7+ study. Nutrients, 10(12), 1976 https://doi.org/10.3390/nu10121976.
Lantz, P. M., House, J. S., Lepkowski, J. M., Williams, D. R., Mero, R. P., & Chen, J. (1998). Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA, 279(21), 1703–1708. https://doi.org/10.1001/jama.279.21.1703.
Lawrence, E., Mollborn, S., & Hummer, R. (2017). Health lifestyles across the transition to adulthood: implications for health. Social Science & Medicine, 193, 23–32. https://doi.org/10.1016/j.socscimed.2017.09.041.
Lee, R. E., & Cubbin, C. (2002). Neighborhood context and youth cardiovascular health behaviors. American Journal of Public Health, 92(3), 428–436. https://doi.org/10.2105/AJPH.92.3.428.
Lippert, A., Evans, C., Razak, F., & Subramanian, S. (2017). Associations of Continuity and Change in Early Neighborhood Poverty with Adult Cardiometabolic Biomarkers in the United States: Results from the National Longitudinal Study of Adolescent to Adult Health, 1995–2008. American Journal of Epidemiology, 185(9), 765–776.
MacKinnon, D., Fairchild, A., & Fritz, M. (2007). Mediation analysis. Annual Review of Psychology, 58, 593 https://doi.org/10.1146/annurev.psych.58.110405.085542.
Martin, C. L., Kane, J. B., Miles, G. L., Aiello, A. E., & Harris, K. M. (2019). Neighborhood disadvantage across the transition from adolescence to adulthood and risk of metabolic syndrome. Health & Place, 57, 131–138. https://doi.org/10.1016/j.healthplace.2019.03.002.
Mcardle, N., & Acevedo-Garcia, D. (2019). Consequences of segregation for children’s opportunity and wellbeing. 16. Joint Center for Housing Studies, Harvard University. © 2017 President and Fellows of Harvard College.
McGonagle, K. & Freedman, V. (2015). The Panel Study of Income Dynamics’ Childhood Retrospective Circumstances Study (PSID-CRCS) user guide: final release. Institute for Social Research, University of Michigan. https://psidonline.isr.umich.edu/CRCS/2014UserGuide.pdf.
McGrath, J., Matthews, K., & Brady, S. (2006). Individual versus neighborhood socioeconomic status and race as predictors of adolescent ambulatory blood pressure and heart rate. Social Science & Medicine, 63(6), 1442–1453.
Melchior, M., Moffitt, T., Milne, B., Poulton, R., & Caspi, A. (2007). Why do children from socioeconomically disadvantaged families suffer from poor health when they reach adulthood? A life-course study. American Journal of Epidemiology, 166(8), 966–974.
Mendes, M., de, A., Silva, I., da, Ramires, V., Reichert, F., Martins, R., Ferreira, R., & Tomasi, E. (2018). Metabolic equivalent of task (METs) thresholds as an indicator of physical activity intensity. PLOS One, 13(7), e0200701 https://doi.org/10.1371/journal.pone.0200701.
Moore, L. V., Diez Roux, A. V., Evenson, K. R., McGinn, A. P., & Brines, S. J. (2008). Availability of recreational resources in minority and low socioeconomic status areas. American Journal of Preventive Medicine, 34(1), 16–22.
Morenoff, J., House, J., Hansen, B., Williams, D., Kaplan, G., & Hunte, H. (2007). Understanding social disparities in hypertension prevalence, awareness, treatment, and control: the role of neighborhood context. Social Science & Medicine, 65(9), 1853–1866.
Morland, K., Wing, S., Diez Roux, A., & Poole, C. (2002). Neighborhood characteristics associated with the location of food stores and food service places. American Journal of Preventive Medicine, 22(1), 23–29. https://doi.org/10.1016/S0749-3797(01)00403-2.
Mujahid, M., Diez Roux, A., Morenoff, J., Raghunathan, T., Cooper, R., Ni, H., & Shea, S. (2008). Neighborhood characteristics and hypertension. Epidemiology, 19(4), 590–598.
Muthen, L. & Muthen, B. (1998). Mplus user’s guide (7th ed.). Muthen & Muthen.
Non, A. L., Rewak, M., Kawachi, I., Gilman, S. E., Loucks, E. B., Appleton, A. A., Román, J. C., Buka, S. L., & Kubzansky, L. D. (2014). Childhood social disadvantage, cardiometabolic risk, and chronic disease in adulthood. American Journal of Epidemiology, 180(3), 263–271. https://doi.org/10.1093/aje/kwu127.
Non, A., Román, J., Gross, C., Gilman, S., Loucks, E., Buka, S., & Kubzansky, L. (2016). Early childhood social disadvantage is associated with poor health behaviours in adulthood. Annals of Human Biology, 43(2), 144–153.
Pais, J., Crowder, K., & Downey, L. (2014). Unequal trajectories: racial and class differences in residential exposure to industrial hazard. Social Forces, 92(3), 1189–1215.
Rothstein, R. (2018). The color of law. Liveright Publishing Corporation.
Salvi, S. (2007). Health effects of ambient air pollution in children. Paediatric Respiratory Reviews, 8(4), 275–280. https://doi.org/10.1016/j.prrv.2007.08.008.
Schwartz, S. J. (2016). Turning point for a turning point: advancing emerging adulthood theory and research. Emerging Adulthood, 4(5), 307–317. https://doi.org/10.1177/2167696815624640.
Schulz, A. J., Williams, D. R., Israel, B. A., & Lempert, L. B. (2002). Racial and spatial relations as fundamental determinants of health in detroit. The Milbank Quarterly, 80(4), 677–707. https://doi.org/10.1111/1468-0009.00028.
Sharkey, P. (2014). Spatial segmentation and the black middle class. American Journal of Sociology, 119(4), 903–954. https://doi.org/10.1086/674561.
Shen, W., Zhang, T., Li, S., Zhang, H., Xi, B., Shen, H., Fernandez, C., Bazzano, L., He, J., & Chen, W. (2017). Race and sex differences of long-term blood pressure profiles from childhood and adult hypertension. Hypertension, 70(1), 66–74.
Shonkoff, J. P., Slopen, N., & Williams, D. R. (2021). Early childhood adversity, toxic stress, and the impacts of racism on the foundations of health. Annual Review of Public Health, 42, 115–134.
Singh, G. (2003). Area disadvantage and widening inequalities in US Mortality, 1969–1998. American Journal of Public Health, 93(7), 1137–1143.
Steptoe, A., & Feldman, P. (2001). Neighborhood problems as sources of chronic stress: development of a measure of neighborhood problems, and associations with socioeconomic status and health. Annals of Behavioral Medicine, 23(3), 177–185.
Suglia, S., Campo, R., Brown, A., Stoney, C., Boyce, C., Appleton, A., Bleil, M., Boynton-Jarrett, R., Dube, S., Dunn, E., Ellis, B., Fagundes, C., Heard-Garris, N., Jaffee, S., Johnson, S., Mujahid, M., Slopen, N., Su, S., & Watamura, S. (2020). Social determinants of cardiovascular health: early life adversity as a contributor to disparities in cardiovascular diseases. The Journal of Pediatrics, 219, 267–273.
Troxel, W. M., Shih, R. A., Ewing, B., Tucker, J. S., Nugroho, A., & D’Amico, E. J. (2017). Examination of neighborhood disadvantage and sleep in a multi-ethnic cohort of adolescents. Health & Place, 45, 39–45. https://doi.org/10.1016/j.healthplace.2017.03.002.
Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Cheng, S., Delling, F. N., Elkind, M. S. V., Evenson, K. R., Ferguson, J. F., Gupta, D. K., Khan, S. S., Kissela, B. M., Knutson, K. L., Lee, C. D., Lewis, T. T. & Tsao, C. (2021). Heart disease and stroke statistics—2021 Update. Circulation, 143(8), e254–e743. https://doi.org/10.1161/CIR.0000000000000950.
Wang, D., Choi, J. K., & Shin, J. (2020). Long-term neighborhood effects on adolescent outcomes: mediated through adverse childhood experiences and parenting stress. J Youth Adolescence, 49, 2160–2173. https://doi.org/10.1007/s10964-020-01305-y.
Wardle, J., Jarvis, M. J., Steggles, N., Sutton, S., Williamson, S., Farrimond, H., Cartwright, M., & Simon, A. E. (2003). Socioeconomic disparities in cancer-risk behaviors in adolescence: baseline results from the Health and Behaviour in Teenagers Study (HABITS). Preventive Medicine, 36(6), 721–730. https://doi.org/10.1016/S0091-7435(03)00047-1.
Williams, D., & Collins, C. (2001). Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Reports, 116(5), 404–416.
Williams, D. R., & Sternthal, M. (2010). Understanding racial-ethnic disparities in health: sociological contributions. Journal of Health and Social Behavior, 51(1_suppl), S15–S27.
U.S. Census Bureau. (2020). Census tract. Glossary. www.census.gov/programs-surveys/geography/about/glossary.html.
Yang, L., Magnussen, C. G., Yang, L., Bovet, P., & Xi, B. (2020). Elevated blood pressure in childhood or adolescence and cardiovascular outcomes in adulthood: a systematic review. Hypertension, 75(4), 948–955.
Yano, Y., Reis, J. P., Colangelo, L. A., Shimbo, D., Viera, A. J., Allen, N. B., Gidding, S. S., Bress, A. P., Greenland, P., Muntner, P., & Lloyd-Jones, D. M. (2018). Association of Blood Pressure Classification in Young Adults Using the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline with Cardiovascular Events Later in Life. JAMA, 320(17), 1774–1782. https://doi.org/10.1001/jama.2018.
Acknowledgements
The authors are grateful to Connor Martz, Brian Vaughn, Mona El-Sheikh, and David Chae who provided insightful comments on earlier drafts, and to undergraduate research assistants, Diamond Alexander, Mike Arias, Rachel Breuers, Catherine Bryant, Tristan Hazebrook, William Illiano, Karen Ngugi, Cindy Nguyen, Sarika Patel, Harrison Reeves, Menglin Wei, Kelsey White, Mikaela White, and Stefani Yates, who assisted with data collection and coding efforts for this study.
Authors’ Contributions
O.I.N. conceived of the study, participated in data curation, performed statistical analyses, and drafted original manuscript; T.E.F.R. acquired funding, participated in conceptualization, supervised study design, data collection and statistical analyses, and writing and editing; A.T.R. participated in study design, conceptualization, writing and editing; D.E. participated in writing and editing; L.K.H. participated in data curation. All authors read and approved of the final manuscript.
Funding
This work was supported by the National Heart, Lung, and Blood Institute (grant number 1R15HL140504-01A1); and the USDA National Institute of Food and Agriculture (Hatch project 1003947).
Data Sharing and Declaration
The data analyzed for the current study are not publicly available but available from the corresponding author upon reasonable request.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interests.
Ethical Approval
The study was approved by the Internal Review Board at Auburn University (#16-267 MR 1607).
Informed Consent
Informed consent was obtained from all participants included in the study.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
About this article
Cite this article
Nichols, O.I., Fuller-Rowell, T.E., Robinson, A.T. et al. Neighborhood Socioeconomic Deprivation in Early Childhood Mediates Racial Disparities in Blood Pressure in a College Student Sample. J Youth Adolescence 51, 2146–2160 (2022). https://doi.org/10.1007/s10964-022-01658-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10964-022-01658-6