Session: Adversity and the Origins of Chronic Disease and Disparity in Childhood and Adolescence (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

The promotion of equitable health outcomes is core to the mission of social work and its grand challenges. This symposium advances this cause by examining the contribution of adversity to the development of chronic disease from infancy to adolescence. Specifically, the studies examine adversity in relation to body mass index (BMI), sleep, regulation, substance use, and subjective health. Collectively, the studies inform our understanding of how health disparities may develop through their inclusion of key understudied samples (i.e., Latinx children, diverse youths at risk for child maltreatment, low-income youths in large U.S. cities), examination of racial differences, and the conceptualization of important sociocultural and economic contextual factors. The studies epitomize the biopsychosocial perspective and illuminate the important role of protective factors in shaping health outcomes.

Study 1 examines how conditions that reflect adverse caregiving environments, such as those characterized by child maltreatment and instability in night-to-night sleep patterns of mothers and infants, shape regulatory outcomes in a low-income and racially and ethnically diverse sample of mother-infant dyads. Findings suggest that higher child maltreatment severity and sleep variability may be key risk factors implicated in poor regulatory health in mothers and infants. Using a unique sample of Latinx pre-K students in south Texas, Study 2 identifies the relationships between school- and neighborhood-level poverty and BMI. Findings indicate that school- and neighborhood-level poverty are significant factors but not necessarily in the direction one would expect. Studies 3 and 4 use data from the Fragile Families and Child Wellbeing Studies. Study 3 examines adverse childhood experiences and economic hardship in relation to BMI trajectories from ages 3 to 15 years, identifying internalizing and externalizing problems as mediators and religious/spiritual and community group involvement as protective factors. Study 4 finds that both sleep quality and positive childhood experiences mediate the relation between adverse childhood experiences and self-rated health in adolescence. Finally, Study 5 examines how child maltreatment types across discrete developmental periods and poverty relate to BMI and substance use disorder at 18 years, drawing from the Longitudinal Studies of Child Abuse and Neglect. Finding suggests gender and race differences in stress coping behaviors.

This symposium provides a forum for discussion of the theorized salience of adversity experienced throughout childhood in the development of chronic disease. Significant relations are revealed between adversity and multiple health outcomes during infancy, childhood, and adolescence, suggesting future longitudinal research might encompass sleep, regulation, BMI and substance use to gain further perspective on their interrelations. Findings articulate specific protective pathways to mitigate health risks and clearly suggest the importance of preventing childhood adversity and promoting positive experiences. Symposium implications pinpoint important targets for social work intervention, including positive and consistent caregiving, healthy sleep, and internalizing and externalizing behaviors. Finally, results highlight the critical importance for social work interventions to integrate sociocultural and economic context in efforts to prevent chronic disease and disparity, including consideration of compounded risk at intersections of race and gender and across school and neighborhood contexts.