Historical Structural Racism in the Built Environment and Physical Health among Residents of Allegheny County, Pennsylvania.

Historical structural racism in the built environment contributes to health inequities, yet to date, research has almost exclusively focused on racist policy of redlining. We expand upon this conceptualization of historical structural racism by examining the potential associations of probable blockbusting, urban renewal, and proximity to displacement from freeway construction, along with redlining, to multiple contemporary health measures. Analyses linked historical structural racism, measured continuously at the census-tract level using archival data sources, to present-day residents' physical health measures drawn from publicly accessible records for Allegheny County, Pennsylvania. Outcome measures included average life expectancy and the percentage of residents reporting hypertension, stroke, coronary heart disease, smoking, insufficient sleep, sedentary behavior, and no health insurance coverage. Multiple regression analyses were conducted to examine separate and additive associations between structural racism and physical health measures. Redlining, probable blockbusting, and urban renewal were associated with shorter life expectancy and a higher prevalence of cardiovascular conditions, risky health behaviors, and residents lacking health insurance coverage. Probable blockbusting and urban renewal had the most consistent correlations with all 8 health measures, while freeway displacement was not reliably associated with health. Additive models explained a greater proportion of variance in health than any individual structural racism measure alone. Moreover, probable blockbusting and urban renewal accounted for relatively more variance in health compared to redlining, suggesting that research should consider these other measures in addition to redlining. These preliminary correlational findings underscore the importance of considering multiple aspects of historical structural racism in relation to current health inequities and serve as a starting point for additional research.

Diversity of spatial activities and parents' spatial talk complexity predict preschoolers' gains in spatial skills.

Children's spatial activities and parental spatial talk were measured to examine their associations with variability in preschoolers' spatial skills (N = 113, Mage = 4 years, 4 months; 51% female; 80% White, 11% Black, and 9% other). Parents who reported more diversity in daily spatial activities and used longer spatial talk utterances during a spatial activity had children with greater gains in spatial skills from ages 4 to 5 (ß = .17 and ß = .40, respectively). Importantly, this study is the first to move beyond frequency counts of spatial input and investigate the links among the diversity of children's daily spatial activities, as well as the complexity of parents' spatial language across different contexts, and preschoolers' gains in spatial skills, an important predictor of later STEM success.

Economic hardship and adolescent behavioral outcomes: Within- and between-family associations.

Understanding how youth perceive household economic hardship and how it relates to their behavior is vital given associations between hardship and behavioral development. Yet, most studies ignore youth's own perceptions of economic hardship, instead relying solely on caregiver reports. Moreover, the literature has tended to treat economic hardship as a stable force over time, rather than a volatile one that varies month-to-month. This study addressed extant limitations by collecting monthly measures of economic hardship, specifically caregiver- and youth-reported material deprivation and youth-reported financial stress, and youth internalizing and externalizing problems from 104 youth-caregiver dyads (youth: 14-16 years, 55% female, 37% Black, 43% White) over nine months. We examined month-to-month variability of these constructs and how youth-reports of material deprivation and financial stress predicted their behavior problems, controlling for caregiver-reports of material deprivation. We found that hardship measures varied month-to-month (ICCs = 0.69-0.73), and youth-reported material deprivation positively predicted internalizing when examining both within- and between-individual variability (ß = .19-.47). Youth-reported financial stress positively predicted within-individual variation in externalizing (ß = .18), while youth reports of material deprivation predicted externalizing when looking between families (ß = .41). Caregiver-reported material deprivation was unrelated to youth behavior when accounting for youth perceptions of economic hardship.

Beyond Neighborhood Disadvantage: Local Resources, Green Space, Pollution, and Crime as Residential Community Correlates of Cardiovascular Risk and Brain Morphology in Midlife Adults.

OBJECTIVE: Residing in communities characterized by socioeconomic disadvantage confers risk of cardiometabolic diseases. Residing in disadvantaged communities may also confer the risk of neurodegenerative brain changes via cardiometabolic pathways. This study tested whether features of communities-apart from conventional socioeconomic characteristics-relate not only to cardiometabolic risk but also to relative tissue reductions in the cerebral cortex and hippocampus. METHODS: Participants were 699 adults aged 30 to 54 years (340 women; 22.5% non-White) whose addresses were geocoded to compute community indicators of socioeconomic disadvantage, as well as air and toxic chemical pollutant exposures, homicide rates, concentration of employment opportunities, land use (green space), and availability of supermarkets and local resources. Participants also underwent assessments of cortical and hippocampal volumes and cardiometabolic risk factors (adiposity, blood pressure, fasting glucose, and lipids). RESULTS: Multilevel structural equation modeling demonstrated that cardiometabolic risk was associated with community disadvantage ( ß = 0.10, 95% confidence interval [CI] = 0.01 to 0.18), as well as chemical pollution ( ß = 0.11, 95% CI = 0.02 to 0.19), homicide rates ( ß = 0.10, 95% CI = 0.01 to 0.18), employment opportunities ( ß = -0.16, 95% CI = -0.27 to -0.04), and green space ( ß = -0.12, 95% CI = -0.20 to -0.04). Moreover, cardiometabolic risk indirectly mediated the associations of several of these community features and brain tissue volumes. Some associations were nonlinear, and none were explained by participants' individual-level socioeconomic characteristics. CONCLUSIONS: Features of communities other than conventional indicators of socioeconomic disadvantage may represent nonredundant correlates of cardiometabolic risk and brain tissue morphology in midlife.

Subjective Social Status and Longitudinal Changes in Systemic Inflammation.

BACKGROUND: Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status. PURPOSE: We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex. METHODS: Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race. RESULTS: Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (ß = -0.06), hopelessness (ß = -0.06), and depressive symptoms (ß = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (ß = -0.06), but was slightly attenuated after adjusting for hopelessness (ß = -0.06) and depressive symptoms (ß = -0.06). There were no associations for CRP or moderation by race or sex. CONCLUSIONS: Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.

Subjective social status (SSS) refers to how people perceive their social rank compared with others and has been linked to meaningful differences in physical health. Increases in inflammation may contribute to associations between lower SSS and poorer physical health. In a sample of healthy adults, we examined whether SSS was associated with prospective, multiyear changes in markers of systemic inflammation and if this differed by sex or race. We found that adults who perceived their social status as lower than peers in their community exhibited an accelerated increase in interleukin-6, a marker of systemic inflammation, over a 3-year period. When participants were asked to compare themselves to people in the broader USA, the pattern was similar but less robust. Results were independent of individual differences in sociodemographic characteristics including family-adjusted income and education. Findings did not differ by sex or race and were not explained by differences in adiposity and symptoms of depression and hopelessness. Effects for C-reactive protein, a second marker of inflammation, were generally nonsignificant. Although preliminary, findings suggest an immune pathway by which perceived social status may relate to chronic diseases of aging.

Early Life SES, Childhood Trauma Exposures, and Cardiovascular Responses to Daily Life Stressors in Middle-aged Adults.

BACKGROUND: Dysregulation in physiological responses to stress may provide a mechanism through which low socioeconomic status (SES) in childhood negatively impacts health. Evidence linking early life SES to physiological stress responses is inconsistent. Exposure to childhood trauma may be an important source of heterogeneity accounting for mixed findings. Guided by the adaptive calibration model, we examined whether childhood SES and childhood trauma jointly predict ambulatory measures of cardiovascular responses to daily life stressors. METHOD: A sample of 377 healthy, middle-aged adults (62% female, 80% White, 64% college-educated, Mage = 52.59 ± 7.16) completed a 4-day ecological momentary assessment protocol that measured task strain, social conflict, and ambulatory systolic and diastolic blood pressure (SBP and DBP, respectively) at hourly intervals throughout the day. Average ambulatory blood pressure responses to stress were calculated by regressing momentary SBP and DBP on momentary measures of stress within the multilevel models. Early life SES and childhood trauma were measured retrospectively by self-report questionnaire. RESULTS: Multilevel models controlling for momentary influences on blood pressure and age, sex, and race showed no main effects of early life SES or childhood trauma on ambulatory measures of cardiovascular responses to daily life stress. An interaction emerged for DBP responses to social conflict, where individuals raised in middle SES families who experienced trauma showed a blunted response relative to those who did not ([Formula: see text]-0.93, 95% CI: [-1.62, -0.24], p = .008). There was no significant SES-trauma interaction in predicting SBP responses to social conflict or blood pressure responses to task strain. CONCLUSION: Results do not provide support for our predictions that were derived from the adaptive calibration model, but do suggest that the impacts of early childhood experiences on cardiovascular responses may vary by type of daily stress experience.

Exploring the role of "in the moment" and global caregiver and child factors in caregiver questioning during shared book viewing.

Questions of high (vs. low) cognitive demand (CD), which encourage children to engage in abstract or critical thinking (e.g., problem solve, reason about cause-and-effect relations, make inferences), may drive relations between children's language exposure and early skills. The present study adopted a micro-analytic approach to examine caregivers' high-CD questioning with their preschool-aged children while viewing a wordless picture book (n = 121) and "in the moment" (e.g., interaction time, child responses) and global factors (e.g., caregiver education). The probability of caregivers' high-CD questioning increased with interaction time and caregiver education. Post-hoc exploratory analyses revealed that the relation between children's responses and caregivers' high-CD questioning depended on caregivers' perceptions of children's vocabulary skills. Specifically, the probability of caregivers' subsequent high-CD questioning was greater if their child did not respond previously and if caregivers perceived them to have high vocabulary skills. In contrast, caregivers' questioning remained relatively constant for responsive children across different vocabulary skills. Thus, caregivers may employ certain types of input during brief, informal learning interactions with their children by considering their own and their child's propensities and micro-level changes that occur during their conversations.

Unpacking the Home Numeracy Environment: Examining Dimensions of Number Activities in Early Childhood.

A growing body of research has examined parents' practices to support their young children's number learning at home, i.e., the home numeracy environment. Many of these studies focus on formal and informal domains of numeracy activities, which are inconsistently defined and related to children's math learning. In this study, we explore dimensions of the home numeracy environment and examine their relations with children's math skills among a sample of four-year-old children and their parents over the course of one year. Parents reported on the frequency of 21 numeracy activities when children were four and five. Exploratory and confirmatory factor analyses revealed a two-factors solution: number-related play activities and use of educational materials with numbers. Frequency of play with numbers was positively related to children's ability to solve applied math problems at age five, controlling for prior number skills, child age, and socioeconomic status. In contrast, neither measure of the home numeracy environment predicted symbolic number knowledge or non-symbolic number sense when controlling for covariates. These findings underscore the need to differentiate between factors of the home numeracy environment and to develop clear theoretical definitions of these factors.

Associations among socioeconomic status and preschool-aged children's, number skills, and spatial skills: The role of executive function.

Extensive literature has documented socioeconomic status (SES) disparities in young children's standardized math achievement, which primarily reflect differences in basic number and arithmetic skills. In addition, growing evidence indicates that direct assessments of executive function (EF) both predict standardized math achievement and mediate SES differences in standardized math tests. However, early spatial skills and children's approximate number system (ANS) acuity, critical components of later math competence, have been largely absent in this past research. The current study examined SES associations with multiple direct assessments of early ANS, cardinality, and spatial skills, as well as standardized math achievement, in a socioeconomically diverse sample of 4-year-old children (N = 149). Structural equation modeling revealed SES effect sizes of .21 for geometric sensitivity skills, .23 for ANS acuity, .39 for cardinality skills, and .28 for standardized math achievement. Furthermore, relations between SES and children's spatial skills, ANS acuity, cardinality, and standardized math skills were mediated by a composite measure of children's EF skills. Implications of pervasive SES disparities across multiple domains of early math development, as well as the mitigating role of EF, are discussed.

Time spent playing predicts early reading and math skills through associations with self-regulation.

Children's play time has declined in recent decades, which could negatively impact early self-regulation-a vital component of school readiness. To date, studies have not fully explored how the time spent playing relates to children's self-regulatory skills, and in turn, their early reading and math competencies. Using data from time diaries and direct assessments of self-regulation, prereading, and math skills, this study examined how minutes spent playing at home predict these skills in a sample of 128 children followed from age four to five. Additionally, it considered whether self-regulation explained links between play time and prereading and math. Results showed that the time spent playing positively related to children's self-regulation. Moreover, through its association with self-regulation, play time had indirect effects on prereading and math skills measured one year later. Results suggest that fostering opportunities for play time during the preschool years may help to boost school readiness skills.

Examining income dynamics and externalizing and internalizing trajectories through a developmental psychopathology lens: A nationally representative study.

Prior research has documented elevations in levels of internalizing and externalizing behaviors among children in lower income families in comparison to more advantaged peers. However, most studies focus on behavior problems at a single point in time or within a short developmental period. Associations between income dynamics and developmental trajectories of behavior problems over time are less understood. To address this, the current study uses data from the National Longitudinal Study of Youth (N = 7,476; 50.8% male) to examine how income dynamics (annual income and income volatility) across three distinct developmental periods from early childhood to early adolescence relate to trajectories of externalizing and internalizing problems. Group-based mixture modeling revealed a five-group trajectory model for externalizing behavior and a four-group trajectory model for internalizing behavior. Higher cumulative annual income predicted greater likelihood of belonging to the low-stable group compared to the other, more problematic groups for both externalizing and internalizing trajectories. In addition, income losses predicted higher risk of membership in any group other than the low-stable group for internalizing and externalizing behavior. Developmental period-specific income dynamics, though not as consistent as cumulative dynamics, also predicted trajectory group membership.

What's in a question? Parents' question use in dyadic interactions and the relation to preschool-aged children's math abilities.

The cognitive complexity of adults' questions, particularly during shared book reading, supports children's developing language skills. Questions can be described as having low cognitive demand (CD; e.g., labeling, matching) or high-CD (e.g., comparing, predicting). Little is known about the relation between different types of parental questioning and children's math abilities. The current study examined the quantity of low- and high-CD and domain-specific math questions that parents posed to their 4-year-old children in three structured activities and how the frequency of those questions relates to children's concurrent math and language skills. Parent-child dyads (n = 121) were observed interacting with a picture book, grocery store toys, and a puzzle for about 5 min each, and children completed math and spatial assessments. Although the frequency with which parents asked questions did not relate to children's outcomes, parents' use of high-CD questions was associated with children's spatial skills, standardized math scores, and vocabulary skills after controlling for parental utterances, child utterances, child age, and family socioeconomic status. However, domain-specific math questions were not related to any child outcomes above and beyond parents' total questions. This study suggests that domain-general questions that vary in CD (low and high) are differentially related to children's math and language abilities, which can inform the ways in which parents engage in early learning opportunities with their children.

A randomized pilot trial of a school-based psychoeducational intervention for children with asthma.

BACKGROUND: Asthma is a common childhood illness with high morbidity and mortality among minority and socio-economically disadvantaged children. Disparities are not fully accounted for by differences in asthma prevalence, highlighting a need for interventions targeting factors associated with poorer asthma control. One such factor is psychological stress. OBJECTIVE: Here, we examine the feasibility and acceptability of "I Can Cope (ICC)," a school-based stress management and coping intervention for children with asthma. METHODS: A parallel randomized pilot trial was conducted. One hundred and four low-income children (mean age 10 years; 54% male; 70% African American) with persistent asthma were recruited from 12 urban schools and randomized to the following: (a) ICC or one of two control conditions: (b) "Open Airways for Schools (OAS)"-an asthma education intervention or (c) no treatment. RESULTS: Seventy one percentage of eligible children participated in the study, with a dropout rate of 12%. ICC was rated as highly acceptable by participating children and parents. Preliminary efficacy data suggest that when compared with no treatment, ICC resulted in decreased symptoms of depression, perceived stress and child-reported symptoms of asthma, and improvements in sleep quality and child-reported asthma control. There were no intervention-related changes in objective measures of asthma morbidity. The magnitude of intervention effects on psychological function did not differ between the ICC and OAS groups. CONCLUSIONS: Results support the feasibility and acceptability of utilizing school-based interventions to access hard to reach children with asthma. Preliminary findings offer support for future, large-scale efficacy studies of school-based interventions designed to target multiple factors that contribute to asthma disparities.

Moving Beyond Correlations in Assessing the Consequences of Poverty.

In the United States, does growing up in a poor household cause negative developmental outcomes for children? Hundreds of studies have documented statistical associations between family income in childhood and a host of outcomes in childhood, adolescence, and adulthood. Many of these studies have used correlational evidence to draw policy conclusions regarding the benefits of added family income for children, in particular children in families with incomes below the poverty line. Are these conclusions warranted? After a review of possible mechanisms linking poverty to negative childhood outcomes, we summarize the evidence for income's effects on children, paying particular attention to the strength of the evidence and the timing of economic deprivation. We demonstrate that, in contrast to the nearly universal associations between poverty and children's outcomes in the correlational literature, impacts estimated from social experiments and quasi-experiments are more selective. In particular, these stronger studies have linked increases in family income to increased school achievement in middle childhood and to greater educational attainment in adolescence and early adulthood. There is no experimental or quasi-experimental evidence in the United States that links child outcomes to economic deprivation in the first several years of life. Understanding the nature of socioeconomic influences, as well as their potential use in evidence-based policy recommendations, requires greater attention to identifying causal effects.

Predictors of Public Early Care and Education Use among Children of Low-Income Immigrants.

Little is known about predictors of publicly funded early care and education (ECE) use among low-income children of immigrants. Without this knowledge, it is difficult to effectively increase participation in these public programs, which promote school readiness but are underused by children of immigrants. Using nationally representative data from the Early Childhood Longitudinal Study -Birth Cohort (ECLS-B), this study attempts to identify pertinent family, child, maternal ECE preference, broader contextual, and immigrant specific characteristics predictive of ECE use among 4-year old children in a sample of low-income children of immigrants (N ≈ 1,050). Specifically, we estimate multinomial logistic regression models predicting type of ECE (Head Start, public pre-k, subsidized ECE, unsubsidized ECE, parental care) from these characteristics. Findings suggest that even in a low-income sample, correlates of disadvantage such as low maternal education and prior receipt of public benefits are important predictors of public ECE use, as are maternal preferences for certain features of care and supply-side factors such as ECE availability. Immigrant-specific factors such as English proficiency, citizenship status, availability of non-English speaking caregivers, and generosity of state policies toward immigrants emerged as particularly salient for explaining the public ECE selection patterns of low-income immigrants. Results point to future research areas and potential policy solutions aimed at increasing public ECE use for children who may stand to benefit the most.

REFLECTIONS ON QUALITY AND DOSAGE OF PRESCHOOL AND CHILDREN'S DEVELOPMENT.

This ambitious monograph tackles several important questions related to children's preschool experiences that have relevance for program and policy initiatives at the state and federal levels. The authors' approach is rigorous: they conduct parallel analyses across eight large and diverse studies of preschool children in center care and use meta-analysis to summarize patterns across studies. The study finds nonlinear associations between preschool quality and gains in language and literacy skills, with larger associations in higher versus lower quality classrooms. Results also show that domain-specific measures of preschool quality were more strongly related to children's development than global quality measures. The "dosage" of preschool was likewise important: more years in Head Start predicted larger vocabulary and literacy gains, whereas more time spent on instruction predicted greater literacy and math skills growth. In this commentary, we situate these findings in the broader literature addressing links between preschool experiences and children's development and discuss key takeaways for research, practice, and policy.

Examining Profiles of U.S. Children's Screen Time and Associations with Academic Skills.

Children's screen time (ST) increased in recent years, but investigations of the content and context (e.g., parental presence, and device type) of ST in predicting early academic skills remains understudied. In this study of 127 four- and five-year-olds, we examined whether the educational content and contextual information about children's ST from time diary interviews at age 4 predicted direct assessments of academic skills at age five. Cluster analyses detected three unique groups: Cluster One was "lowest ST and highest non-educational TV, with little parental presence," Cluster Two was "moderate ST and highest educational mobile devices, with moderate parental presence," and Cluster Three was "highest total ST and moderate educational ST and high parental presence." Children in Cluster Two scored significantly higher in literacy skills at age five than peers in Cluster One and Cluster Three. Children in Cluster One scored significantly higher in spatial skills compared to those in Cluster Three. No significant associations were detected between children's ST and number skills. Findings suggest that educational content and contextual features of ST combine in meaningful ways and appear to better predict children's literacy and spatial skills compared to variable-centered approaches. Methodological implications of this research and future directions are discussed.

Psychological stress and the longitudinal progression of subclinical atherosclerosis.

OBJECTIVE: In a midlife sample of adults, the present study tested the extent to which changes in psychological stress relate to the progression of subclinical cardiovascular disease over multiple years and explored the potential moderating role of cardiometabolic risk. METHOD: Participants were screened to exclude those with clinical cardiovascular, respiratory, metabolic, and other chronic illnesses, as well as those taking psychotropic, cardiovascular, lipid, and glucose control medications. At baseline (N = 331) and then again at follow-up an average of 3 years later (N = 260), participants completed the 10-item Perceived Stress Scale, underwent assessments of their cardiometabolic risk, and underwent ultrasonography to measure carotid artery intima-media thickness (IMT), which is a surrogate indicator of subclinical atherosclerosis. RESULTS: Regression models showed that the change in psychological stress from baseline to follow-up was positively associated with the corresponding change in IMT, with covariate control for age at baseline, sex at birth, and variability in length of follow-up across participants. Cardiometabolic risk factors did not statistically moderate this longitudinal association. In exploratory analyses, cardiometabolic risk factors also did not statistically mediate this association. CONCLUSION: These longitudinal findings suggest that increases in psychological stress in midlife relate to corresponding increases in subclinical atherosclerosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Historical Structural Racism in the Built Environment and Contemporary Children's Opportunities.

BACKGROUND AND OBJECTIVES: There are well-documented links between structural racism and inequities in children's opportunities. Yet, when it comes to understanding the role of the built environment, a disproportionate focus on redlining obscures other historical policies and practices such as blockbusting, freeway displacement, and urban renewal that may impact contemporary child development. We hypothesized that historical structural racism in Allegheny County, Pennsylvania's, built environment would be associated with fewer contemporary educational, socioeconomic, and health opportunities. We also hypothesized that these measures would explain more collective variance in children's opportunities than redlining alone. METHODS: We used geospatial data from the US Census, Mapping Inequality Project, and other archival sources to construct historical measures of redlining, blockbusting, freeway displacement, and urban renewal in ArcGIS at the census tract level. These were linked with data from the Child Opportunity Index 2.0 to measure children's opportunities across domains of education, socioeconomic status, and health. We ran spatial regression analyses in Stata 18.0 to examine individual and collective associations between structural racism and children's opportunities. RESULTS: Historical redlining, blockbusting, and urban renewal were largely associated with fewer contemporary educational, socioeconomic, and health opportunities, and explained up to 47.4% of the variance in children's opportunities. The measures collectively explained more variance in children's opportunities than redlining alone. CONCLUSIONS: In support of our hypotheses, novel measures of structural racism were related to present-day differences in children's opportunities. Findings lay the groundwork for future research focused on repairing longstanding harm perpetuated by structural racism.