What happems to and around children in the earliest years of their life may set the trajectory for their long-term health and wellbeing, argues Dr. Katherine Theall, director of the Mary Amelia Douglas-Whited Community Women’s Health Education Center. Theall, associate professor of global community health and behavioral sciences, and her colleagues are collaborating to understand the nexus of genetics, psychosocial exposures, and social determinants of health in New Orleans children as part of the Stress and Environment Research Collaborative on Health Disparities (SERCH).
I definitely think taking a life course perspective on how early exposures shape health disparities is important,” explains Theall, whose body of research has examined the relationship between social factors such as poverty, discrimination, violence, psychosocial stress, and health outcomes.
SERCH, housed in the J. Bennett Johnston Building, seeks to:
- identify an epigenetic psychophysiological profile that sets the health trajectory;
- uncover causes of health disparities, particularly exposures in the physical and social environment;
- define and explore the impact of community-level and interpersonal stress in development of this trajectory;
- design and test interventions to promote healthy trajectories and reduce health disparities;
- and take a leadership role in interdisciplinary training related to health disparities.
Under this umbrella, research projects are considering factors such as a child’s attachment to parents, diet, physical activity, stress, community and interpersonal violence, zero tolerance policies in the schools, dropout rates, and racial discrimination, along with health outcomes. Researchers involved in SERCH include Stacy Drury, assistant professor of psychiatry in the School of Medicine, and at least 15 additional faculty across five schools within Tulane University.
The research looks not only at the factors children face in early childhood, but the experience of their mothers during pregnancy. In particular, Theall’s team is interested in the impact of racial discrimination, historical racial trauma, and stress on pregnancy outcomes.
“For example, we are looking at racial residential segregation, and how that produces disparities in poor birth outcomes between black
Violence and DNA
Exposure to family violence or trauma, such as incarceration, may alter children’s DNA, increasing the chance that they will have poorer health as they grow up. Theall, Drury, and their team observed that young girls in particular have shorter telomeres – a component of DNA that usually protects DNA during replication — if their families are fractured by violence or trauma.
The researchers analyzed demographic data and DNA from participating children at ages 5 to 15 in the New Orleans area. They talked to parents about adversity in the family, sampled saliva from the children, and took a look at the DNA. Telomere length, from buccal cell DNA, was determined by using monochrome multiplex quantitative real-time polymerase chain reaction. The results, which showed a relationship between exposure to violence or trauma and telomere length, appeared in the June 2014 issue of Pediatrics. Shorter telomeres, a measure of aging and physical stress, suggest a greater risk of poor health later on.
Theall argues that this study and others conducted by SERCH researchers are yielding information that can help communities and families position themselves to give children the best shot at a healthy life.
“Domestic violence still plays a huge role and is probably more proximal to some of the outcomes that we are looking at, but we are also trying to look at the community-level factors, and how that plays a role in the domestic violence,” she says. “Ultimately, our research is showing that the violence and stress around
Information to Action
As the data clarifies the relationship between early exposure to stress from a variety of sources and health outcomes, Theall says that her team is challenged to find ways to share that information.
“That’s where the Mary Amelia Douglas-Whited Community Women’s Health Education Center has been helpful in linking to SERCH, because it’s a community health education center, so we can incorporate the information into our programs, working with community-based organizations and others, to address such exposures, and the role that those factors play in children’s health,” says Theall.
But she also is realistic about the difficulty of communicating her team’s research results. For example, knowing that domestic violence may have altered a child at the DNA level could leave already stressed parents feeling more helpless. Theall argues that there may be ways to reverse the damage, such as healthy, active lifestyles, but the ideal approach is to prevent it in the first place by identifying risk factors and developing creative strategies for reducing them.
“Not that these things aren’t reversible, but if we know there are so many factors that shape health disparities that start in utero or before age 5, what can we be doing to make a difference in the long-term production of health? We have to explain what this research means in the grand scheme of things,” she says. Theall and her team at the center reach out to community partners who work with mothers and families, doctors’ offices, and to mothers themselves to find out how best to use the research results. They are also looking at ways to communicate with policy makers, hoping to promote prevention efforts among multiple audiences.
— Madeline Vann
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