The origins of many adult diseases can be traced to early negative experiences associated with social class and other markers of disadvantage.
Confronting the causes of adversity before and shortly after birth may be a promising way to improve adult health and reduce premature deaths, researchers argue in a paper published today in JAMA: The Journal of the American Medical Association. These adversities establish biological "memories" that weaken physiological systems and make individuals vulnerable to problems that can lie dormant for years.
"Improving the developmental trajectory of a child by helping the parents and improving the home environment is probably the single most important thing we can do for the health of that child," says co-author Bruce McEwen, Alfred E. Mirsky Professor and head of the Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology at The Rockefeller University. "Adverse childhood experience is one of the largest contributors to such chronic health problems as diabetes and obesity, psychiatric disorders, drug abuse - almost every major public health challenge we face."
In the report, McEwen and his co-authors distinguish between levels of stress experienced by young children. "Positive" and "tolerable" stress, with the support of adults, help the body and brain learn to cope with brief situations of adversity, while "toxic" stress, which can disrupt brain architecture and other organ systems, increases the risk for stress-related disease and cognitive impairment well into adulthood. Major risk factors for toxic stress include extreme poverty, recurrent physical and/or emotional abuse, chronic neglect, severe maternal depression, parental substance abuse, and family violence.
An intervention to relieve toxic stress that children experience early in life could not only affect their own individual well-being and longevity but also improve overall societal health, the report concludes. In particular, the researchers highlight three findings and propose promising applications in health policy and clinical practice: