Growing a New Study: Environmental Influences on Child Health Outcomes.

Abstract

Prevalence rates for asthma, autism spectrum disorders, obesity, attention-deficit/hyperactivity disorder, and many other chronic childhood diseases remain stubbornly high in the United States.1 It is also now widely understood that environmental exposures in early development and even preconception can adversely affect an individual’s health long after childhood.2 Environmental factors in child development therefore affect the health not just of children themselves but of all society. Now the National Institutes of Health (NIH) is developing a large-scale long-term program to better understand these factors, dubbed Environmental Influences on Child Health Outcomes (ECHO). A new program known as Environmental Influences on Child Health Outcomes will take advantage of existing birth cohorts, and possibly new cohorts, as well to study key areas of concern to children’s development and health. NIH leaders envision building ECHO around four areas of public health interest: 1) upper- and lower-airway conditions, such as asthma and allergies; 2) obesity and related conditions such as diabetes and metabolic syndrome; 3) pre-, peri-, and postnatal outcomes, including birth defects; and 4) neurodevelopment and related conditions and outcomes such as autism, behavior, and cognition. Standardized core elements expected to be measured across each focus area will include demographics, growth, sleep, nutrition, and activity patterns, among others, plus newer parameters enabled by more recent scientific advances, including those pertaining to the microbiome and epigenetic influences on childhood development. In a Request for Information (RFI) issued 13 July 2015, the NIH solicited input on these plans.3 Approximately 190 comments were received. As a general theme, the comments applauded the NIH’s effort to pull together a large, racially diverse study, while also raising concerns about how ECHO will integrate data sets derived from different sources and address the effects of early-life exposures, especially during gestation.