Lifecourse Exposures and Socioeconomic Disparities in Child Health

Abstract

This chapter focuses on what is known about socioeconomic disparities (SES) in child health and different types of exposures during childhood, in utero, and from the previous generation that may contribute to those disparities. SES disparities in child health appear to be substantial, begin at very young ages, persist, and compound over the lifecourse. Few types of exposures specifically during childhood appear to be promising explanations for observed linkages between SES and child health, although neighborhood and city characteristics, environmental toxins, parent behaviors, and children’s epigenetic responses to exposures deserve more scrutiny. An increasing number of studies point to the importance of in utero and intergenerational exposures, suggesting that health disparities emerge earlier than previously thought. Maternal nutrition (in utero, prior to conception, and during the mother’s own fetal development and childhood) is a promising area of research for understanding SES disparities in child health, as are prenatal and preconceptional exposures to toxins through occupations and residential environments. For significant advances to be made in understanding health disparities among both children and adults, we need a better conceptualization of the process leading to health disparities, more knowledge about determinants of health, and better conceptualization and measurement of health, particularly among children.