Cumulative Risk Exposure Research Articles

Family Income, Cumulative Risk Exposure, and White Matter Structure in Middle Childhood.

Family income is associated with gray matter morphometry in children, but little is known about the relationship between family income and white matter structure. In this paper, using Tract-Based Spatial Statistics, a whole brain, voxel-wise approach, we examined the relationship between family income (assessed by income-to-needs ratio) and white matter organization in middle childhood (N = 27, M = 8.66 years). Results from a non-parametric, voxel-wise, multiple regression (threshold-free cluster enhancement, p < 0.05 FWE corrected) indicated that lower family income was associated with lower white matter organization [assessed by fractional anisotropy (FA)] for several clusters in white matter tracts involved in cognitive and emotional functions including fronto-limbic circuitry (uncinate fasciculus and cingulum bundle), association fibers (inferior longitudinal fasciculus, superior longitudinal fasciculus), and corticospinal tracts. Further, we examined the possibility that cumulative risk (CR) exposure might function as one of the potential pathways by which family income influences neural outcomes. Using multiple regressions, we found lower FA in portions of these tracts, including those found in the left cingulum bundle and left superior longitudinal fasciculus, was significantly related to greater exposure to CR (β = -0.47, p < 0.05 and β = -0.45, p < 0.05).

In risky environments, emotional children have more behavioral problems but lower allostatic load.

Developmental models of temperament by environment interactions predict that children's negative emotionality exacerbates the detrimental effects of risky environments, increasing the risk for pathology. However, negative emotions may have an adaptive function. Accordingly, the present study explores an alternative hypothesis that in the context of high adversity, negative emotionality may be a manifestation of an adaptive coping style and thus be protective against the harmful effects of a stressful environment. Prospective combined effects of negative emotionality and cumulative risk (confluence of multiple risk factors related to poverty) on children's internalizing and externalizing symptoms and allostatic load, an index of cumulative physiological dysregulation, were assessed in 239 children (46% female, baseline age = 9). Negative emotionality and cumulative risk were assessed at baseline. Internalizing and externalizing behaviors were measured at 4- and 8-year follow-ups. Allostatic load was measured at baseline and both follow-ups using neuroendocrine, cardiovascular, and metabolic parameters. Linear mixed-effect models were used to analyze the prospective associations between negative emotionality, cumulative risk, and the outcomes-allostatic load and internalizing and externalizing behaviors. The combination of high cumulative risk exposure and high negative emotionality was associated with highest levels of internalizing and externalizing behaviors. However, consistent with the alternative hypothesis, negative emotionality reduced the effects of high cumulative risk on allostatic load. In the context of risky environments, negative emotionality may offer some physical health benefits. (PsycINFO Database Record

Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance: The Young Finns Study

BackgroundIn adults, high blood pressure (BP), adverse serum lipids, and smoking associate with cognitive deficits. The effects of these risk factors from childhood on midlife cognitive performance are unknown. ObjectivesThis study sought to investigate the associations between childhood/adolescence cardiovascular risk factors and midlife cognitive performance. MethodsFrom 1980, a population-based cohort of 3,596 children (baseline age: 3 to 18 years) have been followed for 31 years in 3- to 9-year intervals. BP, serum lipids, body mass index, and smoking were assessed in all follow-ups. Cumulative exposure as the area under the curve for each risk factor was determined in childhood (6 to 12 years), adolescence (12 to 18 years), and young adulthood (18 to 24 years). In 2011, cognitive testing was performed in 2,026 participants aged 34 to 49 years. ResultsHigh systolic BP, elevated serum total-cholesterol, and smoking from childhood were independently associated with worse midlife cognitive performance, especially memory and learning. The number of early life risk factors, including high levels (extreme 75th percentile for cumulative risk exposure between ages 6 and 24 years) of systolic BP, total-cholesterol, and smoking associated inversely with midlife visual and episodic memory and visuospatial associative learning (–0.140 standard deviations per risk factor, p < 0.0001) and remained significant after adjustment for contemporaneous risk factors. Individuals with all risk factors within recommended levels between ages 6 and 24 years performed 0.29 standard deviations better (p = 0.006) on this cognitive domain than those exceeding all risk factor guidelines at least twice. This difference corresponds to the effect of 6 years aging on this cognitive domain. ConclusionsCumulative burden of cardiovascular risk factors from childhood/adolescence associate with worse midlife cognitive performance independent of adulthood exposure.

Resting sympathetic arousal moderates the association between parasympathetic reactivity and working memory performance in adults reporting high levels of life stress.

The neurovisceral integration model stipulates that autonomic function plays a critical role in the regulation of higher-order cognitive processes, yet most work to date has examined parasympathetic function in isolation from sympathetic function. Furthermore, the majority of work has been conducted on normative samples, which typically demonstrate parasympathetic withdrawal to increase arousal needed to complete cognitive tasks. Little is known about how autonomic regulation supports cognitive function in populations exposed to high levels of stress, which is critical given that chronic stress exposure alters autonomic function. To address this, we sought to characterize how parasympathetic (high-frequency heart rate variability, HF-HRV) and sympathetic (preejection period, PEP) measures of cardiac function contribute to individual differences in working memory (WM) capacity in a sample of high-risk women. HF-HRV and PEP were measured at rest and during a visual change detection measure of WM. Multilevel modeling was used to examine within-person fluctuations in WM performance throughout the task concurrently with HF-HRV and PEP, as well as between-person differences as a function of resting HF-HRV and PEP levels. Results indicate that resting PEP moderated the association between HF-HRV reactivity and WM capacity. Increases in WM capacity across the task were associated with increases in parasympathetic activity, but only among individuals with longer resting PEP (lower sympathetic arousal). Follow-up analyses showed that shorter resting PEP was associated with greater cumulative risk exposure. These results support the autonomic space framework, in that the relationship between behavior and parasympathetic function appears dependent on resting sympathetic activation.

Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Moderating Role of Sex.

Children exposed to multiple stressors are more likely to be overweight, but little is known about the mechanisms explaining this association. This cross-sectional study examined whether children exposed to multiple stressors had higher waist circumference, and whether this association was mediated through children's television time. Participants were 319 parent-child dyads. Children were 2-5years old and had at least one overweight parent (BMI≥25kg/m2). Data were collected at baseline of a larger childhood obesity prevention study and included information on psychosocial stressors (e.g., parenting stress), demographic stressors (e.g., low income), children's television time, and children's waist circumference. Two cumulative risk scores were created by summing stressors in each domain (demographic and psychosocial). Mediation and moderated mediation analyses were conducted. Indirect effects of both cumulative risk scores on waist circumference through television time were not significant; however, moderated mediation analyses found significant moderation by gender. The indirect effects of both risk scores on waist circumference through television time were significant and positive for girls, but near-zero for boys. Reducing television time should be explored as a strategy for buffering against the negative health effects of exposure to multiple stressors among girls. Longitudinal and intervention research is needed to confirm these results and to identify mediating factors between cumulative risk and body weight among boys.

Longitudinal Pathways from Cumulative Contextual Risk at Birth to School Functioning in Adolescence: Analysis of Mediation Effects and Gender Moderation.

Children and adolescents exposed to multiple contextual risks are more likely to have academic difficulties and externalizing behavior problems than those who experience fewer risks. This study used data from the Northern Finland Birth Cohort 1986 (a population-based study; N = 6961; 51 % female) to investigate (a) the impact of cumulative contextual risk at birth on adolescents' academic performance and misbehavior in school, (b) learning difficulties and/or externalizing behavior problems in childhood as intervening mechanisms in the association of cumulative contextual risk with functioning in adolescence, and (c) potential gender differences in the predictive associations of cumulative contextual risk at birth with functioning in childhood or adolescence. The results of the structural equation modeling analysis suggested that exposure to cumulative contextual risk at birth had negative associations with functioning 16 years later, and academic difficulties and externalizing behavior problems in childhood mediated some of the predictive relations. Gender, however, did not moderate any of the associations. Therefore, the findings of this study have implications for the prevention of learning and conduct problems in youth and future research on the impact of cumulative risk exposure.

Cumulative social risk exposure in childhood and smoking and excessive alcohol use in adulthood.

Social inequalities in adult smoking and excessive alcohol intake may be associated with exposure to multiple childhood social risk factors across different domains of risk within the household. We used data from a cross-sectional cohort study of adults (40-75 years) in 1993-97 living in England (N = 19466) to examine the association between clusters of childhood social risks across different domains with adult smoking and excessive alcohol use. Participants reported exposure to six childhood social risk factors, current smoking behaviour and alcohol intake. Factor analysis was used to identify domains of social risk. We created a childhood cumulative domain social risk score (range 0-2) from summing the total number of domains. Factor analysis identified two domains of childhood social risk within the household: maladaptive family functioning (parental unemployment, substance misuse, physical abuse) and parental separation experiences : maternal separation, divorce, being sent away from home). Compared to those children with risk exposure in no single domain, children with risk exposure in both domains (i.e. maladaptive family functioning, parental separation experiences) had a higher prevalence of adult smoking [men: Prevalence ratio (PR) = 1.74, 95% confidence intervals (CI): 1.35-2.26; women: PR = 1.71 95% CI: 1.34-2.18]. There was a trend association between the number of childhood social risk domains and adult smoking (both sexes: P < 0.001) and excessive alcohol use (men: P <0.008). Further work is needed to understand if addressing cumulative risk exposure to maladaptive family functioning and parental separation experiences can reduce social inequalities in adult smoking and excessive alcohol intake.

Cumulative contextual risk and behavior problems among children with substance using mothers: The mediating role of mothers' and children's coping strategies.

Substance using mothers vary in their exposure to an accumulation of contextual risks associated with their drug-using lifestyles, likely leading to variability in their children's behavioral outcomes. The present study examined a mediation model interrelating mothers' cumulative risk exposure, children's behavior problems, and coping strategies of both mothers and children. Findings showed that mothers' greater exposure to cumulative risk was associated with lower utilization of task-oriented coping and higher utilization of emotion-oriented coping. Further, mothers' emotion-oriented coping mediated the association between mothers' cumulative risk exposure and children's behavior problems. These findings underscore the importance of considering the family socialization context in understanding children's problem behaviors in a high-risk population. The finding that mothers' emotion-oriented coping exerted a strong influence on children's behavior problems suggests that emotion-oriented coping may be a critical intervention target for family based prevention interventions. (PsycINFO Database Record

RACE AND THE DISTRIBUTION OF SOCIAL AND PHYSICAL ENVIRONMENTAL RISK: A Case Example from the Detroit Metropolitan Area.

Since W. E. B. Du Bois documented the physical and social environments of Philadelphia's predominantly African American Seventh Ward over a century ago, there has been continued interest in understanding the distribution of social and physical environments by racial make-up of communities. Characterization of these environments allows for documentation of inequities, identifies communities which encounter heightened risk, and can inform action to promote health equity. In this paper, we apply and extend Du Bois's approach to examine the contemporary distribution of physical environmental exposures, health risks, and social vulnerabilities in the Detroit metropolitan area, one of the most racially-segregated areas in the United States. We begin by mapping the proximity of sensitive populations to hazardous land uses, their exposure to air pollutants and associated health risks, and social vulnerabilities, as well as cumulative risk (combined proximity, exposure, and vulnerability), across Census tracts. Next, we assess, quantitatively, the extent to which communities of color experience excess burdens of environmental exposures and associated health risks, economic and age-related vulnerabilities, and cumulative risk. The results, depicted in maps presented in the paper, suggest that Census tracts with greater proportions of people of color disproportionately encounter physical environmental exposures, socioeconomic vulnerabilities, and combined risk. Quantitative tests of inequality confirm these distributions, with statistically greater exposures, vulnerabilities, and cumulative risk in Census tracts with larger proportions of people of color. Together, these findings identify communities that experience disproportionate cumulative risk in the Detroit metropolitan area and quantify the inequitable distribution of risk by Census tract relative to the proportion of people of color. They identify clear opportunities for prioritizing communities for legislative, regulatory, policy, and local actions to promote environmental justice and health equity.

The Roles of School Readiness and Poverty-Related Risk for 6th Grade Outcomes.

Low-income students are at increased risk for grade retention and suspension, which dampens their chances of high school graduation, college attendance, and future success. Drawing from a sample of 357 children and their families who participated in the Chicago School Readiness Project, we examine whether greater exposure to cumulative poverty-related risk from preschool through 5th grade is associated with greater risk of student retention and suspension in 6th grade. Logistic regression results indicate that exposure to higher levels of cumulative risk across the elementary school years is associated with students’ increased risk of retention in 6th grade, even after controlling for child school readiness skills and other covariates. Importantly, findings of the association between average cumulative risk exposure and student suspension are more complex; the role of poverty-related risk is reduced to non-significance once early indicators of child school readiness and other covariates are included in regression models. While, children’s early externalizing behavior prior to kindergarten places children at greater risk of suspension 7 years later, children’s higher levels of internalizing behaviors and early math skills are associated with significantly decreased risk of suspension in the 6th grade. Together, findings from the study suggest the complex ways that both early school readiness and subsequent exposure to poverty-related risk may both serve as compelling predictors of children’s likelihood of “staying on track” academically in the 6th grade.

Cumulative social risk exposure and risk of cancer mortality in adulthood.

BackgroundAdults in the United States (U.S) can be simultaneously exposed to more than one social risk factor over their lifetime. However, cancer epidemiology tends to focus on single social risk factors at a time. We examined the prospective association between cumulative social risk exposure and deaths from cancer in a nationally representative sample of U.S. adults.MethodsThe study included 8745 adults (aged ≥ 40 years) in the NHANES Survey III Mortality Study over a median follow-up of 13.5 years (1988-1994 enrollment dates and 1988 through 2006 for mortality data). Social risk factors (low family income, low education level, minority race, and single-living status) were summed to create a cumulative social risk score (0 to ≥3). We used Cox proportional hazard models to estimate age- and sex-adjusted hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for the association between cumulative social risk with deaths from all-cancers combined, tobacco-related cancers, and screening-detectable cancers.ResultsDeaths from all-cancers combined (P for trend = 0.001), tobacco-related cancers (P for trend = <0.001), and lung cancer (P for trend = 0.01) increased with an increasing number of social risk factors. As compared with adults with no social risk factors, those exposed to ≥3 social risk factors were at increased risk of deaths from all-cancers combined (HR = 1.8, 95 % CI = 1.3-2.4), tobacco-related cancers (HR = 2.6, 95 % CI: 1.6-4.0), and lung cancer (HR = 2.3, 95 % CI = 1.3-4.1).ConclusionsU.S. adults confronted by higher amounts of cumulative social risk appear to have increased mortality from all-cancers combined, tobacco-related cancers, and lung cancer. An enhanced understanding of the cumulative effect of social risk factors may be important for targeting interventions to address social disparities in cancer mortality.

Childhood Cumulative Risk Exposure and Adult Amygdala Volume and Function.

Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined the neurological underpinnings of these robust findings. This study investigates amygdala volume and reactivity to facial stimuli among adults (mean 23.7 years of age, n = 54) as a function of cumulative risk exposure during childhood (9 and 13 years of age). In addition, we test to determine whether expected cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socioemotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes were positively related to cumulative risk exposure during childhood. The links between childhood cumulative risk exposure and elevated amygdala responses to emotionally neutral facial stimuli in adulthood were mediated by the corresponding amygdala volumes. Cumulative risk exposure in later adolescence (17 years of age), however, was unrelated to subsequent adult amygdala volume or function. Physical and socioemotional risk exposures early in life appear to alter amygdala development, rendering adults more reactive to ambiguous stimuli such as neutral faces. These stress-related differences in childhood amygdala development might contribute to the well-documented psychological distress as a function of early risk exposure.

Poor, Unsafe, and Overweight: The Role of Feeling Unsafe at School in Mediating the Association Among Poverty Exposure, Youth Screen Time, Physical Activity, and Weight Status.

This study applied socioecological and cumulative risk exposure frameworks to test the hypotheses that 1) the experience of poverty is associated with feeling less safe at school, and 2) feeling less safe is associated with engaging in poorer weight-related behaviors, as well as an increased probability of being overweight or obese. Data were from the ongoing Québec Longitudinal Study of Child Development, initiated in 1998 with a population-based cohort of 2,120 Québec (Canada) infants 5 months of age and their parent or primary caregiver. Measures of youths' (age, 13 years) self-reported feelings of safety, screen time, physical activity, and objectively assessed not overweight/obese (70%), overweight (22%), and obese (8%) weight status were collected in 2011. Family poverty trajectory from birth was assessed by using latent growth modeling. As hypothesized, exposure to poverty was associated with feeling less safe at school and, in turn, with an increased probability of being overweight or obese. The association was most pronounced for youths who experienced chronic poverty. Compared with youths who experienced no poverty and felt unsafe, those who experienced chronic poverty and felt unsafe were nearly 18% more likely to be obese (9.2% vs. 11.2%). Although feeling unsafe was associated with screen time, screen time did not predict weight status.

Abstract 16673: Framingham Risk Trajectories Predict Left Ventricular Dyssynchrony as a Measure of Subclinical Myocardial Dysfunction: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Left ventricular (LV) dyssynchrony is a measure of myocardial dysfunction in heart failure patients. However, its significance as a marker of incipient myocardial dysfunction in response to cumulative risk burden among asymptomatic individuals is not known. Our objective was to evaluate the extent of LV dyssynchrony in relationship to longitudinal changes in cardiovascular risk in otherwise healthy middle age individuals. Methods &amp; Results: We defined five distinct Framingham risk score (FRS, D’Agostino Circulation 2008) (excluding age) trajectories in the CARDIA cohort (n=4634) to estimate the pattern of cumulative cardiovascular risk exposure over 25 year. Standard deviation of time to peak systolic circumferential strain (SD-TPS) among 6 mid-ventricular segments using 2-dimensional speckle-tracking echocardiography determined the extent of LV dyssynchrony in 2718 participant (54.3% women). Using multivariate linear regression after adjustment for demographics and LV ejection fraction, we found that among women in comparison to the low-stablegroup (reference trajectory), increased burden of cardiovascular risk was associated with progressively higher values of SD-TPS; B-coefficients were 3.50msec (95%CI, 0.23 - 6.77, p=0.04) for the moderate-stable, 7.32msec (2.56 - 12.09, p=0.003) for the elevated-stable, 8.79msec (3.49 - 14.10, p=0.001) for the moderate-increasing, and 9.54msec (0.09 - 18.99, p=0.048) for the elevated-increasing groups. There was attenuation of parameter estimates after further adjustment for cumulative body-mass-index (BMI) with loss of statistical significance. These associations were not statistically significant in men. Conclusions: Women had higher values of subclinical LV dyssynchrony in response to incremental cumulative cardiovascular risk burden over 25 years. Such relationships were absent in men. Cumulative BMI was the strongest predictor of LV dyssynchrony.

Cumulative Social Risk Exposure, Infant Birth Weight, and Cognitive Delay in Infancy

ObjectiveTo determine the effect of exposure to multiple social risks on cognitive delay at 9 months of age; and whether obstetric factors mediate the relationship between cumulative social risk and cognitive delay. MethodsData were from 8950 mother–child dyads participating in the first wave of the Early Childhood Longitudinal Study, Birth Cohort. Cognitive delay was defined as falling in the lowest 10% of mental scale scores from the Bayley Short Form–Research Edition. Five social risk factors were combined and categorized into a social risk index. Staged multivariable logistic regressions were used to investigate whether obstetric factors mediated the impact of social risk on the odds of cognitive delay. ResultsInfants with cognitive delay were more likely to live with social risks than infants without cognitive delay. The percentage of infants with cognitive delay increased with the number of social risks. In adjusted analyses, exposure to multiple social risk factors was associated with higher odds of cognitive delay at 9 months of age (adjusted odds ratio 2.11; 95% confidence interval 1.18–3.78 for 4 or more risks vs no risks). Accounting for birth weight attenuated this relationship (P < .001). ConclusionsThis population-based study investigated the independent and cumulative effects of social risk factors on cognitive delay in infancy. Findings revealed a significant cumulative relationship between exposure to social risk and cognitive delay, which was partly mediated by birth weight. Programs that address the social context of US infants are needed to improve their developmental trajectories.

New York City Environmental Justice Alliance Waterfront Justice Project

This paper reviews key challenges and opportunities addressed by the New York City Environmental Justice Alliance's (NYC-EJA) Waterfront Justice Project, a citywide campaign to promote climate resilience and sustainability in urban industrial waterfront communities of New York City. NYC-EJA is a non-profit membership-driven network linking grassroots organisations from low-income neighbourhoods and communities of colour in their struggle for environmental justice. The Waterfront Justice Project is documenting community vulnerability in the context of climate change impacts, sources of industrial pollution, and demographic and socio-economic trends. This campaign is enabling community-based organisations, environmental justice communities, city planners, local and state government agencies, local business-owners, and other stakeholders to work in partnership to achieve community resilience while advocating for local jobs and promoting best practices in pollution prevention. New York City's waterfront policies ease the siting and clustering of public infrastructure, water pollution control plants, waste transfer stations, energy facilities, and heavy manufacturing uses in six areas designated as Significant Maritime and Industrial Areas (SMIAs). The SMIAs are located in environmental justice communities, largely low-income communities and communities of colour, in the South Bronx, Brooklyn, Queens, and Staten Island. New York City's local waterfront land use and zoning policies create cumulative risk exposure not only to residents and workers in the host waterfront communities, but also, in the event of storm surge or sea-level rise, to neighbouring, upland communities.

Diurnal cortisol rhythms in youth from risky families: Effects of cumulative risk exposure and variation in the serotonin transporter linked polymorphic region gene—ERRATUM

Building on research on cumulative risk and psychopathology, this study examines how cumulative risk exposure is associated with altered diurnal cortisol rhythms in an ethnically diverse, low-income sample of youth. In addition, consistent with a diathesis-stress perspective, this study explores whether the effect of environmental risk is moderated by allelic variation in the serotonin transporter linked polymorphic region (5-HTTLPR) gene. Results show that youth with greater cumulative risk exposure had flatter diurnal cortisol slopes, regardless of 5-HTTLPR genotype. However, the association of cumulative risk with average cortisol output (area under the curve [AUC]) was moderated by the 5-HTTLPR genotype. Among youth homozygous for the long allele, greater cumulative risk exposure was associated with lower cortisol AUC, driven by significant reductions in cortisol levels at waking. In contrast, there was a trend-level association between greater cumulative risk and higher cortisol AUC among youth carrying the short allele, driven by a trend-level increase in bedtime cortisol levels. Findings are discussed with regard to the relevance of dysregulated diurnal cortisol rhythms for the development of psychopathology and the implications of genetically mediated differences in psychophysiological adaptations to stress.

Associations between parenting, media use, cumulative risk, and children's executive functioning.

This study was designed to examine how parenting style, media exposure, and cumulative risk were associated with executive functioning (EF) during early childhood. A nationally representative group of US parents/caregivers (N = 1156) with 1 child between 2 and 8 years participated in a telephone survey. Parents were asked to report on their child's exposure to television, music, and book reading through a 24-hour time diary. Parents also reported a host of demographic and parenting variables as well as questions on their child's EF. Separate multiple regressions for preschool (2-5 years) and school-aged (6-8 years) children grouped by cumulative risk were conducted. Parenting style moderated the risks of exposure to background television on EF for high-risk preschool-age children. Educational TV exposure served as a buffer for high-risk school-aged children. Cumulative risk, age, and parenting quality interacted with a number of the exposure effects. The study showed a complex pattern of associations between cumulative risk, parenting, and media exposure with EF during early childhood. Consistent with the American Academy of Pediatrics, these findings support the recommendation that background television should be turned off when a child is in the room and suggest that exposure to high-quality content across multiple media platforms may be beneficial.

Diurnal cortisol rhythms in youth from risky families: effects of cumulative risk exposure and variation in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) [corrected

Building on research on cumulative risk and psychopathology, this study examines how cumulative risk exposure is associated with altered diurnal cortisol rhythms in an ethnically diverse, low-income sample of youth. In addition, consistent with a diathesis-stress perspective, this study explores whether the effect of environmental risk is moderated by allelic variation in the promoter region of the serotonin transporter gene-linked polymorphic region (5-HTTLPR). Results show that youth with greater cumulative risk exposure had flatter diurnal cortisol slopes, regardless of 5-HTTLPR genotype. However, the association of cumulative risk with average cortisol output (area under the curve [AUC]) was moderated by the 5-HTTLPR genotype. Among youth homozygous for the long allele, greater cumulative risk exposure was associated with lower cortisol AUC, driven by significant reductions in cortisol levels at waking. In contrast, there was a trend-level association between greater cumulative risk and higher cortisol AUC among youth carrying the short allele, driven by a trend-level increase in bedtime cortisol levels. Findings are discussed with regard to the relevance of dysregulated diurnal cortisol rhythms for the development of psychopathology and the implications of genetically mediated differences in psychophysiological adaptations to stress.

Walking in the shoes of another: assessing the boundaries of an environmental justice community and cumulative risk exposure through collaborative research

This project examines a methodology for collaboration to identify potential sources of cumulative exposures for community members during their routine weekly travels. While many sources of exposures require registration with state or federal regulatory systems, other small-scale sites may go unnoticed except by everyday occupants of the area. Residents who have few financial resources may call home those environments where exposures to multiple contaminants coexist with psychosocial stress and occur either simultaneously or sequentially to create synergistic effects on individual health. We conducted a “nested” model of community-based collaborative research with community organizations and individuals employing interviews, cognitive mapping, and geographic information systems to characterize a proposed environmental justice community in Yonkers in New York state, USA. The ability to tap into local knowledge and obtain a more comprehensive assessment of potential contaminants presents opportunities for more thorough assessment of cumulative exposures, calling for context-relevant forms of participation.