title: Childhood poverty and blood pressure reactivity to and recovery from an acute stressor in late adolescence: the mediating role of family conflict.
abstract: OBJECTIVE
  Childhood deprivation is inimical to health throughout the life course. Early experiences of stress could play a role in health inequalities. An important aspect of childhood poverty that has not received much attention is cardiovascular reactivity to and recovery from acute stressors.
  
  
  METHODS
  Piecewise, multilevel growth curve regression was used to examine blood pressure reactivity to and recovery from a mental arithmetic task among late adolescents (mean [standard deviation] = 17.3 [1.0] years, n = 185) as a function of early childhood poverty (9 years). We also tested whether exposure to family conflict at age 13 years mediated expected linkages between childhood poverty and adolescent blood pressure reactivity and recovery to an acute stressor.
  
  
  RESULTS
  Blood pressure reactivity was unaffected by household income during childhood, but late adolescents with lower household income during childhood showed slower systolic (b = -0.29, p = .004) and diastolic (b = -0.19, p = .002) recovery. These results include age and sex as statistical covariates. The significant poverty impact on systolic but not on diastolic blood pressure recovery was mediated by exposure to family conflict (95% confidence interval = - 0.1400 to - 0.0012).
  
  
  CONCLUSIONS
  We show that late adolescents who grew up in poverty have delayed blood pressure recovery from an acute stressor. Furthermore, childhood exposure to family conflict, a well-documented component of early childhood deprivation, accounted for some of the adverse effects of childhood poverty on stressor recovery among these adolescents. We discuss the importance of considering physiological stress accompanying early experiences of deprivation in thinking about health inequalities.
authors: Departments of Design & Environmental Analysis, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA. gwe1@cornell.edu
authors: Gary W
authors: GW
authors: Evans
authors: Deinera
authors: D
authors: Exner-Cortens
authors: Pilyoung
authors: P
authors: Kim
authors: Daniel
authors: D
authors: Bartholomew
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D002319:Cardiovascular System / Q000503:physiopathology*; D002648:Child; D054541:Family Conflict; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D055361:Multilevel Analysis; D009518:New York; D011203:Poverty / Q000706:statistics & numerical data*; D012424:Rural Population; D012923:Social Class; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology
keywords: blood pressure; childhood poverty; stress reactivity and recovery
references: Health Psychol. 2003 Jan;22(1):106-10
references: 12558208
references: Dev Psychopathol. 2008 Winter;20(1):233-55
references: 18211736
references: Psychol Sci. 2007 Nov;18(11):953-7
references: 17958708
references: Psychosom Med. 2000 Nov-Dec;62(6):760-7
references: 11138994
references: Hypertension. 2000 Jan;35(1 Pt 2):496-500
references: 10642348
references: Am Heart J. 1987 Mar;113(3):812-8
references: 3825870
references: Psychophysiology. 1997 Nov;34(6):649-59
references: 9401420
references: Multivariate Behav Res. 2001 Apr 1;36(2):249-77
references: 26822111
references: Psychol Bull. 1984 Nov;96(3):435-64
references: 6393178
references: Multivariate Behav Res. 2004 Jan 1;39(1):99
references: 20157642
references: Hypertension. 2010 Apr;55(4):1026-32
references: 20194301
references: Child Dev. 2002 Jul-Aug;73(4):1238-48
references: 12146745
references: Ann N Y Acad Sci. 2010 Feb;1186:223-39
references: 20201875
references: Annu Rev Psychol. 2007;58:175-99
references: 16903807
references: Annu Rev Public Health. 2010;31:329-47 3p following 347
references: 20070189
references: Proc Natl Acad Sci U S A. 2009 Apr 21;106(16):6545-9
references: 19332779
references: Child Dev. 2004 Jul-Aug;75(4):1039-52
references: 15260863
references: Am Psychol. 1998 Feb;53(2):121-35
references: 9491743
references: Psychol Bull. 2011 Nov;137(6):959-97
references: 21787044
references: Psychol Sci. 2012 Sep 1;23(9):979-83
references: 22825357
references: Ann N Y Acad Sci. 2010 Feb;1186:1-4
references: 20201864
references: Psychosom Med. 1998 Nov-Dec;60(6):765-72
references: 9847038
references: Eur Heart J. 2002 Nov;23(22):1757-63
references: 12419295
references: Physiol Behav. 2012 Apr 12;106(1):29-39
references: 21888923
references: Psychol Bull. 2013 Jul;139(4):901-16
references: 23025924
references: Psychol Rev. 2010 Jan;117(1):134-74
references: 20063966
references: Psychosom Med. 2005 Jul-Aug;67(4):514-21
references: 16046362
references: Ann N Y Acad Sci. 2010 Feb;1186:37-55
references: 20201867
references: Int J Psychophysiol. 1999 Jan;31(2):111-9
references: 9987057
references: Child Dev. 2001 Jul-Aug;72(4):1231-46
references: 11480944
references: Health Psychol. 2007 May;26(3):296-304
references: 17500616
references: Child Dev. 1993 Apr;64(2):500-15
references: 8477631
references: Psychol Methods. 2004 Mar;9(1):30-52
references: 15053718
references: Ann N Y Acad Sci. 2010 Feb;1186:190-222
references: 20201874
references: Dev Psychopathol. 2005 Spring;17(2):303-28
references: 16761547
references: Dev Psychopathol. 2011 Aug;23(3):897-906
references: 21756440
references: Health Psychol. 2011 Sep;30(5):570-8
references: 21644806
references: Science. 1997 Aug 15;277(5328):918-24
references: 9252316
references: Dev Psychopathol. 2005 Spring;17(2):271-301
references: 16761546
references: Psychophysiology. 1992 Jan;29(1):17-28
references: 1609024
references: Ethn Dis. 1998 Autumn;8(3):367-76
references: 9926907
references: Psychosom Med. 2005 Jan-Feb;67(1):9-15
references: 15673618
references: Child Dev. 2001 Nov-Dec;72(6):1844-67
references: 11768149
references: Psychophysiology. 1988 Jan;25(1):97-106
references: 3353490
references: Psychol Bull. 2002 Mar;128(2):295-329
references: 11931521
references: Brain Behav Immun. 2010 Nov;24(8):1324-31
references: 20600814
references: Health Psychol. 1999 Mar;18(2):140-50
references: 10194049
references: Soc Cogn Affect Neurosci. 2008 Jun;3(2):91-6
references: 18594696
references: Annu Rev Public Health. 2008;29:235-52
references: 18031225
references: N Engl J Med. 1998 Jan 15;338(3):171-9
references: 9428819
references: Health Psychol. 2009 May;28(3):338-46
references: 19450040
references: Psychol Bull. 2003 May;129(3):447-66
references: 12784938
references: Am J Public Health. 2010 Apr 1;100 Suppl 1:S186-96
references: 20147693
references: JAMA. 2009 Jun 3;301(21):2252-9
references: 19491187
references: Am Psychol. 2004 Feb-Mar;59(2):77-92
references: 14992634
references: Ann Behav Med. 2001 Spring;23(2):101-11
references: 11394551
references: Health Psychol. 1997 Mar;16(2):131-6
references: 9269883
references: Psychol Bull. 2002 Mar;128(2):330-66
references: 11931522
references: Annu Rev Psychol. 2011;62:501-30
references: 20636127
references: Psychol Methods. 2011 Jun;16(2):93-115
references: 21500915