title: Do race, neglect, and childhood poverty predict physical health in adulthood? A multilevel prospective analysis.
abstract: Childhood neglect and poverty often co-occur and both have been linked to poor physical health outcomes. In addition, Blacks have higher rates of childhood poverty and tend to have worse health than Whites. This paper examines the unique and interacting effects of childhood neglect, race, and family and neighborhood poverty on adult physical health outcomes. This prospective cohort design study uses a sample (N=675) of court-substantiated cases of childhood neglect and matched controls followed into adulthood (M(age)=41). Health indicators (C-Reactive Protein [CRP], hypertension, and pulmonary functioning) were assessed through blood collection and measurements by a registered nurse. Data were analyzed using hierarchical linear models to control for clustering of participants in childhood neighborhoods. Main effects showed that growing up Black predicted CRP and hypertension elevations, despite controlling for neglect and childhood family and neighborhood poverty and their interactions. Multivariate results showed that race and childhood adversities interacted to predict adult health outcomes. Childhood family poverty predicted increased risk for hypertension for Blacks, not Whites. In contrast, among Whites, childhood neglect predicted elevated CRP. Childhood neighborhood poverty interacted with childhood family poverty to predict pulmonary functioning in adulthood. Gender differences in health indicators were also observed. The effects of childhood neglect, childhood poverty, and growing up Black in the United States are manifest in physical health outcomes assessed 30 years later. Implications are discussed.
authors.affiliation: John Jay College of Criminal Justice, Psychology Department, 524 W 59th Street, Suite # 10.63.35, New York, NY 10019, USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Nikulina
authors.affiliation: John Jay College of Criminal Justice, Psychology Department, 524 W 59th Street, Suite # 10.63.35, New York, NY 10019, USA.
authors.forename: Cathy Spatz
authors.initials: CS
authors.lastname: Widom
mesh_terms: D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000208:ethnology* / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology*; D008171:Lung Diseases / Q000453:epidemiology / Q000208:ethnology*; D008297:Male; D011203:Poverty / Q000208:ethnology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein
keywords: Childhood neglect; Childhood poverty; Physical health; Prospective design; Race