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Early Environments on Health Trajectories

Understanding and Improving Nutrition for Pregnancy 

Growing evidence shows that the nutrition a baby receives while still in the womb affects its health as an adult in many ways. This has vital implications for public policy to improve pregnant women’s health and diet. Nutrition includes both micronutrients—vitamins and minerals—and macronutrients, or fat, carbohydrates, and protein. Adding vitamin supplements during pregnancy can increase birth weight, a measure of newborn health. But what about macronutrients? IPR anthropologist Christopher Kuzawa, Zaneta Thayer (PhD 2013) of Dartmouth College, and former IPR postdoctoral fellow Julienne Rutherford of the University of Illinois at Chicago propose a new model to understand how nutrition is delivered to the fetus during pregnancy. In Evolution, Medicine, & Public Health, they argue that their Maternal Nutritional Buffering Model explains why other changes to pregnant women’s diets have limited effects on fetal development and birth weight. Using an evolutionary perspective, the authors point out that the mother’s body protects the growing fetus from both nutritional ups and downs, tempering the benefits of short-term diet interventions. The researchers propose that the most effective way to improve babies’ health both at birth and as future adults is to improve their mothers’ nutrition far earlier before they become pregnant. Kuzawa is the John D. MacArthur Professor of Anthropology. 

The Impact of JFK’s Assassination on Birth Outcomes

The association between stressful events during pregnancy and worrying birth outcomes, such as premature birth and low birthweight, has been widely studied. In Maternal and Child Health Journal, IPR researchers postdoctoral fellow Alexa Freedman, health psychologist Greg Miller, obstetrician and gynecologist Ann Borders, and their colleagues explore whether–and in what ways—the shock of the assassination of President John F. Kennedy (JFK) affected births to women pregnant on November 22, 1963. The study employs data from the Collaborative Perinatal Project, 1959–65, which followed pregnant participants at 12 U.S. sites over time. The researchers analyzed the births of over 30,200 pregnant participants, about 5,800 of whom were pregnant at the assassination. They determine that only those in their first trimester showed any measurable effects. They find an increased risk—a hazard ratio of 1.17, or about one-sixth more risk—of preterm birth for babies born to women in their first trimester when JKF was killed. They also detect a link to a slight reduction in birthweight for children born to those women. Additionally, the researchers compared the birth outcomes of over 1,100 pairs of siblings born to women in the study who had a child prior to the assassination and then were pregnant when the assassination occurred, seeing similar effects. The researchers did not find a connection between first trimester stress and inflammation of the placenta, which they had considered a possible mechanism in the adverse birth outcomes. The research supports the association between stress exposure early in pregnancy and preterm birth. Miller is the Louis W. Menk Professor of Psychology.

Early Origins of Socioeconomic Inequalities in Chronic Inflammation

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IPR biological anthropologists Thomas McDade (left) and Christopher Kuzawa have discovered that environmental conditions early in development can cause inflammation in adulthood.

The United States is characterized by persistent and widening social inequities in many adult health outcomes, and researchers have begun to ask how these outcomes trace back to childhood. In Social Science & Medicine, IPR anthropologist Thomas McDade and IPR postdoctoral fellow Stephanie Koning consider the extent to which socioeconomic inequalities in adult health may be influenced by experiences earlier in life. Utilizing data from the National Longitudinal Study of Adolescent to Adult Health of 7,610 young adults aged 24­–32 years, the researchers documented a strong relationship between  lower socioeconomic status (SES) and higher levels of chronic inflammation in adulthood, as measured by C-reactive protein. They also examined the participants’ birth weight and duration of breastfeeding in infancy, and investigated whether they could account for the SES gradient in chronic inflammation.  They find that increasing the time a mother breastfeeds to three or more months reduces the SES gradient in inflammation  by more than 80%. The results indicate that environments early in infancy are important determinants of chronic inflammation in adulthood, and that breastfeeding three months or longer could reduce SES-based inequalities in cardiometabolic disease, which result in part from higher levels of chronic inflammation. The researchers suggest that social policies addressing structural barriers to extended breastfeeding, such as paid family leave, could have the greatest impact in reducing inequalities in breastfeeding. McDade is Carlos Montezuma Professor of Anthropology.

How Therapists Can Help Patients With Unexplained Illness

Functional Neurological Disorders (FNDs) are surprisingly common, yet poorly understood neurological conditions which are determined to be “incompatible” with known diseases. In a 2020 article for Social Science & Medicine, IPR anthropologist Rebecca Seligman and her postdoctoral fellow, Northwestern anthropologist Maddalena Canna, who is the paper’s lead author, argue that a cultural analysis is required to better understand and help people with FNDs. Seligman and Canna analyze three case studies, focusing on one particular kind of FND, a disorder known as PNES (Psychogenic-Non-Epileptic Seizure). They describe three key ways in which FNDs are mediated by culture: how patients use existing cultural meanings and representations to mediate and describe their own experience; the forms of expression available and strategies for dealing with trauma in a given context; and the judgment and social stigma patients may face due to their symptoms. Seligman and Canna conclude that given this complex system of cultural factors, effective therapies should be based on constructing a shared set of meanings between patient and therapist. They recommend therapists and patients de-emphasize the need to come to an objective “truth” about the disease, in favor of a willingness to view it through the other’s perspective. The researchers note that making space for patients’ definition of their disorder leaves open the possibility of future medical diagnoses that may explain the roots and causes of FNDs.

Disproportionate School Punishment of Black Students and Life Outcomes

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IPR health psychologists Edith Chen (right) and Greg Miller investigate why poverty is associated with poor physical health outcomes in children, with a focus on the psychological and biological mechanisms that explain these relationships.

Racial disparities exist in school disciplinary practices, with Black students being more likely to receive punishment than White students. In Psychological Science, IPR health psychologists Edith Chen and Greg Miller, along with their colleagues, study the relationship between racial inequalities in the punishment of Black students and their long-term outcomes. The researchers used data from an 18-year longitudinal study of 261 Black young adults—91 male and 170 female—from working- poor households in rural Georgia. The researchers collected assessments of academic outcomes, mental health, and physical health (including blood samples) from participants at age 27.  The researchers also examined high school discipline records to calculate the punishment rates for Black and White students at each of the high schools attended by students in the sample. They find in schools with higher rates of punishment for Black relative to White students, the Black youth in the sample with high self-control in early adolescence had higher academic orientation in late adolescence that eventually led to higher academic attainment, higher income, and better mental health in adulthood. But these students also had worse insulin resistance in adulthood, which is a predictor of cardiometabolic diseases. These results suggest that achieving success in the face of racial inequalities, such as disproportionate school punishment, may come at a cost to the physical health of Black youth. The researchers argue that there are psychological characteristics that can help individuals to stay resilient even in the face of inequality-related adversities. Chen is the John D. and Catherine T. MacArthur Professor of Psychology. Miller is the Louis W. Menk Professor of Psychology.