Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2016 Jun 1

PMID 27244844

Citations 29

Authors

Tina L Cheng

Sara B Johnson

Elizabeth Goodman

Affiliations

Soon will be listed here.

Abstract

Health disparities in the United States related to socioeconomic status are persistent and pervasive. This review highlights how social disadvantage, particularly low socioeconomic status and the health burden it brings, is passed from 1 generation to the next. First, we review current frameworks for understanding the intergenerational transmission of health disparities and provide 4 illustrative examples relevant to child health, development, and well-being. Second, the leading strategy to break the cycle of poverty in young families in the United States, the 2-generation approach, is reviewed. Finally, we propose a new 3-generation approach that must combine with the 2-generation approach to interrupt the intergenerational cycle of disadvantage and eliminate health disparities.

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References

Fall C, Sachdev H, Osmond C, Lakshmy R, Biswas S, Prabhakaran D . Adult metabolic syndrome and impaired glucose tolerance are associated with different patterns of BMI gain during infancy: Data from the New Delhi Birth Cohort. Diabetes Care. 2008; 31(12):2349-56. PMC: 2584194. DOI: 10.2337/dc08-0911. View

Beaver K, Belsky J . Gene-environment interaction and the intergenerational transmission of parenting: testing the differential-susceptibility hypothesis. Psychiatr Q. 2011; 83(1):29-40. DOI: 10.1007/s11126-011-9180-4. View

Schulz L . The Dutch Hunger Winter and the developmental origins of health and disease. Proc Natl Acad Sci U S A. 2010; 107(39):16757-8. PMC: 2947916. DOI: 10.1073/pnas.1012911107. View

Patel S, Surkan P . Unwanted childbearing and household food insecurity in the United States. Matern Child Nutr. 2014; 12(2):362-72. PMC: 4401646. DOI: 10.1111/mcn.12143. View

Hansen C, Barnett A, Pritchard G . The effect of ambient air pollution during early pregnancy on fetal ultrasonic measurements during mid-pregnancy. Environ Health Perspect. 2008; 116(3):362-9. PMC: 2265059. DOI: 10.1289/ehp.10720. View

Tu Y, West R, Ellison G, Gilthorpe M . Why evidence for the fetal origins of adult disease might be a statistical artifact: the "reversal paradox" for the relation between birth weight and blood pressure in later life. Am J Epidemiol. 2004; 161(1):27-32. DOI: 10.1093/aje/kwi002. View

Barker D . The malnourished baby and infant. Br Med Bull. 2002; 60:69-88. DOI: 10.1093/bmb/60.1.69. View

Shonkoff J, Garner A . The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2011; 129(1):e232-46. DOI: 10.1542/peds.2011-2663. View

Smith C, Farrington D . Continuities in antisocial behavior and parenting across three generations. J Child Psychol Psychiatry. 2004; 45(2):230-47. DOI: 10.1111/j.1469-7610.2004.00216.x. View

10.

McEwen B, Gianaros P . Stress- and allostasis-induced brain plasticity. Annu Rev Med. 2010; 62:431-45. PMC: 4251716. DOI: 10.1146/annurev-med-052209-100430. View

11.

Fomby P, Krueger P, Wagner N . Age at Childbearing over Two Generations and Grandchildren's Cognitive Achievement. Res Soc Stratif Mobil. 2015; 35:71-88. PMC: 4354864. DOI: 10.1016/j.rssm.2013.09.003. View

12.

Duncan G, Ziol-Guest K, Kalil A . Early-childhood poverty and adult attainment, behavior, and health. Child Dev. 2010; 81(1):306-25. DOI: 10.1111/j.1467-8624.2009.01396.x. View

13.

Adler N, Stewart J . Health disparities across the lifespan: meaning, methods, and mechanisms. Ann N Y Acad Sci. 2010; 1186:5-23. DOI: 10.1111/j.1749-6632.2009.05337.x. View

14.

Heckman J . Skill formation and the economics of investing in disadvantaged children. Science. 2006; 312(5782):1900-2. DOI: 10.1126/science.1128898. View

15.

Meaney M . Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annu Rev Neurosci. 2001; 24:1161-92. DOI: 10.1146/annurev.neuro.24.1.1161. View

16.

Finer L, Zolna M . Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011; 84(5):478-85. PMC: 3338192. DOI: 10.1016/j.contraception.2011.07.013. View

17.

Halfon N, Larson K, Lu M, Tullis E, Russ S . Lifecourse health development: past, present and future. Matern Child Health J. 2013; 18(2):344-65. PMC: 3890560. DOI: 10.1007/s10995-013-1346-2. View

18.

McEwen B . From molecules to mind. Stress, individual differences, and the social environment. Ann N Y Acad Sci. 2001; 935:42-9. View

19.

Hertzman C, Boyce T . How experience gets under the skin to create gradients in developmental health. Annu Rev Public Health. 2010; 31:329-47 3p following 347. DOI: 10.1146/annurev.publhealth.012809.103538. View

20.

Capaldi D, Pears K, Patterson G, Owen L . Continuity of parenting practices across generations in an at-risk sample: a prospective comparison of direct and mediated associations. J Abnorm Child Psychol. 2003; 31(2):127-42. DOI: 10.1023/a:1022518123387. View