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Troubled Childhoods May Lead To Chronic Health Problems; But Can America Implement The Solution?

Chronic Health Problems May Be Prevented By Childhood Interventions
The epigenetic effects of a stressed childhood may be blunted through early intervention, breaking cycles of poverty and destruction, researchers say. U.S. Government

A troubled childhood may lead to chronic physical and mental problems as an adult, in turn leaving an indelible mark on the next generation, researchers say.

Exposure to mistreatment, domestic violence, poverty, and a parent with mental or behavioral health problems has been linked time and again to myriad chronic health problems associated with not just a miserable life but a short one.

In seeking to stretch the traditional bounds of medicine, Dr. David A. Brent, a pediatrician and specialist in epidemiological psychiatry, advocated on Tuesday for changes in the United States to social policy and the delivery of mental health care for children. "I recommend that we change the delivery of mental health care" to a model in which the primary care physician directs a comprehensive strategy for at-risk children, he said in New York City, at a meeting held by the Journal of the American Medical Association.

Brent said numerous studies show a link between stressed childhoods and later conditions associated with premature death, such as smoking, substance abuse, obesity, cardiovascular disease, depression, and attempted suicide. Moreover, animal studies have shown that one's hangovers and hang-ups from childhood transmit to the next generation through epigenetic mechanisms, as environmental stressors change not the underlying DNA but the expression of genes within a person.

In other words, one might inherit not only phenotypic traits from a parent but behaviors, modalities of thought, a risk of suicide — the "sins" of the father.

Researchers believe the causal link between childhood adversity and later outcomes might be mediated by changes in stress responsivity, Brent said. "While the pathways by which adversity exerts its effects have not been as elegantly elaborated in humans, it is posited that these epigenetic changes can contribute to immune dysfunction, insulin resistance, and cognitive difficulties that in turn lead to risky behavior and predispose to emotional [instability] and depression."

To this problem lies a solution that is medically simple but politically hard. Brent said physicians should advocate for social change in America by supporting home visits for at-risk children and universal access to quality preschool education, interventions shown to be effective in stopping cycles of poverty and destruction.

The research is "a clarion call to us that we should advocate for changes to social policy... we saw during the election that people who experience adversity -- the other 47 percent — are someone else," he said. "But it affects us one way or another: If we want a country with citizens that are more productive we have to focus on this protean that is childhood adversity."

However some Americans espouse the tradition of rugged individualism or libertarianism, the economic costs of childhood adversity are borne by society, with increased poverty and decreased productivity, higher rates of incarceration and lower rates of employment, in addition to markedly higher public costs of health care.

"The good news is that, if detected early enough, the impact of family adversity on child health outcomes can be reversed, or at least attenuated," Brent said. Even the neurobiological and cognitive damage caused by the most extreme deprivations in infancy, can be to some extent reversed by early placement of the child in foster care, he added.

Although the proposed solutions might seem unlikely to gain support in many parts of the country, Brent said "We're doing it in Pittsburgh."

Below is a video on epigenetics:

 

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