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Childhood Poverty and Blood Pressure Reactivity to and Recovery From an Acute Stressor in Late Adolescence: The Mediating Role of Family Conflict

Evans, Gary W. PhD; Exner-Cortens, Deinera MPH; Kim, Pilyoung PhD; Bartholomew, Daniel BS

doi: 10.1097/PSY.0b013e31829f9823
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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.

From the Departments of Design & Environmental Analysis and of Human Development (G.W.E., D.B.) and Human Development (G.W.E., D.E.-C.), Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, New York; and Department of Psychology (P.K.), University of Denver, Denver, Colorado.

Address correspondence and reprint requests to Gary W. Evans, PhD, Human Ecology, Cornell University, Ithaca, NY 14853-4401. E-mail: gwe1@cornell.edu

Received for publication September 23, 2012; revision received May 8, 2013.

Copyright © 2013 by American Psychosomatic Society
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