SOCIAL ECONOMICS OF CHILDHOOD GLUCOCORTICOID STRESS-RESPONSE AND HEALTH

This study examines socioeconomic conditions, psychosocial stress, and health among 264 infants, children, adolescents, and young adults age d 2 months to 18 years residing in a rural Caribbean village. Fieldwor k was conducted over a 9 year period (1988-1996). Research methods and techniques include salivary cortisol radioimmunoassay (N = 22,438), s ystematic behavioral observations, psychological questionnaires, healt h evaluations, medical records, informal interviews, and participant o bservation. Analyses of data indicate complex relations among socioeco nomic conditions, stress, and health. Household income, land ownership , parental education, and other socioeconomic measures are weakly asso ciated with child illness. There is no evidence that apparent material benefits of high socioeconomic status-such as improved housing, diet, work loads, and access to private healthcare-have important direct ef fects on child health in this population. However, social relationship s, especially family environment, may have important effects on childh ood psychosocial stress and illness. Abnormal glucocorticoid response profiles, diminished immunity, and frequent illness are associated wit h unstable mating relationships of parents/caretakers and household co mposition. We suggest that family relationships and concomitant stress and immunosuppression are important intermediary links between socioe conomic conditions and child health. (C) 1997 Wiley-Liss, Inc.