Allostatic load occurs when dynamic physiological set points become chronically dysregulated as the body incurs sustained stressors. Under chronic stress, multiple systems (neuroendocrine, immune, metabolic) respond to frequent activation that can eventually lead to cumulative inadequate response. A high allostatic load could function as an early warning indicator for potential adverse health outcomes, with allostatic load markers signaling the accumulation of physiological dysregulation prior to a clinical diagnosis. High allostatic load in adulthood has been linked to an increased risk of morbidity and mortality, yet a significant research gap exists in understanding how early life adversity influences the relationship between childhood allostatic load and adult outcomes. This study will investigate how these physiological systems change across development and how these variables mediate the trajectories of allostatic load into adult health outcomes.
Early life adversity, which includes dimensions of threat, deprivation, unpredictability, and loss, has been recognized as a potent stressor that can exert a lasting impact on an individual’s physiological and psychological development. Previous research on allostatic load incurred due to early life adversity has focused on cross-sectional data from adult populations relying on retrospective, self-reported information on childhood stress. This pilot study will establish a relationship between chronic stress beginning in early life and inadequate physiological responses into adulthood in an ongoing longitudinal study that has collected robust information on psychosocial factors and biomarkers beginning from ages 9 to mid-adulthood.
Understanding this complex dynamic between environment and physiology throughout the life course can shed light on why some individuals exposed to childhood adversity are more susceptible to cardiometabolic diseases, helping to address health disparities. Early life adversity disproportionately affects children exposed to poverty and those who lack adequate educational and health system resources. Investigating the relationship between physiological adaptation to chronic stress and overall health in a longitudinal cohort across rural Appalachian communities may reveal how health disparities in this environmental context become physiologically embedded. By identifying the mechanisms linking childhood adversity to long term health impacts, this study can help inform how early intervention and prevention strategies can target high risk individuals.
Aim 1: Measure allostatic load and cardiometabolic health indices in childhood and adulthood in people from rural North Carolina who have previously been stratified to “high” and “low” early life adversity.
Aim 2: Test whether allostatic load in childhood predicts allostatic load in adulthood.
Aim 3: Test whether allostatic load in childhood predicts cardiometabolic outcomes in adulthood and/or mediates the effects of adversity or adult allostatic load on adult cardiometabolic outcomes.