PROJECT SUMMARY/ABSTRACT
Disparities in maternal-child health increase generationally because stress experienced by mothers can be
transferred to their children, with both biological and psychological consequences. Without clear understanding
of factors driving these disparate outcomes and without longitudinal assessments across racial and ethnic
groups, inequities will persist. The Environmental influences on Child Health Outcomes (ECHO) Program aims
to understand the effects of early environmental factors on child health and development, and therefore needs
a diverse cohort of children and their parents who represent the variety of U.S. populations, especially racial and
ethnic minority populations who often are at the intersection of socioeconomic adversity and social stressors
related to race/ethnicity. We propose to establish the Miami-ECHO cohort of racially and ethnically diverse
mothers, children, and fathers. We will recruit and retain a racially and ethnically diverse cohort of pregnant
women (N=1,250), their offspring, and the conceiving father from Miami-Dade County (MDC), Florida. In addition,
we will recruit and retain 60-80% of the cohort mothers into the ECHO preconception pilot protocol. MDC is a
minority-majority county with a population of 69.4% Hispanic/Latinos (including Afro-Caribbeans), 17.7% African
Americans, 12.9% Non-Hispanic Whites, 3% Asians, and 1.3% multi-racial individuals.to one of the most
ethnically and culturally diverse U.S. populations. MDC, however, is not yet represented in the ECHO Program.
Our diverse, multi-disciplinary team has access to the largest populations of pregnant women and those giving
birth in MDC, and to community-based infrastructures caring for the most vulnerable women in the region for
over 40 years. Furthermore, to advance ECHO science, we will address these aims: A) Examine social
environment and placental genome influences on children's neurodevelopment and global health. We
will determine whether the placental genome mediates the relationship between pre- and perinatal social
environment and children's neurodevelopment and global health during early and middle childhood; and identify
the interactive (gene x epigene x social environment) effects on children's neurodevelopment and global health
during early and middle childhood. B) Identify factors that protect against the effects of discrimination on
children's neurodevelopment and global health. We will distinguish the effects of maternal and paternal
discrimination – separately and in combination – on children's neurodevelopment and global health from early
to middle childhood; and determine the degree to which the social environment, social identity (race, ethnicity,
skin color, nativity), and social support mediate the effects of discrimination on children's neurodevelopment and
global health. C) Identify the effects of modifiable social determinants of health and access to family
planning during the pre-conception period on subsequent pregnancy morbidity and birth outcomes.