Sanford School of Public Policy and the Center for Child and Family Policy, Duke University, Durham, North Carolina 27708, USA.
Annu Rev Public Health. 2013;34:29-48. doi: 10.1146/annurev-publhealth-031912-114447. Epub 2013 Jan 7.
Exposure to toxic stress accelerates the wear and tear on children's developing bodies and leaves a lasting mark on adult health. Prior research has focused mainly on children exposed to extreme forms of adversity, such as maltreatment and extreme neglect. However, repeated exposure to less severe, but often chronic stressors is likely to play as large, if not larger, of a role in forecasting children's future mental and physical health. New tools from neuroscience, biology, epigenetics, and the social sciences are helping to isolate when and how the foundations for adult health are shaped by childhood experiences. We are now in the position to understand how adversity, in both extreme and more mundane forms, contributes to the adult health burden and to identify features in children's families and environments that can be strengthened to buffer the effects of toxic stressors. We are also positioned to develop and implement innovative approaches to child policy and practice that are rooted in an understanding of how exposure to toxic stressors can become biologically embedded. The stage is set for the creation of new interventions--on both grand and micro scales--to reduce previously intractable health disparities.
有毒压力会加速儿童身体的损耗,对成年后的健康留下持久的印记。之前的研究主要集中在那些遭受极端逆境的儿童身上,如虐待和极度忽视。然而,反复接触不那么严重但往往是慢性的压力源,很可能在预测儿童未来的身心健康方面发挥同样大的作用,如果不是更大的作用的话。神经科学、生物学、表观遗传学和社会科学的新工具正在帮助我们确定,童年经历是如何以及何时塑造成年健康基础的。我们现在能够了解到,无论是极端形式还是更常见的形式的逆境,如何导致成年健康负担,并确定儿童家庭和环境中的哪些特征可以得到加强,以缓冲有毒压力源的影响。我们也有能力制定和实施创新的儿童政策和实践方法,这些方法植根于对接触有毒压力源如何在生物学上形成的理解。现在已经为创造新的干预措施创造了条件,无论是在大规模还是微观层面上,这些措施都旨在减少以前难以解决的健康差距。