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Associations between socioeconomic gradients and racial disparities in preadolescent brain outcomes

Pediatric Research volume 94, pages 356–364 (2023)Cite this article

Abstract

Background

The aim of this study was to determine the extent to which socioeconomic characteristics of the home and neighborhood are associated with racial inequalities in brain outcomes.

Methods

We performed a cross-sectional analysis of the baseline dataset (v.2.0.1) from the Adolescent Brain and Cognitive Development (ABCD) Study. Cognitive performance was assessed using the National Institutes of Health Toolbox (NIH-TB) cognitive battery. Standard socioeconomic indicators of the family and neighborhood were derived from census-related statistics. Cortical morphometric measures included MRI-derived thickness, area, and volume.

Results

9638 children were included. Each NIH-TB cognitive measure was negatively associated with household and neighborhood socioeconomic characteristics. Differences in cognitive scores between Black or Hispanic children and other racial groups were mitigated by higher household income. Most children from lowest-income families or residents in impoverished neighborhoods were Black or Hispanic. These disparities were associated with racial differences in NIH-TB measures and mediated by smaller cortical brain volumes.

Conclusions

Neighborhood socioeconomic characteristics are associated with racial differences in preadolescent brain outcomes and mitigated by greater household income. Household income mediates racial differences more strongly than neighborhood-level socioeconomic indicators in brain outcomes. Highlighting these socioeconomic risks may direct focused policy-based interventions such as allocation of community resources to ensure equitable brain outcomes in children.

Impact

  • Neighborhood socioeconomic characteristics are associated with racial differences in preadolescent brain outcomes and mitigated by greater household income.

  • Household income mediates racial differences more strongly than neighborhood-level socioeconomic indicators in brain outcomes.

  • Highlighting these disparities related to socioeconomic risks may direct focused policy-based interventions such as allocation of community resources to ensure equitable brain outcomes in children.

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Fig. 1: Associations between cortical morphometric variables and cognitive outcomes.
Fig. 2: Socioeconomic indices are negatively associated with cognitive performance and total cortical volume in preadolescents (n = 9638).
Fig. 3: Racial differences in associations between neighborhood disadvantage and brain outcomes.
Fig. 4: Comparison of the direct and indirect effects from mediation models of associations between socioeconomic indices and regional brain volumes.

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Acknowledgements

Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9–10 and follow them over 10 years into early adulthood. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/consortium_members/. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. This manuscript reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators. The ABCD data repository grows and changes over time. The ABCD data used in this report came from https://doi.org/10.15154/1523037. Instructions on how to create an NDA study are available at https://nda.nih.gov/training/modules/study.html).

Funding

The ABCD Study® is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041048, U01DA050989, U01DA051016, U01DA041022, U01DA051018, U01DA051037, U01DA050987, U01DA041174, U01DA041106, U01DA041117, U01DA041028, U01DA041134, U01DA050988, U01DA051039, U01DA041156, U01DA041025, U01DA041120, U01DA051038, U01DA041148, U01DA041093, U01DA041089, U24DA041123, U24DA041147. A full list of supporters is available at https://abcdstudy.org/federal-partners.html.

Author information

Author notes

  1. These authors contributed equally: Amal Isaiah, Linda Chang.

Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Amal Isaiah

  2. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Amal Isaiah

  3. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Thomas M. Ernst, HuaJun Liang, Meghann Ryan, Eric Cunningham, Pedro J. Rodriguez, Miriam Menken, Dianne Kaschak, Ciara Guihen & Linda Chang

  4. Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, 96813, USA

    Thomas M. Ernst & Linda Chang

  5. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Thomas M. Ernst & Linda Chang

  6. Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Gloria Reeves, Nancy Lever & Sarah M. Edwards

  7. Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Linda Chang

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Contributions

A.I. conceptualized and designed the study, performed statistical analysis, drafted the initial manuscript, and reviewed and revised the manuscript. L.C., and T.M.E. conceptualized and designed the study, the data collection instruments, supervised data collection, and reviewed and revised the manuscript. S.M.E., H.L., N.L., G.R., C.G., D.K., M.R., and P.J.R. performed data collection, and critically reviewed and revised the manuscript for important intellectual content.

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Correspondence to Amal Isaiah.

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The authors declare no competing interests.

Ethics approval and consent to participate

The study protocol was approved by the local as well as the constituent member Institutional Review Boards of the ABCD Study. Parents of all children gave written consent to participate in the study.

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Isaiah, A., Ernst, T.M., Liang, H. et al. Associations between socioeconomic gradients and racial disparities in preadolescent brain outcomes. Pediatr Res 94, 356–364 (2023). https://doi.org/10.1038/s41390-022-02399-9

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