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Primary Submission Category: Health equity
The role of childhood homeownership in shaping multilevel trajectories of life course stress among pregnant people in Georgia
Authors: Kaitlyn Stanhope, Michael Kramer, Jade Stafford, Marisa Young, Shakira Suglia,
Presenting Author: Kaitlyn Stanhope*
The Weathering Hypothesis posits that accumulation of exposure to adverse events and environmental threats drives excess risk of poor perinatal outcomes in marginalized communities. Yet this accumulation is often simplified in research as a count of events, ignoring context. Our objective was to create a multilevel longitudinal measure of life course stress and examine its association with early life wealth.
We used data from a cohort of 434 pregnant individuals in Atlanta Georgia who completed a resident address history and life course stress inventory. We fit group-based trajectory models to identify patterns of multilevel stress, including residence in a low-resource tract, traumatic stressor count, chronic stressor count, and life event stressor count for 5-year intervals up to current age. We used model fit to identify the optimal number and structure of trajectories and posterior probability to assign individuals to trajectories. We fit multinomial models to quantify the association between family homeownership in childhood and trajectory membership.
We identified four trajectories, characterized by differences in levels and patterns of stress exposure across the life course. The most common trajectory (35%), “Stable Low” was characterized by a consistently low stress exposure with peak probability of experiencing a stressor in each category ~25%. The rarest pattern (13%), “High exposure to multilevel stressors in childhood” was characterized by high report of all three event-based stressors in early childhood (>50%), with ~25% also residing in a low-resource neighborhood. Individuals whose family never owned their home in childhood were 5.7 times more likely to belong to the riskiest (“High exposure”) pattern compared to the stable low pattern (95% CI: 2.3, 14.4).
Family homeownership in childhood may prevent exposure to adversity across the life course, supporting calls for housing provision to prevent childhood adversity.