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The studies reported here examines stress-related psychobiological processes that might account for the high, disproportionate rates of dental caries, the most common chronic disease of childhood, among children growing up in low socioeconomic status (SES) families. In two 2004-2006 studies of kindergarten children from varying socioeconomic backgrounds in the San Francisco Bay Area of California (Ns = 94 and 38), we performed detailed dental examinations to count decayed, missing or filled dental surfaces and microtomography to assess the thickness and density of microanatomic dental compartments in exfoliated, deciduous teeth (i.e., the shed, primary dentition). Cross-sectional, multivariate associations were examined between these measures and SES-related risk factors, including household education, financial stressors, basal and reactive salivary cortisol secretion, and the number of oral cariogenic bacteria. We hypothesized that family stressors and stress-related changes in oral biology might explain, fully or in part, the known socioeconomic disparities in dental health. We found that nearly half of the five-year-old children studied had dental caries. Low SES, higher basal salivary cortisol secretion, and larger numbers of cariogenic bacteria were each significantly and independently associated with caries, and higher salivary cortisol reactivity was associated with thinner, softer enamel surfaces in exfoliated teeth. The highest rates of dental pathology were found among children with the combination of elevated salivary cortisol expression and high counts of cariogenic bacteria. The socioeconomic partitioning of childhood dental caries may thus involve social and psychobiological pathways through which lower SES is associated with higher numbers of cariogenic bacteria and higher levels of stress-associated salivary cortisol. This convergence of psychosocial, infectious and stress-related biological processes appears to be implicated in the production of greater cariogenic bacterial growth and in the conferral of an increased physical vulnerability of the developing dentition., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: Socioeconomically disadvantaged children have poorer physical and mental health and lower social and school/academic functioning compared to children with higher socioeconomic status (SES). These associations are not static but may vary by choice of SES indicator and child race/ethnicity. However, little is known about these associations in middle-childhood, a distinct and critical developmental period. We explore these associations in a small exploratory study designed to examine associations between SES and child developmental outcomes in middle childhood., Materials and Methods: We recruited 60 families with a child between 8-12 years of age from the San Francisco Bay area September 2005-June 2006. The MacArthur Health and Behavior Questionnaire was used to assess health and adaptive functioning across four developmental domains: physical health, mental health, social functioning, and school/academic functioning. We examined a range of SES measures including continuous and categorical assessments of poverty, income, wealth, maternal and overall family educational attainment, subjective social status, and cumulative social risk. A series of multivariate ordinary least squares regressions was performed on the total sample and within race-specific groups., Results: Although the long-recognized, graded relations among SES and outcomes were present, associations employing categorical representations of SES were far more pervasive; and stronger in magnitude. Wealth and highest degree earned in the family showed the strongest associations across virtually all health/functioning domains. Health and functioning was more strongly associated with educational attainment among Whites and financial resources among Blacks. Among Whites more wealth was associated with worse outcomes., Conclusions: Further research is needed to confirm the study findings. However, this study raises important questions about the measurement of SES for studying disparities in child health and developmental outcomes. This initial research suggests that improvements in health and functioning in middle childhood may require more significant status transitions; more targeted social interventions to address racial/ethnic disparities in child health and developmental outcomes; and a need to intervene on adversities facing affluent youth, a potentially hidden yet vulnerable group in middle childhood.