Health disparities in the United States related to socioeconomic status are persistent and pervasive. This review highlights how social disadvantage, particularly low socioeconomic status and the health burden it brings, is passed from 1 generation to the next. First, we review current frameworks for understanding the intergenerational transmission of health disparities and provide 4 illustrative examples relevant to child health, development, and well-being. Second, the leading strategy to break the cycle of poverty in young families in the United States, the 2-generation approach, is reviewed. Finally, we propose a new 3-generation approach that must combine with the 2-generation approach to interrupt the intergenerational cycle of disadvantage and eliminate health disparities.
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June 2016
State-of-the-Art Review Article|
Poverty and Health Disparities|
June 01 2016
Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach
Tina L. Cheng, MD;
aDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland;
bDepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Baltimore, Maryland;
Address correspondence to Tina L. Cheng, MD, MPH, Johns Hopkins University General Pediatrics & Adolescent Medicine, 200 N. Wolfe St, Suite 2055, Baltimore, MD 21287. E-mail: tcheng2@jhmi.edu
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Sara B. Johnson, PhD;
Sara B. Johnson, PhD
aDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland;
bDepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Baltimore, Maryland;
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Elizabeth Goodman, MD
Elizabeth Goodman, MD
cMassGeneral Hospital for Children, Boston, Massachusetts; and
dDepartment of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Address correspondence to Tina L. Cheng, MD, MPH, Johns Hopkins University General Pediatrics & Adolescent Medicine, 200 N. Wolfe St, Suite 2055, Baltimore, MD 21287. E-mail: tcheng2@jhmi.edu
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2016) 137 (6): e20152467.
Article history
Accepted:
December 30 2015
Citation
Tina L. Cheng, Sara B. Johnson, Elizabeth Goodman; Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach. Pediatrics June 2016; 137 (6): e20152467. 10.1542/peds.2015-2467
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