Academic journal article International Journal of Child Health and Human Development

Impact of Housing on Pubertal Timing

Academic journal article International Journal of Child Health and Human Development

Impact of Housing on Pubertal Timing

Article excerpt

Introduction

For the past several decades, puberty, more specifically pubertal timing, has been the subject of fierce controversy and debate. Typically, puberty in girls is characterized by certain momentous transitions. It begins with breast development, followed by the appearance of pubic and axillary hair, a growth spurt, finally culminating in menstruation. As research continues to pursue this tumultuous process, there is mounting consensus that key pubertal markers, specifically breast and pubic hair development, are presenting earlier in girls' lives (1-7). Recent epidemiological studies find that by the age of 8 years, approximately 43% of Black girls, 31% of Hispanic girls, and 18% of White girls have exhibited breast development (2). Consequently, an increasing number of families are forced to confront the social and physical challenges of puberty before they may be prepared to do so.

Early puberty is associated with a myriad of adverse short and long-term consequences, including cardiovascular disease, type II diabetes, endometriosis, depression, teen pregnancy, and breast and other reproductive cancers (8-10).

While obesity is frequently implicated as the leading cause of early puberty, novel insights in the field emphasize that increases in body size and weight account for only part of the decline in pubertal age (11, 12). Instead, we now understand that the observed descent in age is likely the product of powerful environmental and lifestyle transformations. One study (13), which tracked over two thousand girls in Copenhagen, Denmark, observed that girls with higher body mass index (BMI) exhibited earlier onset of puberty. However, the trend persisted among normal-weight girls too (13). Accordingly, various coalescing processes have been linked with earlier development in addition to weight and genetics, including, diet, specific endocrine disruptors, gut flora, hormone-laden cosmetics and activity level (1417). Thus, the timing of puberty may be useful indicator of a girl's physiologic response to her environment.

Exposures associated with housing impact physiological health (e.g., lead, radon, mold, extreme temperatures), psychological health (e.g., noise, inadequate light), and safety (e.g., falls, fires). Thus, delivery of adequate housing, specifically for children, continues to be a major public health issue in the United States (18). To date, no known studies, have examined the influence of housing quality, or the psychosocial implications of poor housing, on pubertal onset.

Presently, over one million Americans are residing in federally subsidized public housing units. The New York City Housing Authority is the largest public housing agency in the nation, and it provides homes for over 112,000 children ages 5-18 years. Even so, the agency's buildings are notorious for decrepit conditions, poor ventilation, elevated levels of allergens, and pest infestations (19-24). These hazards are not without consequence. The prevalence of asthma among children living in New York City public housing is nearly two times higher than rates of children living in other types of housing in the city. Most recently, the agency has been entangled in numerous lawsuits pertaining to inadequate housing quality, including leaks, flooding, mold, warped floors, holes in walls, and broken stoves, toilets, doors, windows, buzzers, and mailboxes. Unfortunately, the landscape in New York City is the same in many urban locations. Furthermore, disadvantaged minorities disproportionately shoulder these burdens, and, in the context of poor access to care, face significantly higher rates of morbidity and mortality. For example, African-Americans are three times more likely to die from asthma and its complications than their white counterparts (18, 2527).

Predictably, risks factors associated with poor housing determine behavioral health and psychosocial outcomes as well. A 2010 study conducted by the New York University found that students living in public housing in New York City performed substantially worse on standardized math and reading exams than their peers living elsewhere in the city (28). …

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