We need new integrative, life course and intergenerational scientific models that will seek to understand how the accumulation of social adversities and resources can alter biological processes, including gene expression, to affect health.144, 167 Given that high levels of stress in early childhood can alter biological structures and processes and lead to increased risk of disease in adulthood, these models must pay particular attention to early childhood exposures.167 This will include giving adequate attention to capturing the role of socioeconomic adversity over the life course. Carson and colleagues168 found that a cumulative measure of life course SES that captured childhood, young adulthood (age 30) and older adulthood (ages 45–64) SES was associated with greater subclinical arthrosclerosis for both blacks and whites. A recent national study found that among women who spend their childhoods in or near poverty, upward social mobility was associated with improved birth outcomes for white but not black women.169 We do not know the extent to which this finding reflects differences in the effects of early childhood adversity across race or whether early childhood adversity among African
