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Homeless street children in Nepal: Use of allostatic load to assess the burden of childhood adversity

Published online by Cambridge University Press:  23 January 2008

Carol M. Worthman  and
Catherine Panter-Brick
Carol M. Worthman*
Affiliation:
Emory University
Catherine Panter-Brick
Affiliation:
Durham University
*
Address correspondence and reprint requests to: Carol M. Worthman, Department of Anthropology, Emory University, Atlanta, GA 30322; E-mail: worthman@emory.edu.
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Abstract

As challenges to child well-being through economic disadvantage, family disruption, and migration or displacement escalate world wide, the need for cross-culturally robust understanding of childhood adversity proportionately increases. Toward this end, developmental risk was assessed in four contrasting groups of 107 Nepali children ages 10–14 years that represent distinctive, common conditions in which contemporary children grow up. Relative cumulative burden (allostatic load) indexed by multiple dimensions of physical and psychosocial stress was ascertained among homeless street boys and three family-based groups, from poor urban squatter settlements, urban middle class, and a remote rural village. Biomarkers of stress and vulnerability to stress included growth status, salivary cortisol, antibodies to Epstein–Barr virus, acute phase inflammatory responses (alpha1-antichymotrypsin), and cardiovascular fitness and reactivity (flex heart rate and pressor response). Individual biomarkers of risk and allostatic load differed markedly among groups, were highest in villagers, and varied by components of allostatic load. Such data suggest a need for critical appraisal of homelessness and migration as a risk factor to youth, given prevailing local conditions such as rural poverty, and represents the only multidimensional study of childhood allostatic load and developmental risk in non-Western settings.

Type
Research Article
Information
Development and Psychopathology , Volume 20 , Issue 1 , Winter 2008 , pp. 233 - 255
Copyright
Copyright © Cambridge University Press 2008

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Footnotes

We thank Rachel Baker for long-term work with street children in Kathmandu, Allison Todd for participation in the fieldwork, Joy F. Stallings and Katrina Trivers for laboratory technical assistance, Daniel J. Hruschka for statistical support, Child Workers in Nepal for on-site support, and the Journal Reviewers and Editor for valuable critiques. Our special gratitude goes to the young people and families who participated in this research in Nepal. Funding was supplied by Durham University, Emory University Research Committee, the Russell Sage Foundation, and the Lowenstein Center for the Study of the Development and Prevention of the Disruptive Behavior Disorders.

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