PROJECT SUMMARY/ABSTRACT Disparities in maternal-child health increase generationally because stress experienced by mothers can be transferred to their children, with both biological and psychological consequences. Without clear understanding of factors driving these disparate outcomes and without longitudinal assessments across racial and ethnic groups, inequities will persist. The Environmental influences on Child Health Outcomes (ECHO) Program aims to understand the effects of early environmental factors on child health and development, and therefore needs a diverse cohort of children and their parents who represent the variety of U.S. populations, especially racial and ethnic minority populations who often are at the intersection of socioeconomic adversity and social stressors related to race/ethnicity. We propose to establish the Miami-ECHO cohort of racially and ethnically diverse mothers, children, and fathers. We will recruit and retain a racially and ethnically diverse cohort of pregnant women (N=1,250), their offspring, and the conceiving father from Miami-Dade County (MDC), Florida. In addition, we will recruit and retain 60-80% of the cohort mothers into the ECHO preconception pilot protocol. MDC is a minority-majority county with a population of 69.4% Hispanic/Latinos (including Afro-Caribbeans), 17.7% African Americans, 12.9% Non-Hispanic Whites, 3% Asians, and 1.3% multi-racial individuals.to one of the most ethnically and culturally diverse U.S. populations. MDC, however, is not yet represented in the ECHO Program. Our diverse, multi-disciplinary team has access to the largest populations of pregnant women and those giving birth in MDC, and to community-based infrastructures caring for the most vulnerable women in the region for over 40 years. Furthermore, to advance ECHO science, we will address these aims: A) Examine social environment and placental genome influences on children's neurodevelopment and global health. We will determine whether the placental genome mediates the relationship between pre- and perinatal social environment and children's neurodevelopment and global health during early and middle childhood; and identify the interactive (gene x epigene x social environment) effects on children's neurodevelopment and global health during early and middle childhood. B) Identify factors that protect against the effects of discrimination on children's neurodevelopment and global health. We will distinguish the effects of maternal and paternal discrimination – separately and in combination – on children's neurodevelopment and global health from early to middle childhood; and determine the degree to which the social environment, social identity (race, ethnicity, skin color, nativity), and social support mediate the effects of discrimination on children's neurodevelopment and global health. C) Identify the effects of modifiable social determinants of health and access to family planning during the pre-conception period on subsequent pregnancy morbidity and birth outcomes.

PROJECT NARRATIVE The Environmental influences on Child Health Outcomes (ECHO) Program aims to understand the effects of early environmental factors on child health and development, and therefore needs diverse cohorts of children and their parents who represent the variety of U.S. populations. We propose to establish a Miami-ECHO cohort. by recruiting and retaining racially and ethnically diverse pregnant women (N=1,250), their offspring, and the conceiving father from Miami-Dade County (MDC), Florida, a heavily populated minority-majority metropolitan area.