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Environmental Influences on Child Health Outcomes

Untangling the influences of early environmental exposures and genetics on children’s health and development

Adverse experiences during sensitive developmental windows—the time of conception, late pregnancy, infancy, and early childhood—can have long-lasting effects on children’s health. Air and water pollution, sleep and dietary habits, everyday stress and family dynamics, and biological factors can manifest themselves in a variety of disorders, and in a variety of ways.

Environmental Influences on Child Health Outcomes (ECHO) is an ambitious project of the National Institutes of Health (NIH) to investigate how exposure to a wide range of environmental factors in early development influences the health of children and adolescents. This program is focused on five different health outcomes: pre-, peri-, and postnatal outcomes; obesity and its consequences; upper and lower airway conditions; domains of neurodevelopment; and positive attributes of healthy growth and development.

As part of the seven-year ECHO program, our team at RTI, in association with Johns Hopkins University, is building a data analysis center responsible for managing existing and new data and providing statistical and epidemiological expertise in the design, analysis, and interpretation of studies related to the scientific goals of ECHO. 

ECHOPortal: Rising to the Challenge of Data Capture, Management, and Analysis

A project the size of ECHO—with data on 50,000 children and expectant women enrolled in 84 separate study cohorts, as well as hundreds of researchers, including biostatisticians, epidemiologists, geneticists, and even geospatial scientists—necessarily entails a secure, scalable, and high-performance computational environment to host, analyze, and control access to data.  

Our role in ECHO is to build ECHOPortal, a secure cloud-based environment that supports the acquisition, storage, analysis, and dissemination of information, including a tiered approach to data access and web-based interactive visualization tools. As NIH phrases it, this platform will serve as a national resource with which scientists can address a wide variety of questions about the effects of exposures on child health outcomes. It will feature a metadata catalog that allows researchers to explore characteristics of cohorts, with faceted browsing and search features, as well as other advanced functionality that will make ECHOPortal one of the most sophisticated cloud-based computational environments in the health care field.

One of the early challenges ECHO faces is building consensus for a common ECHO-wide data collection protocol, which will serve as a starting point for the standardized collection of data across the 84 cohorts under the ECHO umbrella—all of which necessarily employ their own procedures and benchmarks. (Most of these studies began before ECHO was conceived.) In 2017, the ECHO-wide data collection protocol was approved by the ECHO Steering Committee. This protocol allows individual researchers a certain amount of flexibility, but also specifies the essential data elements required from all cohorts, as well as recommended data elements from subsets of cohorts that must be shared and stored centrally in the ECHOPortal database.

Spearheading the Way to Improved Child Health Outcomes

By the conclusion of the ECHO project in 2023, we anticipate that ECHOPortal will allow ECHO investigators and researchers in and beyond the United States to address innovative, high-impact research questions that require multiple cohorts and relate a broad range of early environmental influences on child health.

For example, the Navajo Nation Birth Cohort has determined that Navajo children are exposed both prenatally and postnatally to high levels of uranium and other metals associated with waste from abandoned mines on or near tribal lands. Combining this cohort’s data with that of other tribal communities, as well as similarly characterized cohorts across the United States, will allow researchers to explore the long-term impact of these early-life exposures on birth outcomes, cognitive development, and obesity and to identify variations in these effects in different subpopulations.