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In this episode, we chat with Dr. Tim Nelin and Dr. Yarden Fraiman, two authors from the recently published special issue of Children on the life course implications of preterm birth. Together, they explore how inequities—both environmental and social—can shape the long-term health trajectories of preterm infants.

Dr. Nelin introduces the idea of “micro” and “macro” environments, showing how factors such as air pollution, green space, violence, and neighborhood social vulnerability not only contribute to preterm birth risk but also affect infants once they leave the NICU. His research underscores how the same exposures tied to prematurity continue to drive health disparities long after hospital discharge.

Dr. Fraiman focuses on ADHD as a case study of inequity across the life course. He describes the “ADHD care cascade,” illustrating how systemic bias and structural racism impact recognition, diagnosis, and treatment of ADHD among children born preterm. The conversation highlights how inequities layer over time, widening gaps in health and educational outcomes.

While the challenges are significant, the discussion also points to solutions—ranging from policy interventions and community partnerships to family-centered approaches. This episode emphasizes the urgent need to think upstream, addressing the drivers of inequity to create meaningful change for preterm infants and their families.

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