* Abbreviations:
: Pediatric Research in Office Settings
: socioeconomic position

In the past 70 or so years, the tempo and substance of cultural and environmental changes influencing the health and development of children have increased. In many parts of the world, children are entering puberty earlier than ever before. This is associated with a range of adverse health outcomes later in life. To that end, and in an effort toward determining public health interventions to reverse this phenomenon, Sun et al1 in this issue of Pediatrics prospectively examined the cumulative effects of family and neighborhood domains among a birth cohort of 5107 Australian infants followed until they were 10 to 11 years old. Cumulative exposure to extremely unfavorable socioeconomic position (SEP) was associated with 4 times the risk of early puberty in boys and 2 times the risk in girls. A brief historical perspective may help inform the results.

When this journal published the study by Pediatric Research in Office Settings (PROS) on the age of onset of puberty in US girls in 1997,2 a firestorm ensued. In contrast to the widely used norms published by Marshall and Tanner in the …

Address correspondence to Marcia E. Herman-Giddens, PA, MPH, DrPH, Department of Maternal and Child Health, Gillings School of Global Public Health, CB #7445, Chapel Hill, NC 27599-7445. E-mail: mherman-giddens{at}unc.edu