The social environment strongly affects cardiovascular (CV) health during childhood and adolescence (1,2). An extensive scientific literature suggests that family living conditions and social and economic resources influence children’s access to health care, their quality of care, and the development of behavior patterns (e.g., smoking, poor nutrition and weight control, sedentary lifestyle, emotional stress) that increase risk of hypertension (HTN) and cardiovascular disease (CVD). Among the known behavioral risk factors, environmentally induced emotional stress responses are perhaps the most provocative and least well understood contributors to CVD (2). Recent research with urban adolescents provides promising insights into psychological mechanisms linking neighborhood environments with chronic stress and elevated blood pressure (BP). New evidence suggests that exposure to neighborhood poverty, disorder, and violence may undermine youths’ social competence and encourage forms of interpersonal behavior that, although responsive to environmental demands, may impair emotion regulation capabilities, undermine social ties, and contribute to persistent CV stress and related illness.