Mediators and Adverse Effects of Child Poverty in the United States

Abstract

The link between poverty and children's health is well recognized. Even temporary poverty may have an adverse effect on children's health, and data consistently support the observation that poverty in childhood continues to have a negative effect on health into adulthood. In addition to childhood morbidity being related to child poverty, epidemiologic studies have documented a mortality gradient for children aged 1 to 15 years (and adults), with poor children experiencing a higher mortality rate than children from higher-income families. The global great recession is only now very slowly abating for millions of America's children and their families. At this diffi cult time in the history of our nation's families and immediately after the 50th anniversary year of President Lyndon Johnson's War on Poverty, it is particularly germane for the American Academy of Pediatrics, which is "dedicated to the health of all children, " to publish a research-supported technical report that examines the mediators associated with the longrecognized adverse effects of child poverty on children and their families. This technical report draws on research from a number of disciplines, including physiology, sociology, psychology, economics, and epidemiology, to describe the present state of knowledge regarding poverty's negative impact on children's health and development. Children inherit not only their parents' genes but also the family ecology and its social milieu. Thus, parenting skills, housing, neighborhood, schools, and other factors (eg, medical care) all have complex relations to each other and infl uence how each child's genetic canvas is expressed. Accompanying this technical report is a policy statement that describes specifi c actions that pediatricians and other child advocates can take to attenuate the negative effects of the mediators identifi ed in this technical report and improve the well-being of our nation's children and their families.There is no keener revelation of a society's soul than the way in which it treats its children. Although medical care and access to medical care are important factors in the health of children as well as adults, a broader perspective of the social determinants of health throughout the life cycle is critically important if significant gains are to be realized in our efforts to improve the health of this nation's children. -Nelson Mandela TECHNICAL REPORTResearch that examines mediators of health as well as the effects of poverty and other circumstances in which people grow, live, work, and age in childhood and throughout the life course is accumulating rapidly, and findings are providing critical insights that can inform these efforts. 4 The environment in which a child develops is influenced by parents' health, the immediate and extended family, housing, and community. All these factors are related to a family's social, economic, and health status. 5 These multiple factors in both the social and the physical domains have dynamic influences that link them to the long-t...

Childhood family wealth and mental health in a national cohort of young adults

“…This result is seemingly at odds with previous research that has associated very low SES, along with attendant exposure to adverse experiences, with poor health (Kalmakis & Chandler, 2015; Pascoe et al, 2016). It is worth noting, however, that levels of wealth in our sample were low: median childhood wealth was $19,900 while median household wealth in the US in 2000 was close to $74,000 (U.S.…”

“…Childhood socioeconomic status (SES) has been repeatedly identified as a risk factor for adolescent and young adult mental health (Pascoe et al, 2016). Low SES during childhood may increase children and adolescents’ exposure and vulnerability to stressors including daily hassles, traumatic events, violence and family conflict (Melchior, Moffitt, Milne, Poulton, & Caspi, 2007; Pearlin, 1989).…”

“…Low SES during childhood may increase children and adolescents’ exposure and vulnerability to stressors including daily hassles, traumatic events, violence and family conflict (Melchior, Moffitt, Milne, Poulton, & Caspi, 2007; Pearlin, 1989). It may also increase young people’s vulnerability to these stressors through pathways including dysregulation of the biological immune and stress-response systems, poorer nutrition, and a higher burden of chronic physical problems such as asthma and obesity (Pascoe et al, 2016; Pearlin, 1989). However, associations of SES and mental health have varied depending on the measure of SES, suggesting that different components of SES may influence mental health differently.…”

Maternal Interpersonal Trauma and Child Social‐Emotional Development: An Intergenerational Effect

“…Social‐emotional health is foundational to early child development and has been linked to cognitive outcomes and later academic performance . Childhood poverty can compromise environmental supports and increase the risk for impaired development . In a low‐income, urban cohort, 24% of children exhibited symptoms of social‐emotional problems; this compared with 13% in a sample of all children in primary care .…”

“…In a low‐income, urban cohort, 24% of children exhibited symptoms of social‐emotional problems; this compared with 13% in a sample of all children in primary care . Developmental disparities related to poverty have been attributed to features of the environment including psychosocial stress and nutrition . Maternal interpersonal trauma, such as mothers who experienced past abuse, has rarely been studied in the context of offspring development and may be an exposure that further determines risk for negative child social‐emotional functioning.…”