Childhood Poverty: Understanding and Preventing the Adverse Impacts of a Most-Prevalent Risk to Pediatric Health and Well-Being

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Key points

  • Children living in poor households are at greater risk for worse health, less productivity, and harms to well-being far into adulthood and on into subsequent generations.

  • Timing and duration of poverty matter for outcomes throughout the life course, especially for education attainment, health, and lifetime productivity.

  • Attention must be focused on interventions at the levels of policy advocacy and the pediatric health delivery system on ways to protect the health and well-being of children and

Defining the extent of childhood poverty

About 15 million, or 1 in 5, American children live below the federal poverty line (FPL).1 Children are the poorest of all age groups in the United States, where the child poverty rate ranks among the very worst in the developed world.2 Other first-world nations with similar child poverty rates, such as the United Kingdom,3 have managed to reverse course as a result of concerted public and political leadership. Yet, in the United States the number of poor children has remained persistently high

The impact of poverty on health and well-being

Pediatricians are well aware of the health consequences of child poverty. The leading causes of childhood chronic disease and mortality seen in pediatrics every day, including prematurity, obesity, asthma, developmental delay, failure to thrive, accidents, and many more, are strongly linked to being poor, with rates many times higher among low-income children (Table 1). Equally critical are poverty’s impacts on overall well-being, such as failing academic attainment and exposure to emotional

Prevention of child poverty and its adverse effects on health and well-being

How can pediatricians intervene to reduce child poverty and mitigate its harms? Given what is known about the widespread prevalence of financial hardship and its effects on children’s lives, the most challenging decision may be how to begin. There is no single right place to start to prevent the harms of poverty. Poverty’s impact on multiple domains of social determinants, child health, and family well-being means there is no simple silver bullet. Solving such a multifaceted problem requires a

Summary

Economic adversity begets more adversity and poorer health. Therefore, interrupting the cycle of poverty has significant benefits for families today and their children tomorrow. There is much to do in reducing child poverty and many important roles for pediatricians to play in improving the health and well-being of poor families. It can be done, evidenced by efforts in the United Kingdom that cut rates of child poverty by half over the last decade.157 Even in the United States there is

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References (157)

  • B. Needham et al.

    Socioeconomic status and cell aging in children

    Soc Sci Med

    (2012)
  • M.A. Hanson et al.

    Developmental origins of health and disease—global public health implications

    Best Pract Res Clin Obstet Gynaecol

    (2015)
  • C. DeNavas-Walt et al.

    Income and poverty in the United States: 2013

    (2014)
  • P. Adamson

    Measuring child poverty: New league tables of child poverty in the world’s rich countries

    (2012)
  • G.M. Fisher

    The development of the Orshansky poverty thresholds and their subsequent history as the official U.S. poverty measure

    (1997)
  • Short K. The Supplemental Poverty Measure: 2013. Census Current Population Reports. 2014. Available at:...
  • J.T. Allen

    Re-counting poverty

    (2011)
  • T. Renwick

    Geographic adjustments of Supplemental Poverty Measure thresholds: using the American community survey five-year data on housing costs

    (2011)
  • S. Alegretto

    Basic family budgets

    (2005)
  • Corporation for Enterprise Development. Assets & opportunity scorecard. Liquid asset poverty rate. 2015. Available at:...
  • S. Fremstad

    A modern framework for measuring poverty and basic economic security

    (2010)
  • Y. Jiang et al.

    Basic facts about low-income children

    (2015)
  • Agency for Healthcare Research and Quality. National healthcare disparities report. Rockville (MD): AHRQ Publication...
  • Kawachi I, Subramanian SV. Income inequality. Social epidemiology. 2nd edition. In: Berkman LF, Kawachi I, Glymour MM,...
  • J. Eckenrode et al.

    Income inequality and child maltreatment in the United States

    Pediatrics

    (2014)
  • K.E. Pickett et al.

    Child wellbeing and income inequality in rich societies: ecological cross-sectional study

    BMJ

    (2007)
  • National Center for Children in Poverty. Young children at risk. New York. 2012. Available at:...
  • National Center for Children in Poverty. Poor children by parents’ nativity. New York. 2011. Available at:...
  • Passel JS. A portrait of unauthorized immigrants in the United States. Pew Hispanic Center Report. 2009. Available at:...
  • Cingano F. Trends in income inequality and its impact on economic growth. OECD Social, Employment, and Migration...
  • H.J. Holzer et al.

    The economic costs of childhood poverty in the United States

    J Child Poverty

    (2008)
  • A. Kozyrsky et al.

    Association between socioeconomic status and the development of asthma

    Am J Public Health

    (2010)
  • C. Blackburn et al.

    Is the onset of disabling conditions later childhood associated with social disadvantage in earlier childhood?

    BMC Pediatr

    (2013)
  • S. Saegert et al.

    Poverty, housing niches, and health in the United States

    J Soc Issues

    (2003)
  • K. Larson et al.

    Family income gradients in the health and health care access of US children

    Matern Child Health J

    (2010)
  • A. Case et al.

    Economic status and health in childhood

    Am Econ Rev

    (2002)
  • A. Aizer et al.

    Maternal stress and child outcomes: evidence from siblings

    (2012)
  • J.L. Hanson et al.

    Family poverty affects the rate of human infant brain growth

    PLoS One

    (2013)
  • J.L. Hanson et al.

    Association between income and the hippocampus

    PLoS One

    (2011)
  • B. Hart et al.

    Meaningful differences in the everyday experience of young American children

    (1995)
  • V.E. Lee et al.

    Inequality at the starting gate: social background differences in achievement as children begin school

    (2002)
  • L. Fiester

    Early warning confirmed: a research update on third-grade reading

    (2013)
  • R. Heuer et al.

    Comparability of state and local expenditure among schools within districts: a report from the study of school-level expenditures

    (2011)
  • R. Ingersoll

    The problem of under qualified teachers in American secondary schools

    Educ Res

    (1999)
  • D. Muijs et al.

    Improving schools in socioeconomically disadvantaged areas? A review of research evidence

    Sch Effect Sch Improv

    (2004)
  • G. Palardy

    Differential school effects among low, middle, and high social class composition school: a multiple group, multilevel latent class growth curve analysis

    Sch Effect Sch Improv

    (2008)
  • Cass J, Liss S. National Center for Education Statistics. Available at: http://nces.ed.gov/fastfacts/display.asp?id=16....
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