How Poverty Gets Under the Skin HDF 434 – Children and Families in Poverty

Beyond individualism and social structuralism – Ecobiological development How poverty gets under the skin The physiological effects of early or chronic poverty on individual functioning The cumulative effects of poverty

Bioecological framework DNA DNA methylation Whether, when, and how the gene is activated Environment or ecology

Effects of

Types of Stress Positive stress Tolerable stress Toxic Stress Brief, moderate, normative Example? Tolerable stress Moderate to strong, Non-normative Toxic Stress Strong, Frequent or prolonged

Effects of Stress: Working memory What is working memory? Language comprehension, reading, problem-solving Memorize the following letters. ABCDFGPAIQSAT Effects of stress on mood and health https://www.youtube.com/watch?v =ZyBsy5SQxqU

How Poverty Creates Stress: For Parents Short-term effects: Traumatic stress – Loss of job/home (Sinha et al., 2012) Brain shrinkage in area of emotional awareness and self-control More distant, harsh, or inappropriate interactions Financial stress – Worrying about paying bills Drop in IQ of 13 points Physical effects: Blood Pressure Stress hormone cortisol

How Poverty Creates Stress: For Children Prenatal Stress Changes size and shape of brain Impact on learning, memory and mood Stress in infancy Higher cortisol levels at age four (Burghy, Essex, et al., 2012) Aggression, impulsivity, behavior problems at age 6 Brain differences at age 18 Greater anxiety and depression Consistently higher blood pressure (Evans et al., 2011) Cognitive deficits Language, long-term memory, working memory, executive control

Long term effects of stress (Evans & Schamberg, 2009) Chronic stress - wear and tear (allostatic load) Impaired brain functioning Cognition, Emotional control Chronic physical and mental health problems Stress Response systems passed to subsequent generations Intergenerational transmission of poverty?? Tells genome to express certain characteristics and behaviors and to suppress others

Prenatal effects of poverty Before birth (in utero) Growth retardation, birth defects, neurobiological delays Elevated heart rates and lower vagal tone Connected to self-regulation, temperament, attention Why? Lack of prenatal care Maternal stress during pregnancy Maternal mental health Anxiety, depression, substance use

The effects of poverty on health HDF 434 – Children and Families in Poverty

The long reach of childhood poverty Higher rates of death up until age 18 Through adulthood

Health in Adulthood and Poverty: Overall Health Problems by Income Cause or Effect?

Student-Led Discussion

Recap: Direct Effects vs. Indirect Effects Examples of Direct Effects? Examples of Indirect (Aggregate) Effects Actual Effects of US Recession Physical health stable BUT Mental health problems Drop in Health Care Coverage

Trends Among U.S. Adults 1985 to2011 Major Health Problem: The obesity epidemic Trends Among U.S. Adults 1985 to2011 Definitions: Obesity: Body Mass Index (BMI) of 30 or higher. Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters. Source of the data: The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS).

Your thoughts on the obesity epidemic Why is obesity increasing? Why are obesity rates higher among poor people?

Direct effects of Income on Health: Small Group Discussion of Class Matters Share with your group one primary reason why Jean Miele, Will Wilson, and Ewa Gore had such different experiences with their heart attacks. With your group, classify your reason as reflecting one of four perspectives: individualism, social structuralism, culture of poverty, or luck Recorder: Write down the reasons given and the perspective it matches

Should the US Support Changes to Health Care? Yes – HealthHealthCareNow.org and the American Academy of Family Physicians http://www.youtube.com/watch?v=EkGGDOp4uUg No – Heritage Foundation http://www.youtube.com/watch?v=jwae822Sw-4 g Your view?

Who is likely to be left out of health care coverage? Minorities especially Hispanics, American Indians, Alaskan Natives Males overall, especially young adult males Poor and near poor, especially adults

Figure 2. Percentage of persons under age 65 years without health insurance coverage at the time of interview, by age group and sex: United States, January-March 2010 DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2010, Family Core component. The estimates for 2010 are based on data collected from January through March. Data are based on household interviews of a sample of the civilian noninstitutionalized population.   Social stratification - Gender % of persons under age 65 years WITHOUT health insurance coverage: United States, January-March 2010

Social Stratification – Socioeconomic status (SES) % of Adults under 65 without Health Insurance by Poverty Status