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

3. 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

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

5. Effects of

6. 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

7. 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
=ZyBsy5SQxqU

8. 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

9. 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

10. 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

11. 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

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

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

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

16. Student-Led Discussion

17. 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

18. 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).

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

20. 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

21. Should the US Support Changes to Health Care?
Yes – HealthHealthCareNow.org and the American Academy of Family Physicians
No – Heritage Foundation g
Your view?

22. 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

23. 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

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