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Cited by 733Child Abuse and TraumaChild and Adolescent Psychosocial and Emotional DevelopmentFood Security and Health in Diverse Populations

The Effects of Poverty on Childhood Brain Development: The Mediating Effect of Caregiving and Stressful Life Events

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Luby, Joan, Belden, Andy, Botteron, Kelly, Marrus, Natasha, Harms, Michael P., Babb, Casey, Nishino, Tomoyuki, Barch, Deanna·2013·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2013.3139PMC PMC4001721
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Abstract

IMPORTANCE The study provides novel data to inform the mechanisms by which poverty negatively impacts childhood brain development. OBJECTIVE To investigate whether the income-to-needs ratio experienced in early childhood impacts brain development at school age and to explore the mediators of this effect. DESIGN, SETTING, AND PARTICIPANTS This study was conducted at an academic research unit at the Washington University School of Medicine in St Louis. Data from a prospective longitudinal study of emotion development in preschool children who participated in neuroimaging at school age were used to investigate the effects of poverty on brain development. Children were assessed annually for 3 to 6 years prior to the time of a magnetic resonance imaging scan, during which they were evaluated on psychosocial, behavioral, and other developmental dimensions. Preschoolers included in the study were 3 to 6 years of age and were recruited from primary care and day care sites in the St Louis metropolitan area; they were annually assessed behaviorally for 5 to 10 years. Healthy preschoolers and those with clinical symptoms of depression participated in neuroimaging at school age/early adolescence. EXPOSURE Household poverty as measured by the income-to-needs ratio. MAIN OUTCOMES AND MEASURES Brain volumes of children's white matter and cortical gray matter, as well as hippocampus and amygdala volumes, obtained using magnetic resonance imaging. Mediators of interest were caregiver support/hostility measured observationally during the preschool period and stressful life events measured prospectively. RESULTS Poverty was associated with smaller white and cortical gray matter and hippocampal and amygdala volumes. The effects of poverty on hippocampal volume were mediated by caregiving support/hostility on the left and right, as well as stressful life events on the left. CONCLUSIONS AND RELEVANCE The finding that exposure to poverty in early childhood materially impacts brain development at school age further underscores the importance of attention to the well-established deleterious effects of poverty on child development. Findings that these effects on the hippocampus are mediated by caregiving and stressful life events suggest that attempts to enhance early caregiving should be a focused public health target for prevention and early intervention. Findings substantiate the behavioral literature on the negative effects of poverty on child development and provide new data confirming that effects extend to brain development. Mechanisms for these effects on the hippocampus are suggested to inform intervention.

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  • In a prospective study, caregiving behaviors mediated the association of early childhood socioeconomic stress with hippocampal volumetric change.

    “Considering neurodevelopment, a prospective study found that caregiving behaviors mediated the association of early childhood socioeconomic stress with hippocampal volumetric change [97].”

    From Biological embedding of childhood adversity: from physiological mechanisms to clinical implications (2017) · cites this paper as [97]

    The Results section reports that caregiving behaviors mediated the association between income-to-needs ratio and left and right hippocampal volumes. The Design and Participants sections describe prospective follow-up, but neuroimaging occurred at a later session; the paper reports hippocampal volume, not measured volumetric change over time. No page numbers are supplied in our copy. (LLM, conf=0.88)

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  • The family's income-to-needs ratio predicted both white and gray matter volume in 10-year-old children.

    “In a structural MRI study of 10-year-old children, the family's income-to-needs ratio predicted both white and gray matter volume (Luby et al., 2013).”

    From Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project (2016) · cites this paper as Luby et al., 2013

  • In older children and adolescents, lower family income and lower parental education are associated with reduced volumes of cortical grey matter, hippocampus, and amygdala, as well as reduced cortical surface area and cortical thickness.

    “In older children and adolescents, lower family income and lower parental education have been associated with reduced volumes of cortical grey matter, the hippocampus, and the amygdala168 as well as reduced cortical surface area and cortical thickness169, 170.”

    From Imaging structural and functional brain development in early childhood (2018) · cites this paper as [168]

  • Environmental, parental, and youth factors may compound effects on neuromaturation and potentially increase STB and NSSI vulnerability.

    “This may be compounded by environment (e.g., poverty (118)), parent (e.g., mental disorders (119)), and youth (e.g., stress (120); psychiatric symptoms (121)) factors—each affecting neuromaturation—and potentially, increasing STB and NSSI vulnerability.”

    From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [118]

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Authors
Luby, J., Belden, A., Botteron, K., Marrus, N., Harms, M. P., Babb, C., Nishino, T., & Barch, D.
Affiliations
Washington University in St. Louis (US)
Corresponding author
Luby, Joan
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2013-12-01
Volume
167
Issue
12
Pages
1135
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2013.3139
PMC
PMC4001721
OpenAlex
W2134744704
Cited by
733
References
43
Citations by year
2026: 20 · 2025: 37 · 2024: 66 · 2023: 47 · 2022: 73 · 2021: 58 · 2020: 103 · 2019: 63 · 2018: 83 · 2017: 61 · 2016: 52 · 2015: 42 · 2014: 26 · 2013: 1
FWCI
44.82
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Public Health Service (R01 PA07-070)
  • National Institute of Mental Health (K01MH090515, R01MH064769, R01MH090786, T32MH100019)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
Keywords
child poverty, income-to-needs ratio, brain development, hippocampus, amygdala, white matter, cortical gray matter, caregiver support, life events, mediation, preschool children, emotional development, early intervention
MeSH terms
Brain, Child, Child Development, Depression, Female, Humans, Life Change Events, Longitudinal Studies, Magnetic Resonance Imaging, Male, Poverty, Stress, Psychological, Washington, Caregivers

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