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The Effects of Poverty on Childhood Brain Development: The Mediating Effect of Caregiving and Stressful Life Events
Open accessAbstract
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 the citing paper
“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]
Experimental — accuracy not yet measuredIn the citing paper
“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 the citing paper
“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]
In the citing paper
“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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Metadata
- 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
- 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
- green
- europepmc.org
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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