Cited by 543Food Security and Health in Diverse PopulationsChild Abuse and TraumaChild and Adolescent Psychosocial and Emotional Development

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Poverty, Stress, and Brain Development: New Directions for Prevention and Intervention

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Blair, Clancy, Raver, C. Cybele·2016·Academic Pediatrics

DOI 10.1016/j.acap.2016.01.010PMC PMC5765853

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Abstract

We review some of the growing evidence of the costs of poverty to children's neuroendocrine function, early brain development, and cognitive ability. We underscore the importance of addressing the negative consequences of poverty-related adversity early in children's lives, given evidence supporting the plasticity of executive functions and associated physiologic processes in response to early intervention and the importance of higher order cognitive functions for success in school and in life. Finally, we highlight some new directions for prevention and intervention that are rapidly emerging at the intersection of developmental science, pediatrics, child psychology and psychiatry, and public policy.

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Neuroimaging Field Methods Using Functional Near Infrared Spectroscopy (NIRS) Neuroimaging to Study Global Child Development: Rural Sub-Saharan Africa
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Poverty, Parent Stress, and Emerging Executive Functions in Young Children
Finegood, E. D., & Blair, C. (2017) · Springer eBooks · doi:10.1007/978-3-319-55376-4_8 · Cited by 58
Self-citation
The Role of Childhood Executive Function in Explaining Income Disparities in Long-Term Academic Achievement
Deer, L. K., Hastings, P. D., & Hostinar, C. E. (2020) · Child Development · doi:10.1111/cdev.13383 · Cited by 55
Child Poverty in the United States Today: Introduction and Executive Summary
Dreyer, B. P., Chung, P. J., Szilagyi, P. G., & Wong, S. L. (2016) · Academic Pediatrics · doi:10.1016/j.acap.2016.02.010 · Cited by 43
Broadening dementia risk models: building on the 2024 Lancet Commission report for a more inclusive global framework
Mostert, C. M., Udeh-Momoh, C., Winkler, A. S., McLaughlin, C., Eyre, H., Salama, M., Ranchod, K., Trepel, D., Vradenburg, G., Hynes, W., et al. (2025) · eBioMedicine · doi:10.1016/j.ebiom.2025.105950 · Cited by 42
“61 In-come inequality also negatively affects brain measures in females across various global settings, particularly in disadvantaged regions.”
EEG/ERP as a pragmatic method to expand the reach of infant-toddler neuroimaging in HBCD: Promises and challenges
Norton, E. S., MacNeill, L. A., Harriott, E. M., Allen, N. B., Krogh‐Jespersen, S., Smyser, C. D., Rogers, C. E., Smyser, T. A., Luby, J. L., & Wakschlag, L. S. (2021) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2021.100988 · Cited by 45
“Disruptions in typical brain development likely underlie such trajectories, particularly during the first few years of life when brain plasticity is heightened (Blair and Raver, 2016).”
Cash transfer programs and child health and family economic outcomes: a systematic review
Fuller, A. E., Zaffar, N., Cohen, E., Pentland, M., Siddiqi, A., Vandermorris, A., van den Heuvel, M., Birken, C. S., Guttmann, A., & de Oliveira, C. (2022) · Canadian Journal of Public Health · doi:10.17269/s41997-022-00610-2 · Cited by 42
“Parental health is critical to child health as parents buffer the effects of low income on children (Blair & Raver, 2016) and, while there is a strong focus on reducing child poverty in policy and clinical interventions, the importance of promoting parental health cannot be overstated.”
Background
Engaging Parents in Preventive Interventions for Young Children: Working with Cultural Diversity Within Low-Income, Urban Neighborhoods
Dawson‐McClure, S., Calzada, E. J., & Brotman, L. M. (2017) · Prevention Science · doi:10.1007/s11121-017-0763-7 · Cited by 44
“Cultural diversity A robust literature documents the impact of poverty on child development and lifelong health, well-being, and productivity (see Blair and Raver 2016).”
Mendelian randomization study on the causal effects of COVID‐19 on childhood intelligence
Zhu, G., Zhou, S., Xu, Y., Gao, R., Li, H., Su, W., Han, G., & Wang, R. (2022) · Journal of Medical Virology · doi:10.1002/jmv.27736 · Cited by 38
Getting under the skin: Physiological stress and witnessing paternal arrest in young children with incarcerated fathers
Muentner, L., Kapoor, A., Weymouth, L., & Poehlmann, J. (2021) · Developmental Psychobiology · doi:10.1002/dev.22113 · Cited by 39
“…to poor executive function development and less optimal regulation of emotion and attention (Blair, Raver, & Granger, 2011), thereby influencing activity in and development of brain structures and neural circuitry that are crucial for behavior, health, and development (Blair & Raver, 2016).”
Background
Transgender Youth Executive Functioning: Relationships with Anxiety Symptoms, Autism Spectrum Disorder, and Gender-Affirming Medical Treatment Status
Strang, J. F., Chen, D., Nelson, E. E., Leibowitz, S. F., Nahata, L., Anthony, L. G., Song, A. Y., Grannis, C., Graham, E. K., Henise, S. B., et al. (2021) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01195-6 · Cited by 45
Early Childhood Socioeconomic Status and Cognitive and Adaptive Outcomes at the Transition to Adulthood: The Mediating Role of Gray Matter Development Across Five Scan Waves
Barch, D. M., Donohue, M. R., Elsayed, N. M., Gilbert, K., Harms, M. P., Hennefield, L., Herzberg, M. P., Kandala, S., Karcher, N. R., Jackson, J. J., et al. (2021) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2021.07.002 · Cited by 37
“Social Outcomes: We coded for seven outcomes (Supplement): (1) poor peer relationships; (2) peer acceptance/rejection; (3) bullied; (4) relational victimization; and (5) social withdrawal; (6) social inhibition; and (7) prosocial behavior.”
BackgroundMethodInfluential
Wealth and Child Development: Differences in Associations by Family Income and Developmental Stage
Miller, P., Podvysotska, T., Betancur, L., & Votruba‐Drzal, E. (2021) · RSF The Russell Sage Foundation Journal of the Social Sciences · doi:10.7758/rsf.2021.7.3.07 · Cited by 44
“…economic uncertainty or income loss, which would weaken negative links between volatility and children’s self-regulatory and attentional abilities and, in turn, academic and behavioral development (Blair and Raver 2016; Evans et al. 2005; Palacios-Barrios and Hanson 2019; Wadsworth et al. 2016).”
Society to cell: How child poverty gets “Under the Skin” to influence child development and lifelong health
Schmidt, K. L., Merrill, S. M., Gill, R., Miller, G. E., Gadermann, A., & Kobor, M. S. (2021) · Developmental Review · doi:10.1016/j.dr.2021.100983 · Cited by 50
Maximizing research on the adverse effects of child poverty through consensus measures
Pollak, S. D., & Wolfe, B. L. (2020) · Developmental Science · doi:10.1111/desc.12946 · Cited by 36
“A review of this new literature is beyond the scope of this paper, but a number of recent, comprehensive reviews of these studies have been published (see Blair & Raver, 2016; Farah, 2018; Johnson, Riis, & Noble, 2016).”
Background
Testosterone and hippocampal trajectories mediate relationship of poverty to emotion dysregulation and depression
Barch, D. M., Shirtcliff, E. A., Elsayed, N. M., Whalen, D. J., Gilbert, K., Vogel, A. C., Tillman, R., & Luby, J. L. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2004363117 · Cited by 38
“The overwhelming evidence of such associations has encouraged efforts aimed at early intervention and prevention (11, 13).”
Background
Undergraduate neuroscience education: Meeting the challenges of the 21st century
Ramirez, J. J. (2020) · Neuroscience Letters · doi:10.1016/j.neulet.2020.135418 · Cited by 38
The Power of Purposeful Play in Primary Grades: Adjusting Pedagogy for Children’s Needs and Academic Gains
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Maternal mental health mediates links between socioeconomic status and child development
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Effects of Early Literacy Promotion on Child Language Development and Home Reading Environment: A Randomized Controlled Trial
Guevara, J. P., Erkoboni, D., Gerdes, M., Winston, S., Sands, D., Rogers, K., Haecker, T., Jiménez, M. E., & Mendelsohn, A. L. (2020) · The Journal of Pediatrics X · doi:10.1016/j.ympdx.2020.100020 · Cited by 36
Transcending Adversity: Trauma-Informed Educational Development
Imad, M. (2021) · To improve the academy · doi:10.3998/tia.17063888.0039.301 · Cited by 36
“…single event (e.g., a car accident), recurring events accumulated over a generation (e.g., poverty), and recurring events accumulated over generations— intergenerational (e.g., racism) (Blair & Raver, 2016; Lehrner & Yehuda, 2018; Luby et al., 2013; Sangalang & Vang, 2016; Yehuda & Lehrner, 2018).”
Background
SNAP participation and the health and health care utilisation of low-income adults and children
Miller, D. P., & Morrissey, T. W. (2021) · Public Health Nutrition · doi:10.1017/s1368980021003815 · Cited by 36
An unconditional prenatal income supplement is associated with improved birth and early childhood outcomes among First Nations children in Manitoba, Canada: a population-based cohort study
Enns, J. E., Nickel, N. C., Chartier, M., Chateau, D., Campbell, R., Phillips-Beck, W., Sarkar, J., Burland, E., Katz, A., Santos, R., et al. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03782-w · Cited by 32
Material hardship is associated with posttraumatic stress disorder symptoms among low‐income Black women
Holmes, S. C., Callinan, L. S., Facemire, V. C., Williams, M. T., Ciarleglio, M. M., & Smith, M. V. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22741 · Cited by 38
Parental Incarceration and Children’s Well-being: Findings from the Fragile Families and Child Well-being Study
Turney, K., & Haskins, A. R. (2019) · Springer eBooks · doi:10.1007/978-3-030-16707-3_5 · Cited by 34
Relationships Between Material Hardship, Resilience, and Health Care Use
Fuller, A. E., Garg, A., Brown, N. M., Tripodis, Y., Oyeku, S. O., & Gross, R. S. (2020) · PEDIATRICS · doi:10.1542/peds.2019-1975 · Cited by 34
“Neighborhood cohesion was measured by using 3 questions: “To what extent do you agree with these statements about your neighborhood or community: (1) people in this neighborhood help each other out, (2) we watch out for each other’s children in this neighborhood, and (3) when we encounter difficulties, we know where t…”
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A meta-analysis of the validity of the Head-Toes-Knees-Shoulders task in predicting young children's academic performance
Kenny, S. A., Cameron, C. E., Karing, J. T., Ahmadi, A., Braithwaite, P. N., & McClelland, M. M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1124235 · Cited by 40
“Scholars suggest that the construct of self-regulation is multidimensional and involves both conscious (i.e., top-down) and unconscious (i.e., bottom-up) biopsychosocial processes (Best and Miller, 2010; McClelland and Cameron, 2012; Blair, 2016; Nigg, 2017).”
Background
Remixing the School Counselor’s Tool Kit
Levy, I., Cook, A. L., & Emdin, C. (2018) · Professional School Counseling · doi:10.1177/2156759x18800285 · Cited by 33
“Research suggests young people of color from impoverished urban neighborhoods face higher levels of mental, physical, and social stress than their more affluent, mostly White counterparts (Blair & Raver, 2016; Day, Ji, DuBois, Silverthorn, & Flay, 2016; Wade et al., 2014).”
Background
Stripping the Wallpaper of Practice: Empowering Social Workers to Tackle Poverty
McCartan, C. J., Morrison, A., Bunting, L., Davidson, G., & McIlroy, J. (2018) · Social Sciences · doi:10.3390/socsci7100193 · Cited by 33
“The effects of poverty on brain development can be apparent in infancy but there is growing evidence that these negative effects can be mitigated or reversed through targeted parenting interventions and poverty alleviation (Blair and Raver 2016).”
Background
Mindful Family Routines and the Cultivation of Executive Function Skills in Childhood
Semenov, A. D., & Zelazo, P. D. (2019) · Human Development · doi:10.1159/000503822 · Cited by 37
“…and the disruption of daily family routines, and research has examined the potential negative effects of poverty and chaos on cognitive (e.g., Blair & Raver, 2016), socio-emotional (e.g., Evans, Gonnella, Marcynyszyn, Gentile, & Salpekar, 2005), and academic development (e.g., Shonkoff et…”
Background
Let’s Talk Play! Exploring the Possible Benefits of Play-Based Pedagogy on Language and Literacy Learning in Two Title I Kindergarten Classrooms
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Disrupting links between poverty, chronic stress, and educational inequality
Harms, M. B., & Garrett-Ruffin, S. (2023) · npj Science of Learning · doi:10.1038/s41539-023-00199-2 · Cited by 46
“A growing body of evidence suggests that growing up in poverty contributes to cumulative risk exposure — resulting in chronic stress which impacts neurocognitive development in ways that tend to hinder academic performance 12 – 14 .”
Background
A Lifespan Model of Interference Resolution and Inhibitory Control: Risk for Depression and Changes with Illness Progression
Bessette, K. L., Karstens, A. J., Crane, N. A., Peters, A. T., Stange, J. P., Elverman, K. H., Morimoto, S. S., Weisenbach, S. L., & Langenecker, S. A. (2020) · Neuropsychology Review · doi:10.1007/s11065-019-09424-5 · Cited by 33
Long-term effects of a community-based positive youth development program for Black youth: health, education, and financial well-being in adulthood
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Associations between maternal stress and infant resting brain activity among families residing in poverty in the U.S.
Troller‐Renfree, S. V., Sperber, J. F., Hart, E. R., Costanzo, M. A., Gennetian, L. A., Meyer, J. S., Fox, N. A., & Noble, K. G. (2023) · Biological Psychology · doi:10.1016/j.biopsycho.2023.108683 · Cited by 30
“Mothers living in poverty are more likely to experience stress when compared to individuals with economic advantage (Algren et al., 2018; Attar et al., 2010; Blair & Raver, 2016; Evans, 2004; Evans & English, 2002; Evans & Kim, 2010; Hackman et al., 2010; McLoyd, 1990; Senn et al., 2014).”
Background
Impact of educational attainment on the association between social class at birth and multimorbidity in middle age in the Aberdeen Children of the 1950s cohort study
Johnston, M. C., Black, C., Mercer, S. W., Prescott, G. J., & Crilly, M. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-024048 · Cited by 24
“Exposure to stressors when young can impact directly on neurobiological development.(29) Children in families in poverty may have changes in brain function due to the impact of cortisol on the developing brain.”
Background
Structural model of resilience based on parental support: the mediating role of hope and active coping
Cheraghian, H., Moradian, K., & Nouri, T. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04678-z · Cited by 48
“In addition, parental support can protect the child from stressors that are detrimental to their physical and mental health and provide the foundation for social appropriateness and effective learning [5].”
Background
Reclaiming Healthcare’s Healing Mission for a Sustainable Future
Berry, L. L., Yadav, M. S., & Hole, M. K. (2023) · Journal of Service Research · doi:10.1177/10946705231198024 · Cited by 30

Authors: Blair, C., & Raver, C. C.
Affiliations: New York University (US)
Corresponding author: Blair, Clancy
ORCID: Blair, Clancy
Venue: Academic Pediatrics
Publisher: Elsevier BV
Published: 2016-04
Volume: 16
Issue: 3
Pages: S30-S36
ISSN: 1876-2859 (ISSN-L)
DOI: 10.1016/j.acap.2016.01.010
PMC: PMC5765853
OpenAlex: W2327738691
Cited by: 543
References: 72
Citations by year: 2026: 58 · 2025: 63 · 2024: 53 · 2023: 53 · 2022: 79 · 2021: 75 · 2020: 63 · 2019: 42 · 2018: 37 · 2017: 16 · 2016: 4
FWCI: 6.30
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Academic Pediatrics (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Child Health and Human Development (R01 HD51502, P01 HD39667)
National Institute on Drug Abuse
US Administration for Children and Families (90YR0057)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Food Security and Health in Diverse Populations
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: poverty, childhood adversity, stress, early brain development, neuroendocrine function, executive function, cognitive ability, early intervention, prevention, child development, public policy
MeSH terms: Adolescent, Brain, Child, Child Development, Child, Preschool, Cognition, Humans, Hypothalamo-Hypophyseal System, Infant, Infant, Newborn, Pituitary-Adrenal System, Poverty, Stress, Psychological, Parenting, Early Intervention, Educational, Executive Function

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Poverty, Stress, and Brain Development: New Directions for Prevention and Intervention

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