In the United States, >40% of children are either poor or near-poor. As a group, children in poverty are more likely to experience worse health and more developmental delay, lower achievement, and more behavioral and emotional problems than their more advantaged peers; however, there is broad variability in outcomes among children exposed to similar conditions. Building on a robust literature from animal models showing that environmental deprivation or enrichment shapes the brain, there has been increasing interest in understanding how the experience of poverty may shape the brain in humans. In this review, we summarize research on the relationship between socioeconomic status and brain development, focusing on studies published in the last 5 years. Drawing on a conceptual framework informed by animal models, we highlight neural plasticity, epigenetics, material deprivation (eg, cognitive stimulation, nutrient deficiencies), stress (eg, negative parenting behaviors), and environmental toxins as factors that may shape the developing brain. We then summarize the existing evidence for the relationship between child poverty and brain structure and function, focusing on brain areas that support memory, emotion regulation, and higher-order cognitive functioning (ie, hippocampus, amygdala, prefrontal cortex) and regions that support language and literacy (ie, cortical areas of the left hemisphere). We then consider some limitations of the current literature and discuss the implications of neuroscience concepts and methods for interventions in the pediatric medical home.
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April 2016
State-of-the-Art Review Article|
Poverty and Child Health Disparities|
April 01 2016
State of the Art Review: Poverty and the Developing Brain
Sara B. Johnson, PhD;
aDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland;
bDepartment of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and
Address correspondence to Sara B. Johnson, Johns Hopkins School of Medicine, Department of Pediatrics, 200 N Wolfe St, Suite 2017, Baltimore, MD 21287. E-mail: sjohnson@jhu.edu
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Jenna L. Riis, PhD;
Jenna L. Riis, PhD
bDepartment of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and
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Kimberly G. Noble, MD
Kimberly G. Noble, MD
cDepartment of Neuroscience and Education, Teachers College, Columbia University, New York, New York
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Address correspondence to Sara B. Johnson, Johns Hopkins School of Medicine, Department of Pediatrics, 200 N Wolfe St, Suite 2017, Baltimore, MD 21287. E-mail: sjohnson@jhu.edu
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
Pediatrics (2016) 137 (4): e20153075.
Article history
Accepted:
October 20 2015
Citation
Sara B. Johnson, Jenna L. Riis, Kimberly G. Noble; State of the Art Review: Poverty and the Developing Brain. Pediatrics April 2016; 137 (4): e20153075. 10.1542/peds.2015-3075
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