In this issue of Pediatrics, Farrell et al1 describe research linking poverty with child maltreatment fatalities. The American Academy of Pediatrics has addressed the overall issue of the effects of poverty in a recent policy statement.2 An increasing number of reports linking ecology with outcomes for both adults and children have been published describing risk factors for overall health, brain health, and lifetime health trajectories.3,4 Given the sociologic, economic, medical, and myriad other challenges related to poverty, it is not surprising that the authors report a significant increase in fatal child maltreatment related specifically to socioeconomic status. What may be surprising is that although this fact is both intuitive and now statistically proven, given the significant percentage of children living in poverty, the United States has yet to develop a comprehensive plan to address the issue.

Toxic stress, allostatic load, and childhood adversities have...

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