‘It is hard to be poor, harder than we thought’

For a 'rich' country, by global standards, the UK has an awful lot of people who are not. Fourteen million people – one fifth of the population – live in poverty. Of these, four million are more than 50 per cent below the poverty line, and 1.5 million are classed as destitute, unable to afford even basic life essentials.

For children who grow up in poverty, there are impacts that go way beyond the fact of material shortages. 'Children experience poverty as an environment that is damaging to their mental, physical, emotional and spiritual development,' notes UNICEF. Clearly, there's a critical role for psychological research in this area, first in revealing just what poverty does to children and adults — but also in developing strategies to ameliorate those impacts.

The psychological effects on children of growing up poor do make for grim reading. A 2009 study published in the Journal of Cognitive Neuroscience, of 9- and 10-year-olds who differed only in their socioeconomic status, found striking differences in activity in the pre-frontal cortex, which is critical for complex cognition. The PFC response of many of the poor children in response to various tests resembled that of some stroke victims. 'Kids from lower socioeconomic levels show brain physiology patterns similar to someone who actually had had damage in the frontal lobe as an adult,' commented lead researcher, Robert Knight, professor of psychology at the University of California, Berkeley.

The kinds of deficits that the team observed could cause problems with self-regulation, and behavioural difficulties (both of which have been documented among poorer children), as well as difficulties with reasoning. 'This is a wake-up call,' Knight went on. 'It's not just that these kids are poor and more likely to have health problems, but they might actually not be getting full brain development from the stressful and relatively impoverished environment associated with lower socioeconomic status: fewer books, less reading, fewer games, fewer visits to museums.'

Since then, plenty of other studies have found that poverty harms children's brains. In 2014, experiments led by Michele Tine revealed clear deficits in both verbal and visuospatial memory among poor children. A year later, a paper published in JAMA Paediatrics documented 'irregular brain development' in low income children, and tied these lags in the development of the frontal and temporal lobes to substantially lower scores on maths and reading tests. The development of the hippocampus, which is involved in memory, was particularly influenced by the stresses experienced by these children, the team found.

These impacts can be long-lasting. A longitudinal study, published by Gary Evans in PNAS in 2016, found that adults who were poor as children showed memory deficits and experienced greater psychological distress. In 2019, meanwhile, a long-term study of nearly 4,000 families in the Canada, led by Paul Hastings, reported that growing up in a poor urban neighbourhood is associated with a doubling in the risk of developing a psychosis-spectrum disorder by middle adulthood.

These studies paint a very bleak picture of the effects of poverty. But not all poor children are affected in the same way – not every impoverished child in the pre-frontal cortex functioning study showed deficits, for example. This suggested that there are also protective factors. Further research in this area suggests that overall stress levels and also the behaviour of the people close the child can make a big difference.

Something as simple as planting more trees in schools in disadvantaged areas might help, according to research by a team at the University of Illinois, published in 2018. Ming Kuo and her colleagues quantified the level of tree and grass cover in the schoolyards of 318 elementary schools (in which 87 per cent of kids overall fell into a low family income category) and found a correlation with scores in both maths and reading: the greater the number of trees, the better the results. Based partly on other work finding a link between the abundance of trees and academic performance outside a low-income setting, Kuo thinks there is a meaningful link between the two. 'It's not a surprise to anyone that if you don't provide air conditioning or heating in a school then maybe the kids aren't going to do as well. But this is the first time we've begun to suspect that the lack of landscaping, such as trees, may help explain, in part, their poorer test scores,' she says.

A British study published the same year supported these conclusions. This study, of 4758 11-year-olds living in urban areas of England, found that children who lived in greener neighbourhoods performed better on tests of spatial working memory (an effect that held for both deprived and non-deprived neighbourhoods). 'Our findings suggest a positive role of greenspace in cognitive functioning,' commented researcher Eirini Flouri at University College London. What might this role be? Perhaps because it's restful for the brain, and restores the ability to concentrate.

Interventions that focus on the families of kids growing up in poverty should also help. The team that observed the PFC deficits thinks that in theory they could be prevented, or eliminated. Earlier work has shown that children in poor families hear about 30 million fewer words by the time they they are four than children from middle-class families. Just talking more to kids can boost prefrontal cortex performance, the team notes – so, they say, changing the developmental outcomes that they observed might involve something as simple as emphasising to all parents the importance of talking to their kids.

Children raised in low socioeconomic status families also tend to go on to have relatively high rates of chronic illness in adulthood – but again, this isn't inevitable. A nurturing, attentive and emotionally-supportive mother can buffer the impacts of poverty on physical health, finds a 2011 study led by G.E. Miller and published in Psychological Science. 

There's other work, from the University of Liverpool's Sophie Wickham in 2014, suggesting that a person's perceptions of their levels of stress, trust and social support mediate the impact of poverty on rates of depression and paranoia. This highlights a potential role for the broader community in mitigating the effects of poverty on individuals within that community. The research, conducted in two areas of Birmingham, suggested that community resilience to hardships, like joblessness and low income, can be enhanced, and that this primarily relies on relationships 'not just between members of the community, but also between organisations, specifically between the voluntary sector, the local economy and the public sector.'

Of course, the self-evident way to tackle the negative psychological impacts of poverty is to tackle poverty itself.

Relaxing financial strains can make a real difference, according to research published in PNAS last year. This work on low income people who were categorised as being 'chronically indebted' found that a one-off debt relief programme (funded by a charity) eased the participants' anxiety, and improved their cognitive functioning, allowing them to make better financial decisions three months later. Thinking and worrying about un-payable debts is so mentally demanding that it contributes to the poverty trap, the researchers argued. 'Our study shows that because debt impairs psychological functioning and decision-making, it would be extremely challenging for even the motivated and talented to escape poverty,' commented Ong Qiyan at the National University of Singapore. 'Instead, the poor must either have exceptional qualities or be exceptionally lucky to get out of poverty. It is hard to be poor, harder than we thought.'

People who are not poor and have debts simply do not experience the same mental drain, the team comments. 'The findings in this study opens a pragmatic case for designing good debt relief programmes for low income households,' Ong argues. Even if debt can't be written off, streamlining people's debts, so that mentally they are easier to manage, could help, the team writes.

In 2015, the UK government committed to achieving, by 2030, the UN's Sustainable Development Goals (SDG), which include, at number one, 'no poverty', with 'zero hunger' at number 2.  However, in 2019, the House of Commons' Environmental Audit Committee issued a report finding that food insecurity is 'significant and growing' in the UK, with levels among the worst in Europe, especially for children. One in ten households in England, Wales and Northern Ireland have 'low or very low food security' with a further ten per cent classed as 'marginally food secure'. Food bank use is up – between 1 April 2018 and 31 March 2019, the Trussell Trust distributed 1.6 million emergency three-day food supplies to people across the UK, a 19 per cent increase on the previous year,  and more than half a million of these went to children.

These are desperate statistics. Providing more greenspace around schools in deprived areas and providing support programmes for low SES mothers, for example, may work to ameliorate the effects of poverty on children. But for a child whose family can't afford to feed them, it's hard not to wonder what difference such measures could really make. One third of the way into the UK's 15-year timeframe for meeting the UN SDGs of No Poverty and No Hunger, we have an extraordinarily long way to go.

By Emma Young, for our Research Digest blog.

- The British Psychological Society is calling for members with expertise on its 2020 theme, 'From poverty to flourishing'. 

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