The Effects of Poverty on Children

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The Effects of Poverty on Children
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  55 The Effects of Povertyon Children Jeanne Brooks-GunnGreg J. Duncan Abstract  Although hundreds of studies have documented the association between family poverty and children’s health, achievement, and behavior, few measure the effects of the timing, depth, and duration of poverty on children, and many fail to adjust forother family characteristics (for example, female headship, mother’s age, and school-ing) that may account for much of the observed correlation between poverty and childoutcomes. This article focuses on a recent set of studies that explore the relationshipbetween poverty and child outcomes in depth. By and large, this research supports theconclusion that family income has selective but, in some instances, quite substantialeffects on child and adolescent well-being. Family income appears to be more strongly related to children’s ability and achievement than to their emotional outcomes.Children who live in extreme poverty or who live below the poverty line for multiple years appear, all other things being equal, to suffer the worst outcomes. The timingofpoverty also seems to be important for certain child outcomes. Children who expe-rience poverty during their preschool and early school years have lower rates of schoolcompletion than children and adolescents who experience poverty only in later years. Although more research is needed on the significance of the timing of poverty onchild outcomes, findings to date suggest that interventions during early childhoodmay be most important in reducing poverty’s impact on children. I n recent years, about one in five American children—some 12 to 14 mil-lion—have lived in families in which cash income failed to exceed offi-cial poverty thresholds. Another one-fifth lived in families whoseincomes were no more than twice the poverty threshold. 1,2 For a smallminority of children—4.8% of all children and 15% of children who everbecame poor—childhood poverty lasted 10 years or more. 3 Income poverty is the condition of not having enough income to meet basic needs for food, clothing, and shelter. Because children are dependent on others, they enter or avoid poverty by virtue of their family’s economiccircumstances. Children cannot alter family conditions by themselves, at least until they approach adulthood. Government programs, such as thosedescribed by Devaney, Ellwood, and Love in this journal issue, have beendeveloped to increase the likelihood that poor children are provided with  Jeanne Brooks-Gunn,Ph.D., is Virginia and Leonard Marx professor of child development and education, and is direc- tor of the Center for Young Children and Families at Teachers College,ColumbiaUniversity.Greg J. Duncan, Ph.D.,is a professor of educa- tion and social policy,and is a faculty asso- ciate at the Institute for Policy Research, North- westernUniversity. The Future of Children CHILDREN AND POVERTY Vol. 7 •No. 2 – Summer/Fall 1997  56THE FUTURE OF CHILDREN – SUMMER/FALL 199756 basic necessities. But even with these programs, poor children do not fare as well as those whose families are not poor. 4  What does poverty mean for children? How does the relative lack of income influence children’s day-to-day lives? Is it through inadequate nutri-tion; fewer learning experiences; instability of residence; lower quality of schools; exposure to environmental toxins, family violence, and homeless-ness; dangerous streets; or less access to friends, services, and, for adoles-cents, jobs? This article reviews recent research that used longitudinal datato examine the relationship between income poverty and child outcomes inseveral domains. Hundreds of studies, books, and reports have examined the detrimentaleffects of poverty on the well-being of children. Many have been summarizedin recent reports such as Wasting America’s Future  from the Children’s DefenseFund and Alive and Well?  from the National Center for Children in Poverty. 5 However, while the literature on the effects of poverty on children is large,many studies lack the precision necessary to allow researchers to disentanglethe effects on children of the array of factors associated with poverty.Understanding of these relationships is key to designing effective policies toameliorate these problems for children.This article examines these relationships and the consequences for chil-dren of growing up poor. It begins with a long, but by no means exhaustive,list of child outcomes (see Table 1) that have been found to be associated with poverty in several large, nationally representative, cross-sectional surveys.This list makes clear the broad range of effects poverty can have on children.It does little, however, to inform the discussion of the causal effects of incomepoverty on children because the studies from which this list is derived did not control for other variables associated with poverty. For example, poor fami-lies are more likely to be headed by a parent who is single, has low educa-tional attainment, is unemployed, has low earning potential, and is young.These parental attributes, separately or in combination, might account forsome of the observed negative consequences of poverty on children. Nor dothe relationships identified in the table capture the critical factors of the tim-ing, depth, and duration of childhood poverty on children. 6,7 This article focuses on studies that used national longitudinal data setsto estimate the effects of family income on children’s lives, independent of other family conditions that might be related to growing up in a low-incomehousehold. These studies attempt to isolate the effect of family income by taking into account, statistically, the effects of maternal age at the child’sbirth, maternal education, marital status, ethnicity, and other factors onchild outcomes. 2,8 Many used data on family income over several years andat different stages of development to estimate the differential effects of thetiming and duration of poverty on child outcomes. The data sets analyzedinclude the Panel Study of Income Dynamics (PSID), the NationalLongitudinal Survey ofYouth (NLSY) , Children of the NLSY (the follow-upof the children born to the women in the srcinal NLSY cohort), theNational Survey of Families and Households (NSFH), the National Healthand Nutrition Examination Survey (NHANES), and the Infant Health and  Development Program (IHDP). These rich data sets include multiple meas-ures of child outcomes and family and child characteristics. This article is divided into four sections. The first focuses on the conse-quences of poverty across five child outcomes. If income does, in fact, affect child outcomes, then it is important not only to identify these outcomes but also to describe the pathways through which income operates. Accordingly,in the second section, five pathways through which poverty might operateare described. The third section focuses on whether the links betweenpoverty and outcomes can reasonably be attributed to income rather thanother family characteristics. The concluding section considers policy impli-cations of the research reviewed. 57The Effects of Poverty on Children Effects of Income on ChildOutcomes Measures of Child Well-Being  As illustrated in Table 1, poor children sufferhigher incidences of adverse health, devel-opmental, and other outcomes than non-poor children. The specific dimensions of the well-being of children and youths con-sidered in some detail in this article include(1) physical health (low birth weight, growthstunting, and lead poisoning), (2) cogni-tive ability (intelligence, verbal ability, andachievement test scores), (3) school achieve-ment (years of schooling, high school com-pletion), (4) emotional and behavioraloutcomes, and (5) teenage out-of-wedlockchildbearing. Other outcomes are not addressed owing to a scarcity of availableresearch, a lack of space, and because they overlap with included outcomes. While this review is organized aroundspecific outcomes, it could also have beenorganized around the various ages of childhood. 9–11 Five age groups are often dis-tinguished—prenatal to 2 years, early child-hood (ages 3 to 6), late childhood (ages 7 to10), early adolescence (ages 11 to 15), andlate adolescence (ages 16 to 19). Each agegroup covers one or two major transitions ina child’s life, such as school entrances or exits,biological maturation, possible cognitivechanges, role changes, or some combinationof these. These periods are characterized by relatively universal developmental chal-lenges that require new modes of adaptationto biological, psychological, or socialchanges. 10 Somewhat different indicators of childand youth well-being are associated witheach period. For example, grade retention ismore salient in the late childhood years thanin adolescence (since most schools do not hold students back once they reach eighthgrade 12 ). Furthermore, low income might influence each indicator differently. As anillustration, income has stronger effects oncognitive and verbal ability test scores than it has on indices of emotional health in thechildhood years. Physical Health Compared with nonpoor children, poorchildren in the United States experiencediminished physical health as measuredby a number of indicators of health statusand outcomes (see Table 1). In the 1988National Health Interview Survey, parentsreported that poor children were only two-thirds as likely to be in excellent health andalmost twice as likely to be in fair or poorhealth as nonpoor children. These large dif-ferences in health status between poor andnonpoor children do not reflect adjustment for potentially confounding factors (factors,other than income, that may be associated with living in poverty) nor do they distin-guish between long- or short-term poverty orthe timing of poverty. This section reviewsresearch on the relationship of poverty toseveral key measures of child health, low birth weight and infant mortality, growthstunting, and lead poisoning. For the most part, the focus is on research that attempts toadjust for important confounding factorsand/or to address the effect of the durationof poverty on child health outcomes. Birth Outcomes Low birth weight (2,500 grams or less) andinfant mortality are important indicators of child health. Low birth weight is associated with an increased likelihood of subsequent   58THE FUTURE OF CHILDREN – SUMMER/FALL 1997 PercentagePercentageof NonpoorRatio of Poorof Poor ChildrenChildrento NonpoorIndicator(unless noted)(unless noted)ChildrenPhysical Health Outcomes (for children between 0 and 17 years unless noted)Reported to be in excellent health a 37.455.20.7Reported to be in fair to poor health a 11.76.51.8Experienced an accident, poisoning, or injury in the 11.814.70.8past year that required medical attention a Chronic asthma a 4.44.31.0Low birth weight (less than 2,500 grams) b 1.00.61.7Lead poisoning (blood lead levels 16.34.73.510µ/dL or greater) c Infant mortality b 1.4 deaths per0.8 death per1.7100 live births100 live birthsDeaths During Childhood(0 to 14 years) d 1.20.81.5Stunting (being in the fifth percentile for 10.05.02.0height for age for 2 to 17 years) e Number of days spent in bed in past year a 5.3 days3.8 days1.4Number of short-stay hospital episodes in 81.3 stays41.2 stays2.0past year per 1,000 children a Cognitive Outcomes Developmental delay (includes both limited 5.03.81.3and long-term developmental deficits) (0 to 17 years) a Learning disability (defined as having 8.36.11.4exceptional difficulty in learning to read, write, and do arithmetic) (3 to 17 years) a School Achievement Outcomes (5 to 17 years)Grade repetition (reported to have ever 28.814.12.0repeated a grade) a Ever expelled or suspended a 11.96.12.0High school dropout (percentage 16- to 24-year-olds21.09.62.2who were not in school or did not finish high school in 1994) f Emotional or Behavioral Outcomes (3 to 17 years unless noted)Parent reports child has ever had an emotional 16.412.71.3or behavioral problem that lasted three months or more g Parent reports child ever being treated for 2.54.50.6an emotional problem or behavioral problem a Parent reports child has experienced one or 57.457.31.0more of a list of typical child behavioral problems in the last three months h (5 to 17 years) Other Female teens who had an out-of-wedlock birth i 11.03.63.1Economically inactive at age 24 (not employed 15.98.31.9or in school)  j Experienced hunger (food insufficiency) at least 15.91.69.9once in past year k Table 1 Selected Population-Based Indicators of Well-Being for Poorand Nonpoor Children in the United States  59The Effects of Poverty on Children PercentagePercentageof NonpoorRatio of Poorof Poor ChildrenChildrento NonpoorIndicator(unless noted)(unless noted)Children Reported cases of child abuse and neglect l 5.40.86.8Violent crimes (experienced by poor families 5.42.62.1and nonpoor families) m Afraid to go out (percentage of family heads in poor 19.58.72.2and nonpoor families who report they are afraid to go out in their neighborhood) n Note: This list of child outcomes reflects findings from large, nationally representative surveys that collect data on child outcomesand family income. While most data come from the 1988 National Health Interview Survey Child Health Supplement, data fromother nationally representative surveys are included. The rates presented are from simple cross-tabulations. In most cases, the datado not reflect factors that might be important to child outcomes other than poverty status at the time of data collection. The ratiosreflect rounding. a Data from the 1988 National Health Interview Survey Child Health Supplement (NHIS-CHS), a nationwide household interview survey.Children’s health status was reported by the adult household member who knew the most about the sample child’s health, usuallythe child’s mother. Figures calculated from Dawson, D.A. Family structure and children’s health  : United States, 1988  . Vital Health andStatistics, Series 10, no. 178. Hyattsville, MD: U.S. Department of Health and Human Services, Public Health Service, June 1991; andCoiro, M.J., Zill, N., and Bloom, B. Health of our nation’s children  . Vital Health and Statistics, Series 10, no. 191. Hyattsville, MD: U.S.Department of Health and Human Services, Public Health Service, December 1994. b Data from the National Maternal and Infant Health Survey, data collected in 1989 and 1990, with 1988 as the reference period.Percentages were calculated from the number of deaths and number of low birth weight births per 1,000 live births as reported inFederman, M., Garner, T., Short, K., et al. What does it mean to be poor in America? Monthly Labor Review  (May 1996) 119,5:10. c Data from the NHANES III, 1988–1991. Poor children who lived in families with incomes less than 130% of the poverty threshold are clas-sified as poor. All other children are classified as nonpoor. d Percentages include only black and white youths. Percentages calculated from Table 7 inRogot, E. A mortality study of 1.3 million persons by demographic, social and economic factors: 1979–1985 follow-up. Rockville, MD: National Institutes of Health, July 1992. e Data from NHANES II, 1976–1980. For more discussion, see the Child Indicators article in this journal issue. f National Center for Education Statistics. Dropout rates in the United States: 1994  .Table 7, Status dropout rate, ages 16–24, by incomeand race ethnicity: October 1994. Available online at: http://www.ed.gov/NCES/pubs/r9410t07.html. g Data from the NHIS-CHS. The question was meant to identify children with common psychological disorders such as attention deficitdisorder or depression, as well as more severe problems such as autism. h Data from the NHIS-CHS. Parents responded “sometimes true,” “often true,” or “not true” to a list of 32 statements typical of children’sbehaviors. Each statement corresponded to one of six individual behavior problems—antisocial behavior, anxiety, peerconflict/social withdrawal, dependency, hyperactivity, and headstrong behavior. Statements included behaviors such as cheatingor lying, being disobedient in the home, being secretive, and demanding a lot of attention. For a more complete description, seeSection P-11 of the NHIS-CHS questionnaire. i Data from the Panel Study of Income Dynamics (PSID). Based on 1,705 children ages 0 to 6 in 1968; outcomes measured at ages 21to 27. Haveman, R., and Wolfe, B. Succeeding generations: On the effect of investments in children  . New York: Russell SageFoundation, 1994, p. 108, Table 4.10c.  j Data from the PSID. Based on 1,705 children ages 0 to 6 in 1968; outcomes measured at ages 21 to 27. In Succeeding generations:On the effect of investments in children  . Haveman, R., and Wolfe, B. New York: Russell Sage Foundation, 1994, p. 108, Table 4.10d.Economically inactive is defined as not being a full-time student, working 1,000 hours or more per year; attending school part timeand working 500 hours; a mother of an infant or mother of two or more children less than five years old; a part-time student and themother of a child less than five years old. k Data from NHANES III, 1988–1991. Figures reflect food insufficiency, the term used in government hunger-related survey questions.For a more in-depth discussion, see Lewit, E.M., and Kerrebrock, N. Child indicators: Childhood hunger. The Future of Children  (Spring1997) 7,1:128–37. l Data from Study of National Incidence and Prevalence of Child Abuse and Neglect: 1988.In Wasting America’s future  . Children’sDefense Fund. Boston: Beacon Press, 1994, pp. 5–29, 87, Tables 5–6. Poor families are those with annual incomes below $15,000. m Data from the National Crime Victimization Interview Survey. Results are for households or persons living in households. Data were col-lected between January 1992 and June 1993 with 1992 as the reference period. Percentages are calculated from number of violentcrimes per 1,000 people per year. Reported in Federman, M., Garner, T., Short, K., et al. Whatdoes it mean to be poor in America? Monthly Labor Review  (May 1996) 119,5:9. n Data from the Survey of Income and Program Participation. Participation data collection and reference periods areSeptember through December 1992. Reported in Federman, M., Garner, T., Short, K., et al. Whatdoes it mean to be poor inAmerica? Monthly Labor Review  (May 1996) 119,5:9. Table 1 (continued) Selected Population-Based Indicators of Well-Being for Poorand Nonpoor Children in the United States
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