In a cruel double whammy, poor people endure material deprivation while experiencing more than their share of mental disorders. Some scientists theorize that this disproportion of mental illness stems from individuals with genetically based psychological ailments drifting into poverty and staying there. Other researchers suspect that the stress of financial hardship undermines emotional health.
An unusual new study boosts the latter view. During the 4 years after their families moved out of poverty thanks to a community-wide economic windfall, Cherokee children in rural North Carolina exhibited marked declines in behaviors such as delinquency, violence, disobedience, and truancy, according to epidemiologist E. Jane Costello of Duke University Medical School in Durham, N.C., and her coworkers. Mental-health clinicians typically diagnose kids with these problems as having either conduct disorder or oppositional defiant disorder, a penchant to defy authority.
“In families that moved out of poverty, parents were better able to supervise their children, apparently leading to fewer behavioral symptoms,” Costello says. “Poverty or any other single factor can’t fully explain the development of such symptoms.”
The North Carolina study, published in the Oct. 15 Journal of the American Medical Association, came about through scientific serendipity. In 1993, Costello’s team had begun administering annual psychiatric interviews to 1,420 rural children, ages 9 to 13. About one-quarter of the kids were Cherokees residing on a federal reservation. Most of the rest were white and lived in surrounding areas.
Halfway through the 8-year project, a gambling casino that had opened on the reservation started sharing profits with tribal members. Annual payments to each person reached around $6,000 in 2001.
By the end of the study, casino disbursements had moved 14 percent of the Cherokee families out of poverty. Another 53 percent remained poor, while 32 percent had never been poor.
Before the casino payments began, children in poor families displayed substantially more behavioral problems than did kids in families with incomes above the poverty line. After the payments started, behavioral problems among children in formerly poor families–but not among kids in still-poor families–declined to the level of those in never-poor Cherokee families. Interviews indicated that after moving out of poverty, parents supervised their children’s activities more closely.
The windfalls didn’t affect kids’ anxiety and depression.
Similar findings emerged for the study’s white families that, without the benefit of the casino payments, had also moved out of poverty during the same period. In those cases, the researchers note, it’s possible that the added income and improved behavior in children reflected parental characteristics such as ambition and ingenuity.
Costello’s data document how the relief of poverty helps improve family functioning and children’s mental health, remarks psychiatrist Michael Rutter of the Institute of Psychiatry in London in an editorial accompanying the new report.
Ongoing studies of children in foster care who receive subsidies for education and of kids whose parents enter welfare-to-work programs support Costello’s findings, adds epidemiologist Ronald C. Kessler of Harvard Medical School in Boston.
Still, many social forces encourage aggression and delinquency among children, Rutter says. In Western nations, he notes, childhood-behavior problems and family incomes have increased simultaneously.
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