5 minutes reading time (923 words)

Poverty, resilience and hidden stressors

This week  it was reported that over half a million people in the UK now rely on food banks, as hunger and poverty exact a really heavy price and the recession bites deeply (click for article). This is worrying, maybe especially  alongside growing inequality,. wage freezes and a tougher climate for working people generally. We have been seeing in all reports a consistent rise in mental health problems, suicidality and depression in countries affected by the economic crisis. 

Not everyone of course is similarly affected by poverty or poor environments, or by family conflict, violent communities or even abuse or neglect.  There has been a lot of government and other research which has been trying to focus on what they call resilience factors, and why some people seemingly come through such situations less affected than others. 


An interesting new study has just come out which I think might challenge some commonly held ideas about resilience [1] .  It was a study of over 500 african-american children living in the rural south. Some were struggling and obviously suffering, while others on the surface seemed to be doing well, and for example teachers reported that they were functioning well in school, and not showing worrying behavioural or depressive symptoms. They were all from poor SES backgrounds. Yet while these young people on the surface looked like they were doing well, when researchers dug a little deeper they found another story. Despite their hopeful behaviours, when their physiological signs were taken of allostatic load, which basically is a mixture of factors like blood pressure, BMI and stress hormones, the seemingly resilient kids were showing signs, in their bodies at least, of high levels of stress. These result are consistent with the likelihood of what is often called metabolic syndrome diseases later in life, which include diabetes, heart-disease and strokes, for example. The stressful environment was having an effect despite the appearance of resilience. 

Lots of research over the last few years has shown conclusively that bad experiences lead to poor health outcomes. The more adverse early experiences a child suffers, the more likelihood of poor mental and physical health, and early death from a range of causes[2]. We have learnt with increasing clarity that early stress particularly has a profoundly negative effect on later psychological and  health outcomes [3]. We also know that whatever a child’s resilience factors, good nearly parenting leading to secure attachments will act as an inoculation against a biological predisposition to react badly to stress, even when living in poverty [4]. Indeed good experiences and positive emotionality can decrease stress responses [5], as can interventions like mindfulness [6], even slowing the ageing process. However these 'resilience' factors will not be any kind of match for seriously stress-inducing environments, which out-trump the resilience factors every time.

We do of course need good psychological early interventions, and for this reason mental health services need preserving and fighting for. However research such as that which reports the hidden costs of psycho-social stressors should function as a warning that it will never be enough to just try to build resilience factors in individuals and not worry about the effect of poverty and other serious stressors such as poverty, or violent or degraded neighbourhoods [7] , which we know affect allostatic load, raising stress responses and leading to problems later. Poverty and psychosocial stress, particularly within an unequal society, have serious effects, and individual attributes can be over-rated and are less powerful than one might think. Children at social risk who also have high personal resources in fact tend to do worse than economically advantaged children with less personal resilience factors, as we have known for some time [8]. 

[1]        G. H. Brody, T. Yu, E. Chen, G. E. Miller, S. M. Kogan, and S. R. H. Beach, ‘Is Resilience Only Skin Deep? Rural African Americans’ Socioeconomic Status–Related Risk and Competence in Preadolescence and Psychological Adjustment and Allostatic Load at Age 19’, Psychological Science, May 2013.

[2]        V. J. Felitti and R. F. Anda, ‘The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior: implications for healthcare’, The hidden epidemic: The impact of early life trauma on health and disease, pp. 77–87, 2010.


[4]        E. Conradt, J. Measelle, and J. C. Ablow, ‘Poverty, Problem Behavior, and Promise Differential Susceptibility Among Infants Reared in Poverty’, Psychological science, 2013.

[5]        S. D. Pressman and L. L. Black, ‘Positive emotions and immunity’, The Oxford Handbook of Psychoneuroimmunology, p. 92, 2012.

[6]        E. Epel, J. Daubenmier, J. T. Moskowitz, S. Folkman, and E. Blackburn, ‘Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres’, Annals of the New York Academy of Sciences, vol. 1172, no. 1, pp. 34–53, 2009.

[7]        R. A. Karb, M. R. Elliott, J. B. Dowd, and J. D. Morenoff, ‘Neighborhood-level stressors, social support, and diurnal patterns of cortisol: The Chicago Community Adult Health Study’, Social Science & Medicine, vol. 75, no. 6, pp. 1038–1047, Sep. 2012.

[8]        A. Sameroff, L. M. Gutman, and S. C. Peck, ‘Adaptation among youth facing multiple risks: Prospective research findings’, in Resilience and vulnerability: Adaptation in the context of childhood adversities, S. Luthar, Ed. New York: Cambridge University Press, 2003, pp. 364–391.

[9]        A. J. Sameroff, ‘Environmental Risk Factors in Infancy’, Pediatrics, vol. 102, no. 5, pp. 1287–1292, Nov. 1998.

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Monday, 30 November 2020

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