Is Poverty Included Among Adverse Childhood Experiences[ACE]?


Adverse Childhood Experiences[ACE] are loosely defined as extremely stressful events and experiences during one’s childhood years which may also be trauma-inducing. Some of these events are recurring and others can take place one time only. Nonetheless, these ACEs, range from physical, emotional, or sexual abuse to parental divorce or the incarceration of a parent. Abuse and neglect, witnessing intimate partner violence episodes, and now proposed, poverty can be stressful and potentially traumatic life circumstances. This may have a life-long impact on children as they develop into adults.

Unfortunately, not every child living in poverty emerges unscathed.  Poverty is one of the most pressing public health issues, as it negatively impacts nearly every indicator of child well-being and affects more than 1 in 5 children across the nation. Poverty is a strong reinforcing factor in the accumulation of ACEs and a growing body of evidence indicates that poverty is highly comorbid with ACE exposure. Children living in poverty are more likely than their peers to experience frequent and intense adversities, subsequent toxic stress and unfavorable health outcomes in adulthood.

Being poor is associated with so many childhood adversities that it may be considered an ACE itself, more pervasive and persistent than all others, as children’s economic circumstances are inextricably tied
to those of their families. Such cumulative exposure to adversity causes stress that behaves as a toxin in the developing brain of a child. In the absence of protective factors, this toxic stress can change a child’s neural architecture and result in emotional disorders and cognitive deficits.

A variety of childhood adversities have a root cause in family economic insufficiency, indicating that poverty may likely be the first adversity that many children experience. Poverty acts as a reinforcing mechanism, disproportionately burdening low-income families with stressors that give rise to adverse conditions, which then convey additional stress and cognitive dysfunction. The devastating effect of this negative feedback loop on the development of children is
well documented, and childhood poverty has been strongly linked to a variety of negative outcomes across the life course, including low educational attainment, increased exposure to violence, hunger, parental incarceration, and increased likelihood of being subject to abuse and neglect.

The continuing legacy of racial discrimination in access to capital and wealth accumulation, has resulted in a higher incidence of poverty among racial/ethnic minority groups. Researchers estimated in 2013 that child and youth poverty costs the United States nearly $500 billion each year in reduced economic output and increased health
and criminal justice expenditures. To mitigate these largely avoidable costs, family economic security must become a public health priority. The country can decrease some of the impacts of poverty-related toxic
stress on children when their caretakers are able to afford access to basic needs, quality health care, education, and social experiences that promote optimal child development. Public policy investments can have a measurable impact on the economic well-being of children and families.

Expanding access to affordable, high-quality child care could better cultivate human capital and promote employment as well. Early
education serves as a critical protective factor against the adverse effects of poverty during the first years of a child’s life. The vast majority of brain development occurs before age 5, and quality early care experiences have been found to restructure neural pathways in young children with lasting positive effects on their cognitive function, socioemotional development and educational attainment. Quality child care also enables parents to hold stable jobs and receive steady income to establish financial stability and economic security for the family.

Food, housing, and child care assistance subsidies are critical to helping families afford the costs of basic needs as they work to become self sufficient. Recent discussions to limit broad-based categorical eligibility for food assistance through the Supplemental Nutrition Assistance Program (SNAP) could limit the ability of low-income families to provide for the day-to-day needs of dependent children.  The impact of social supports on family budgets shows that without government interventions, more children would live in poverty. Ensuring that the safety nets provided by public supports, we help buffer the adverse effects of poverty on children as their  families work towards financial stability.

Other initiatives which benefit families include the Earned Income Tax Credit as a proven anti-poverty strategy that supports work. They provides additional income for poor working families that help them meet their basic needs. All states should offer refundable EITC for low income working families to simply help them make ends meet.

There are families whose income falls in between Medicaid coverage gaps. They earn too much for Medicaid and not enough for private medical/health care coverage. This poses greater risk for children and parents’ ability to  access preventive care.  The United States should immediately expand Medicaid to prevent children from experiencing the trauma of family poverty and adversity  driven by medical debt and inaccessible care.
Children thrive when their families are financially secure. Without public investments and supports, however, many families are unable to attain financial health. This leaves children exposed to the early adversity of poverty, with grave impacts on human capital due to the profoundly negative effects of toxic stress on child growth and
development. In order to mitigate these effects and avoid
long-term associated costs, we must begin to address child poverty as an ACE and a public health emergency. Proven public policy tools exist to strengthen family economic prospects and promote positive outcomes for children. We should employ them so that every child has a chance to reach their full potential.

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