Effects of poverty on interacting biological systems underlying child development

The developmental sequelae of childhood poverty are well documented. However, it is not poverty per se, but a multitude of risk factors associated with poverty that have a deleterious effect on children's development. Key risks factors that are likely to contribute to the adverse developmental effects of poverty include, for instance, food insecurity, infectious disease, and psychological stress related to the child's rearing environment. In this Review, we highlight synergistic biological pathways through which co-occurring risks related to poverty interact to shape children's neurocognitive development. We focus on pathways related to neural growth, energy metabolism, inflammation, and neuroendocrine responses to stress as key biological axes through which poverty becomes biologically embedded and might have long-term effects on children's neurocognitive development. We also discuss how biomarkers targeting these axes can be used to advance research on the biological processes through which poverty affects children's cognitive outcomes. Although the discussion has global relevance, we focus on low-resource settings where rates of poverty are highest and access to treatment might be limited.