Especially in children.
But a scientific report an East Tennessee State University department chair helped write has moved the American Academy of Pediatrics to urge all pediatric physicians to take a new step toward easing those effects.
That step? Simply asking children or family members a question during annual doctor visits.
Dr. David Wood, chairman of ETSU’s Department of Pediatrics, said after respectfully asking a child or family member, “Do you have difficulty making ends meet at the end of the month?” doctors can then refer families to community resources for help.
Wood spent four years compiling a review of existing research examining the effects poverty has on a child’s health.
“Science over the past 20 years has shown that living in poverty or serious economic stress on families really impacts (their) children,” Wood said.
Child poverty is particularly high in the Tri-Cities.
In six of 10 counties in East Tennessee, at least 30 percent of children are below the federal poverty level.
While Washington County had the region’s second-lowest percentage of children living in poverty — 23 percent — approximately 5,774 children in the county live in a household below the poverty level.
In Carter County, the number was 33 percent, while approximately 31 percent of Unicoi County children live in below-poverty-level households. Overall, 25 percent of children in Tennessee live in poverty; that compares to 14 percent in Virginia.
According to 2014 U.S. Census data, one in five U.S. children — or 15.5 million — under the age of 18 live in poverty. The percentage increases to 43 percent for households designated as poor, near poor or low-income.
Wood said poverty stresses families because they can’t provide for their children in the way they want to, and it makes children more prone to asthma, chronic diseases and developing unhealthy diets.
“I mean, the best deal in town is the dollar menu at McDonald’s, right?” Wood said. “Unhealthy foods are cheaper than healthy foods, so families struggling to feed their kids are selecting foods that aren’t as healthy, and that leads to nutritional problems like obesity, ironically.”
Woods also said poverty impacts children from a relational aspect.
“Children not only inherit their parent’s genes, but also inherit the environment their parents raise them in,” Wood said. “It actually affects how their brain develops, how their genes are expressed and, ultimately, it affects whether or not they’re ready for school or can manage their own behavior. These types of things directly impact children in poverty.”
Dr. John M. Pascoe, lead author of the technical report, said despite the lasting toll poverty can have on a child, there are effective interventions to help buffer the effects, like promoting strong family relationships.
Wood said a nurturing relationship with a parent can help children build resilience for when they face adversity. He recommended participating in programs like “Reach Out and Read” and ETSU’s own “Read n’ Play” to encourage families to play and interact with their children to help develop a working relationship.
To help combat the problem, the American Academy of Pediatrics is calling for expansion of state and federal anti-poverty and safety net programs, health care, childhood education, affordable housing, home visiting programs and nutritional programs like SNAP, WIC and school lunch programs.
“As pediatricians, we want to help promote nurturing environments in families that teach them how to interact with their children so it can enhance their development,” Wood said. “That will mitigate a lot of the negative impacts of poverty, but we do want to attack this problem on multiple levels.”