One of the most insidious effects of living in high-poverty, chronically disadvantaged neighborhoods is the severe strain these areas have on residents’ mental and emotional health. New research shows that poverty imposes a psychological burden so great that the poor are left with little mental “bandwidth” with which to perform everyday tasks.
The constant anxiety and stress resulting from witnessing and experiencing trauma and violence in distressed neighborhoods, negotiating the sacrifices and trade-offs caused by food insecurity, living in unstable housing conditions, struggling to pay bills, and dealing with numerous other worries burn up cognitive capacity that could otherwise be used for productive activities like navigating public assistance systems, providing for an entire family on a limited budget, and helping children with schoolwork.
For children, the long-term mental health effects of poverty are even more alarming. In addition to occupying cognitive resources needed for education (arguably the clearest path out of poverty), poverty is toxic to children. Persistent stress and exposure to trauma trigger harmful stress hormones that permanently affect children’s brain development and even their genes. The damage to childhood development is so severe that medical professionals now describe the early effects of poverty as a childhood disease.
Bringing mental health services to poor communities
Because of the debilitating cognitive effects of poverty on both adults and children, clinical mental health services are a central component of the Urban Institute’s Housing Opportunities and Services Together (HOST) demonstration. HOST is testing an intensive, dual-generation, case management model for children and adults who live in public and mixed-income communities suffering from concentrated poverty, chronic violence, and low levels of trust and social cohesion. HOST’s coordinated and comprehensive place-based intervention aims to stabilize whole families and improve a range of educational, health, and employment outcomes.
Baseline survey data from the first two HOST sites—Chicago’s Altgeld Gardens, a large public housing development that has high rates of crime, and Portland’s mixed-income New Columbia and Humboldt Gardens—clearly illustrate a relationship between distressed neighborhoods and mental health. Rates of elevated worry among HOST adults in both sites are up to six times higher than rates among adults nationwide, and depression among adults in the Portland site is nearly four times more prevalent. Even more disturbing, youth in the Chicago HOST site experience long-term anxiety and worry at levels seven times higher than those of youth nationwide.
What the findings from the HOST baseline survey and the research on the cognitive effects of poverty make plain is that mental health services are desperately needed in poor communities. Addressing trauma and mental health problems is critical to facilitating healthy brain development in poor children, freeing psychological bandwidth for schoolwork, and preparing children to overcome the challenges associated with extreme poverty. Similarly, adults need help coping with the mental taxation, stress, and anxiety of poverty so they can focus on becoming self-sufficient.
HOST families are offered mental health services designed to address the multiple chronic stressors that exist in their communities. As worry and anxiety decreases, we hope to see greater education and employment outcomes among adults, and, among children, increased academic achievement, and fewer incidences of risky behavior. Lessons learned from HOST will help inform policymakers who are interested in lessening the mental toll poverty exacts from the most disadvantaged.
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The Urban Institute podcast, Evidence in Action, inspires changemakers to lead with evidence and act with equity. Co-hosted by Urban President Sarah Rosen Wartell and Executive Vice President Kimberlyn Leary, every episode features in-depth discussions with experts and leaders on topics ranging from how to advance equity, to designing innovative solutions that achieve community impact, to what it means to practice evidence-based leadership.