Socioeconomic Inequality

As Dr. Rishi Manchanda demonstrates in his TED talk, social and economic inequality makes people sick. While doctors are tasked with treating patients in a clinic or hospital setting, they are often not able to address the root causes of illness, which are found “upstream” in their home and work environments.

Multiple studies have documented how “upstream” factors, including poverty and inadequate housing, affect brain development, mental and emotional health:

  • In the largest study of its kind to date, researchers found that parents’ education and family income affect “brain structural development in regions that are critical for the development of language, memory and executive function”–including impulse control and attention, which are often impaired among individuals with ADD. Although researchers said it is “unclear what is driving the links between socioeconomic status and brain structure,” their findings suggest that “income relates most strongly to brain structure among the most disadvantaged children.”
  • A 2013 systematic review of studies that examined socioeconomic status and mental health among children and adolescents found that “socioeconomically disadvantaged children and adolescents were two to three times more likely to develop mental health problems.” Author Franziska Reiss called for a “reduction in socioeconomic inequalities at a societal level to improve mental health in childhood and adolescence.”

Studies have also linked socioeconomic status to cognitive development, including the development of ADD.  A study published in December 2015 examined more than 50,000 pregnancies and births, and tracked the children’s outcomes through the age of seven. Researchers found that the likelihood of the most disadvantaged children developing a neurological problem–including ADD and learning difficulties–was 20.2 percent, compared to 13.5 percent in the least disadvantaged children.

Another study conducted in the United Kingdom “detected a higher prevalence of ADD among socioeconomically disadvantaged groups,” a finding that aligned with the results from several similar studies. ADD was strongly associated with several factors, including poverty, income and lone parenthood. The study concluded that while ADD may be caused by genetic and neurological factors, socioeconomic status seems to influence how ADD develops.

Mental health care access_SAMHSA

Unsurprisingly, low socioeconomic status disproportionately affects minorities and communities of color. For example, in 2005, researchers reported that minority children who lived in public housing were “one of the more severely health-compromised groups among under-served communities.” The study found that Latino and African-American children in the 167 households studied were “two to four times more likely to suffer from chronic physical and mental conditions than the general population.” ADD was one of the top five chronic conditions that children experienced in these households, along with asthma, eye/vision problems, dental problems and depression.