Poverty, Complexity, and a New Way Forward

THE ARTICLES IN this special issue provide a comprehensive view of how poverty affects children and their lifelong prospects. Children living in poverty experience a variety of risks, including elevated levels of stress, family instability, exposure to violence, and poor nutrition. They receive fewer supportive, complex, and developmentally optimizing language interactions; receive less consistent and lower-quality health care, education, and social supports; live in crowded, noisy, dangerous places that challenge formation of prosocial behaviors; are exposed to higher levels of environmental toxins; and live in homes with caregivers who are challenged for time, resources, and services and who often lack the basic skills and tools necessary to buffer the impact and effects of these converging and overwhelming risks. Life course health science has also shown that children carry forward the imprint of poverty in their metabolic, immune, and neuroendocrine systems. 1–4 These povertyinduced changes in life course health development can result in accelerated aging profiles and higher burdens of chronic disease. 5 Poverty in the United States seems to persist through the ups and downs of business cycles; it appears to be built into the very structure of our current economic reality. Poverty levels only seem to budge in response to dramatic increases in economic productivity and employment. Income support programs like the Earned Income Tax Credit have lessened poverty for those who benefit from it, and other support programs like Supplemental Nutrition Assistance Program (SNAP) and Head Start can help lessen the impact of poverty on child health and development. The recent experience in the UK, described by Mansour and Curran 6 in this issue, suggests that significant poverty reduction can be achieved through strong and sustained political leadership that can drive a broad and integrated wholegovernment set of strategic policy changes. Given intense political polarization in the United States, poverty reduction strategies tend to settle for incremental approaches that can potentially appeal to common core values of opportunity, responsibility, and security and that can link educational, family, and workforce interventions into a policy platform that could potentially win support across the political spectrum. 7 REFRAMING COMPLEXITY Framing of poverty simply as an income, resource, or service deficit does not recognize the complex emergent nature of poverty and the deep drivers that result in the seemingly resilient forces of deprivation and marginalization. Instead, it may be more helpful to view the social ecology that seems to inherently generate poverty as a type of complex adaptive system. Doing so acknowledges the multiple interacting social, economic, and cultural components,which areindividuallyand collectivelyadapting, self-organizing, evolving, and manifesting emergent properties. 8 Such a mental model not only helps us understand the role of different drivers and agents, individually and collectively, but also suggests a holistic and more integrated set of strategies designed to influence factors at different levels, with due consideration for different timescales and feedback loops. It also leads to strategies less focused on constructing isolated interventions and aimed more toward altering how the poverty-producing system functions, including factors that impact that system’s resilience and capacity to respond.