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Stress is Toxic: socioeconomic disparity affects children at the cellular level

By: Brittany Ann Stinson

It’s no secret that navigating conditions of low socioeconomic status (SES) is incredibly stressful and burdensome. It can be difficult to focus efforts on school and socialization along with personal growth and development when plagued with uncertainties. Many students are fortunate enough not to worry about whether their families will make rent next month, or lack quality time with parents working multiple jobs to make ends meet. As a result of these stressors, children from low-SES families are more likely to exhibit behavioral problems, and are at higher risk for psychiatric disorders as they age.

Using family income as the primary metric for SES, a study specifically assessed the relationship between family SES and childhood behavioral outcomes. It revealed that lower family income influenced all domains of clinical behavioral patterns (internalized problems, externalized problems, total behavioral problems) at a statistically significant level (Hosokawa, 2018). This holds for both bivariate and multivariate analyses of the data collected.

In addition, the study included parental education level–another predictor of SES, in their analyses. Their results demonstrated lower maternal education had a significant negative influence upon externalized problems and total problems, while paternal education did not influence behavioral problems at a statistically significant level. These behavioral problems are capable of following children later on in life, with the capability of influencing the development of mental health problems later down the road (Velez,1989).

As for the mechanisms via which SES influences behavioral problems, there are numerous and extend beyond simply the deprivation of material resources that can be beneficial for child development. Socioeconomic position relative to one’s peers in society is an important factor that can influence the psychosocial path, even to a greater extent than material inequality (Elgar, 2013). Lower SES is correlated with poor parental mental health, which can negatively impact parental capacity to care for their children, have quality interaction and form bonds with their children (Hart,1997).

These factors not only inflict adverse social and psychiatric outcomes, but have lasting effects which can be traced down to a child's own individual biology at the cellular level–particularly the regulation of stress hormones. The stressors that result from growing up in a low-SES environment have proven themselves to be biologically toxic. Research shows that as a result, children growing up in low-SES families are more likely to exhibit high anxiety.

Low socioeconomic status is linked to negative emotion, the result of which can impact the hypothalamus-pituitary-adrenal (HPA)-axis system. The HPA axis system consists of the interactions between the hypothalamus, pituitary and adrenal glands. Working together they manage the body’s stress response–releasing hormones such as cortisol and mediate other bodily functions.

In two studies investigating the relationship between family SES, parental anxiety, and the HPA system, researchers found that low-SES children experienced higher anxiety mediated by increasing parental anxiety (Zhu, 2019).

These stressors can result in chronic damage to the HPA axis, causing it to become hyper-activated, resulting in an excess of basal cortisol secretion. Low-SES children exhibited higher basal cortisol secretion in the study and reduced cortisol awakening response (CAR). With these stressors, the HPA axis becomes less responsive, and higher levels of cortisol are secreted to compensate. This relationship was mediated by increased parental anxiety, meaning that level of parental anxiety was able to explain the extent to which SES had an effect upon the functioning of the HPA axis.

It is important to consider the implications of the effects that this stress can have upon a child. This is a concrete demonstration as to how low-SES children can be more vulnerable to anxiety. In raising awareness among groups such as parents and educators, they may be more sensitive to the issues that these children could potentially face–and work towards preventative measures. These studies impressively showcase the direct influence of psychological conditions upon the neuroendocrine system.

With better understanding of the extent to which SES influences these factors, interventions can be targeted and tailored towards at-risk groups to tackle the mental and developmental problems that can result. These studies create a compelling argument to implement these interventions early on in childhood when they are most likely to be successful (Center on the Developing Child at Harvard University, 2019)

With behavioral problems having the potential to arise before children reach schooling age, it’s imperative to take these measures before to ensure that low-income students don’t fall further behind their peers. However, the communities that need these interventions the most may not even have access to the professionals that can provide them. There is promise at reversing this trajectory, with state funding being funneled towards early childhood intervention policies specifically targeted at children growing up in poverty (The Center for Disease Control, 2018).


1. CDC. What is “Early Intervention” and is my child eligible? Centers for Disease Control and Prevention. Published April 11, 2018. Accessed May 4, 2020.

2.Elgar FJ, De Clercq B, Schnohr CW, et al. Absolute and relative family affluence and psychosomatic symptoms in adolescents. Social Science & Medicine. 2013;91:25-31. doi:10.1016/j.socscimed.2013.04.030

3.Hart B, Risley T. Meaningful differences in the everyday experience of young American children. The Behavior Analyst. 1997;(20):20-25.

4.Hosokawa R, Katsura T. Effect of socioeconomic status on behavioral problems from preschool to early elementary school – A Japanese longitudinal study. PLOS ONE. 2018;13(5):e0197961. doi:10.1371/journal.pone.0197961

5.Inbrief: early childhood program effectiveness. Center on the Developing Child at Harvard University. Accessed May 4, 2020.

6.Velez CN, Johnson J, Cohen P. A longitudinal analysis of selected risk factors for childhood psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry. 1989;28(6):861-864. doi:10.1097/00004583-198911000-00009

7.Zhu Y, Chen X, Zhao H, et al. Socioeconomic status disparities affect children’s anxiety and stress-sensitive cortisol awakening response through parental anxiety. Psychoneuroendocrinology. 2019;103:96-103. doi:10.1016/j.psyneuen.2019.01.008


Brittany is a senior at Stanford University studying Human Biology. She cares about how socio economic disparities influence barriers to health and well-being.

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