Is there a nexus between poor school achievement, runaway health care costs, and street crime? If yes, is there the possibility of addressing all three through one intervention? There may just be.
The relationship of poor education outcomes to socio-economic status is well documented. It is no coincidence schools described as “low performing” are virtually always centered in areas of high poverty. Street crime and the prevalence of street gangs are issues occupying the time of urban police, especially in poor neighborhoods, much more so than suburban police. Childhood asthma and obesity, and their adult consequences, are maladies afflicting the not well-off to a much greater degree than the well-off.
All indications point to poverty as being the genesis from which myriad societal problems arise. The simple solution would seem to be – cure poverty. As highly idealistic as that sounds, it is equally highly unlikely. Even the imposition of communist rule in which everyone is supposed to share equally failed to eliminate the have-nots – millions of whom starved to death. Is there a less simple solution?
Paul Tough, in his book “How Children Succeed,” may have one. While it may be impossible to eliminate poverty, it is possible to address some of the negative impacts of growing up in poverty. The primary culprit, the one factor leading to poor academic achievement, poor health and street mayhem is the stresses of growing up in poverty.
Stress is endemic in high poverty neighborhoods. The most visible to suburbanites are the news reports of gunfire, murders, stabbings and the like. To children living in the areas, these are not news reports; it is happening on the streets outside their windows where they play and where they go to school. Less visible to outsiders are the stresses of not being sure there will be food in the morning, not knowing when one will be moving again because there is no rent money, not knowing when mom and dad will be home because they are addicted to drugs or alcohol. And if mom and dad do come home, will they be fighting all night? Will the neighbors upstairs be fighting all night? Is the single mother so stressed herself by working all hours she has little left to relieve her child of stress?
The physiological impact of these stresses is not relieved or undone when the stress inducer is abated. The impact is potentially permanent and is cumulative. The more stress, the more long-term damage.
In his book, Tough describes the Adverse Childhood Experiences (ACE) study completed by Vincent Felitti and Robert Anda of the Kaiser Permanente in California. The ACE developed a patient profile based on adverse childhood experiences and then, for the 17,000 respondees, their adult health statistics were recorded. Respondees with the highest stress indices had the most obesity, depression, early sexual activity, smoking, drug use and alcoholism, as well having higher incidences of cancer, heart disease, liver disease and COPD.
In other work reported by Tough, Nadine Harris of the Bayview Child Health Center in San Francisco describes what she refers to as the “Firehouse Effect.” The body handles stress through a process called allostasis – a critical reaction for human survival in that it prepares one for the “fight or flight” when one is threatened. Occasional stress is not a serious issue, but being under near constant duress, as children living in poverty often are, allostasis takes a toll. Harris likens it to calling out the firemen. Even though the fire may be small, each time the firemen arrive they may need to break a window or door, or wet down some walls and rugs. Eventually, the responses to constant stressful situations take their toll.
One toll it takes is on brain chemistry. One of the findings in the ACE study noted above was high childhood stress impairing the brain’s executive function. It is this function that controls behavior – impaired function equals inappropriate behavior. Short-term memory is also adversely impacted. Behavior and short-term memory – two key components of learning. Should there be any question why schools in poor neighborhoods have large concentrations of low performing students? Would impaired executive function – an inability to behave appropriately – not explain the senseless violence found in those same neighborhoods?
Is birth destiny? One of life’s unkindest lotteries would seem to be the natal hospital nursery. It is not so much who gave you birth as to who picks you up and takes you home from the nursery. Where is home? You may be born to an unwed mother, but if she gave you up for adoption and you are taken home to a nice house in the suburbs, your chances of success just improved a thousand fold. But what if you go home with the unwed mother?
Are these children destined to gang violence by nature or nurture – or more likely the lack of nurture? In the July 28 edition of “60 Minutes,” a segment reported on the question, “Are humans born good or is that a learned behavior?” Babies of 5 months were shown scenes in which stuffed toys acted kindly or unkindly toward other stuffed toys. When later given the choice of selecting a stuffed toy, three out of four selected the “kind” toy over the “unkind” toy. As young as 2 months and unable to reach out, infants would stare at the “kind” toy longer than the “unkind” one. It would appear everyone starts out with similar potential for “goodness.”
Can something be done to maintain that potential? If we cannot eliminate poverty, can we, at least, mitigate the stresses of living in poverty and the negative outcomes associated with those stresses? Both Tough, in “How Children Succeed,” and All Colella, in “Let’s Start with the Children,” would suggest the answer is yes.
“Licking and grooming,” a rather indelicate term, may hold the key. Michael Meaney, of McGill University in Montreal, is a neuroscientist researching rats (it is surprising to note the DNA shared by humans and rats). Meany and his staff noted, apart from their primary research, young rats were stressed by the routine handling in the lab. They further noted when the pups were returned to their cages, some of the mother rats would immediately begin a licking and grooming process, which calmed the pups. Intrigued, Meaney’s team created an experiment around what they referred to as LG – as in licking and grooming. Researchers observed how often mothers interacted with their young. When the young reached adulthood, the team devised a series of tests to see if there was a difference in rats that had experienced high LG versus low LG. The outcome? The high LG rats excelled at mazes, were more social, more curious, less aggressive, exhibited more self control, were healthier, and lived longer.
Meany and his staff went a step further. They moved young rats from high LG mothers to low LG mothers and vice versa. The positive high LG outcomes appeared in the pups with high LG mothers whether biological or surrogate. (It is interesting to note low LG mothers were the offspring of low LG mothers, which may offer a partial explanation of the poverty cycle.) They also found, and this ties to the DNA comparison, high LG activity actually affects DNA and the part of the brain that controls stress hormones. Which brings us to Al Colella and “Let’s Start with the Children.”
Colella’s book is more anecdotal than research but may provide a key in how to snap the connection between being raised in poverty and negative outcomes. Colella describes a shared missionary experience between his parish, St. John’s Episcopal of Barrington, and St. Ann’s in the very poor South Bronx. Initially, the support was directed to saving a historically significant church in the South Bronx but quickly morphed into a children’s crusade. St. John’s parishioners regularly journey Route 95 to the South Bronx and work with the church and create relationships with the children. St. John’s provides scholarships for St. Ann’s children to attend the Episcopal summer camp in the woods of Burrillville.
Colella relates story after story of young, streetwise, “tough” kids from the South Bronx who are only concerned about getting by day-to-day, yet when exposed to a nurturing, safe and secure environment become all-around, nice kids expressing hopes and dreams for the future. The experiences he relates corroborate research cited by Tough that children’s brains are malleable throughout their teen years and the damage created by early stresses can be mitigated to an extent by later interventions.
What does this all mean? It could be suggested we, as a society, could improve our lot by intervening in the lives of children born into poverty. It is a point where the interests of bleeding heart liberals and pragmatic capitalists intersect. Intervention means a better-educated population contributing more to state and federal taxes and taking less in services such as welfare and food stamps. It means a more productive population less encumbered by obesity, diabetes, asthma, heart disease and cancer while at the same time creating far less of a drain on our medical resources. It means not having gang members, with stress damaged brains, randomly shooting into groups of people in some perverted sense of street justice then costing thousands of dollars in costs to the police, courts and prisons.
How can we intercede? We already have elements in place. The experiences of Colella and his fellow parishioners present a microcosm of what churches in wealthier areas can do for churches in poorer areas. The YMCAs, Big Brother and Big Sister organizations, and Boys and Girls Clubs already do good work, which could be expanded with additional resources. Colin Powell appears regularly on television exhorting us to mentor children in need. Our schools in poorer neighborhoods need to support students and families in ways beyond the six-hour school day and 180-day year. Our police and courts need to be pre-emptive in reducing crime through the development of corrective systems rather than maintaining punitive systems that have never been particularly effective in reducing crime.
Canada, which has much better student outcomes than the U.S., reports a positive return on investment for the monies it has directed to assisting children in poverty. The money spent today comes back – over and over – in the years to come.
This is America. We can do anything our minds are set to. Let us make it a better place for all – rich and poor.
Joseph H. Crowley is a retired educator and past president of the RI Association of School Principals, past president of the Massachusetts Association of School Business Officials and past chair of the New England Association of Schools and Colleges Commission on Technical and Career Education.