The high, persistent levels of stress that are associated with
poverty undermine parents’ physical and mental health,
leading to high rates of stress-related medical conditions (such
as hypertension and asthma) and psychological problems (such as
depression, anxiety, troubled relationships, and substance abuse).7 Also,
parental stress may interfere with daily interactions that are needed
to establish trust, safety, a sense of cause and effect, and the
ability to express curiosity and contributes to abuse and neglect.8 Lastly,
the ability to climb out of poverty can be limited by joblessness,
particularly of fathers, which is linked to domestic violence and
child abuse. In addition, many institutions that are meant to serve
poor families (eg, welfare and public housing agencies) impose further
stress through demeaning and time-consuming hurdles. These parental
stressors can impact upon their ability to provide sensitive and nurturant
caregiving that optimizes brain development, and this may have a
lifelong impact as discussed in Chapter 81.