Child poverty, housing, and healthy decision-making

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The American Academy of Pediatrics includes child poverty on its list of the most-dire health issues facing children. Child poverty is a multi-determined complex problem with well-documented correlations to profound and enduring negative effects on health and behaviors across the lifespan. Critically, there are substantial gaps in scientific understanding of neurobehavioral mechanisms linking poverty to these outcomes, making it difficult to tailor effective interventions to youth at risk. This project addresses this significant public health issue by testing the effectiveness of an existing anti-poverty program, subsidized housing, on the neural correlates of decision-making and cognitive-control in youths. Though stable housing has never been directly tested with regard to children’s biobehavioral outcomes, there is ample ancillary data from the chronic stress literature to suggest that housing could be leveraged to improve children’s outcomes. The general aim of the proposal is to assess whether receipt of stable housing in childhood can attenuate deficits in cognitive processes (e.g., decision-making, risk-valuation, attention) contributing to poorer academic outcomes and health-related behaviors. The project aims to determine whether means-tested public programs, namely public housing and housing voucher programs, moderate maladaptive judgment and decision-making and examine whether stable housing in childhood is related to longer-term outcomes such as increased academic performance and reduced risk-taking behavior in early adolescence. This exploratory project will determine if there is sufficient evidence to support a full scale R01 to address: (1) Developmental change in adolescents ages 12-15 years, covering transitions when academic problems and risky behaviors emerge, (2) Discrete neurodevelopmental mechanisms that can reveal the efficacy of housing subsidies in mitigating negative outcomes of children growing up in poverty, (3) Characterize aspects of both brain functioning, laboratory-based behavior, and relevant behaviors in adolescents’ actual lives, and (4) Employ sophisticated computational rigor to study these critical questions. Because the experience of childhood/adolescent poverty is a powerful determinant of many subsequent academic and health problems, the high risk-high gain data generated from this project have the potential to profoundly evaluate the efficacy of family housing subsidies in the U.S, and will provide critical information and a framework for evaluating other federally- and state-funded programs. It will do so by highlighting differences in key cognitive processes in the brain necessary for academic achievement and effective decision-making in adolescence and beyond. The project holds potential to open pathways for new research that defines and specifies mechanistic ways in which the environment creates long-term effects on brain and behavior. These foci hold tremendous promise for advancement of knowledge and application to improvement of public health.