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Turning 1 Year of Age in a Low Socioeconomic Environment: A Portrait of Disadvantage

Hurt, Hallam MD*,†,‡; Betancourt, Laura M. PhD*

Journal of Developmental & Behavioral Pediatrics: September 2017 - Volume 38 - Issue 7 - p 493–500
doi: 10.1097/DBP.0000000000000469
Original Articles

In the United States today, 16 million children are growing up poor. Few studies report multiple environmental factors associated with poverty during the first year of life and effects on infant development.

Objectives: To evaluate maternal, home, and neighborhood environment of low and higher socioeconomic status (SES) infants from birth to 1 year and to evaluate the impact of SES and environment on infant developmental outcome at 1 year.

Methods: Low (n = 30) and higher SES (n = 30) African-American mothers and their healthy term gestation female infants were prospectively compared for environmental characteristics and infant developmental outcome. Wechsler Adult Intelligence Scale-IV (WAIS-IV); Beck Depression Inventory; Perceived Stress Scale; Parenting Stress Index-Fourth Edition (PSI-4); Social Support Scale; Home Observation Measurement of the Environment (HOME); Household Food Insecurity (HFI); Concentrated Neighborhood Disadvantage (CND). Bayley Scales of Infant Development Third Edition (BSID-III); Preschool Language Scale (PLS-5).

Results: Environmental risk was greater for low compared with higher SES: lower WAIS-IV (p < .001); higher PSI-4 total (p = .003); lower HOME total and 3 subscales (p < .002); higher HFI (p = .012); and higher CND (p = .027). Low SES infant outcomes differed from higher SES: lower BSID-III Cognitive Composite (p = .005), PLS-5 Total Language (p ≤ .017), and Auditory Comprehension (p ≤ .008). In regressions, after controlling for SES, effects of environmental factors were not found.

Conclusion: By age 1, low SES infants had been exposed to greater environmental disadvantage and already exhibited poorer developmental functioning than higher SES infants. These findings suggest that support for families and children from impoverished circumstances cannot begin too early.

*Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA;

PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA;

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Address for reprints: Hallam Hurt, MD, Division of Neonatology, Department of Pediatrics, 3401 Civic Center Blvd, Philadelphia, PA 19104; e-mail:

Supported by NIH/NICHD: R21HD072461. The NIH/NICHD had no role in study design; collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Disclosure: The authors declare no conflict of interest.

Received October 28, 2016

Accepted May 02, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.