Professional Documents
Culture Documents
Jay Varner
WRTC
1 April 2016
What if I told you that there was a toxic chemical that could threaten the well-being of
millions of people? This toxic substance could increase the risks of a host of physical and mental
health issues including asthma, heart disease, diabetes, reproductive complications, strokes, heart
attacks, depression, anxiety, ADHD, and even stunts in brain development. This substance could
also amplify complex social, cultural, communal, and developmental issues. Those exposed to it
would be more prone to drug addiction, smoking, alcoholism, sexually transmitted diseases, teen
pregnancy, domestic and child abuse, and even suicide. Consequently, this toxin would be
responsible for the inability of those affected to maintain healthy lifestyles- hindering their
ability to achieve academic success, find employment, and maintain stable relationships. It
would completely consume their lives, and the symptoms would even be passed down to their
children.
A substance like this would be avoided like the plague, for it would be comparable to
cancer, HIV, or radioactive matter. Our government would work tirelessly to prevent and reduce
its effects. Policies would be implemented to protect those affected, and billions of dollars would
be spent to mitigate the effects of this harmful toxin. We would stop at nothing to prevent our
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This toxin is real- its called toxic stress. It is one of the most detrimental public health
issues that those in poverty face, influencing ones mental and physical health as well as altering
the architecture of ones brain. How can stress lead to so many health disparities? you may
ask. What makes those in poverty more vulnerable to toxic stress? Scientists are able to
distinguish between three types of stress responses- positive, tolerable, and toxic stress. Each is
characterized by varying levels of intensity and duration of the stress response system (Shonkoff
Positive stress is associated with brief concerns like studying for an exam or preparing for
a job interview. In small doses, these experiences are actually beneficial to our development, as
they strengthen our abilities to combat anxiety. Positive stress may even be a motivating factor
that leads to success, pushing us to reach our goals. Tolerable stress extends beyond deadlines
and is related to serious concerns like mourning the loss of a family member or experiencing a
natural disaster. Although these stressors are serious and traumatic, they arent a threat to the
victims long-term well-being if he or she has the relational support of family and friends.
Conversely, toxic stress results in experiencing chronic and persistent traumatic events in the
absence of such guidance and connections. Examples of these adverse experiences include
parental substance abuse, a low socioeconomic status, violence, abuse, neglect, and addiction,
among a host of others. These realities are typical in the lives of those living in poverty,
especially those living in unstable households. Research has proven that this exposure to
violence causes extreme anxiety, constantly disrupting the bodys stress response system.
(Shonkoff et al.1)
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When most people think of stress they think of the fight or flight system- a lion is about
to attack you, and your body must prepare for survival. In the words of Walter Cannon, the
Harvard physiologist who discovered this phenomenon, this response actually corresponds to an
area of our brain called the hypothalamus, which- when stimulated- initiates a sequence of nerve
cell firing and chemical release that prepares our body for running or fighting (5 Minute Stress
Mastery 1). The body is hard-wired to release chemicals like adrenaline and cortisol into the
bloodstream, preparing us for survival mode. The immune and digestive systems are shunted,
as our energy will be used for fleeing or fighting. Our pupils expand, blood thickens, and our
primitive instincts take over, losing our capability to think logically (5 Minute Stress Mastery
1).
Toxic stress is fight or flight on overdrive, but it isnt a lion that threatens someones
survival. Often times its a childs abusive parent or violent neighborhood. In most cases, these
people arent able to fight or flee, leaving their stress response systems to be constantly
activated. Advances in the ecobiodevelopmental sciences claim that significant levels of stress
hormones can lead to serious medical complications. This excessive flow of stress chemicals in
the blood disrupt the brain circuitry and other organ and metabolic systems during sensitive
developmental periods (Shonkoff and Garner 239). When these systems are irritated, the body
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Results from Dr. Vincent Felitti and Dr. Robert Andas Adverse Childhood Experience
(ACE) Study revealed that stressors contributing to toxic stress during childhood lead to serious
health and social disparities later in life. They evaluated the implications of adverse childhood
experiences- such as poverty, neglect, abuse, and addiction- on 17,000 middle-class citizens in
San Diego, finding a strong correlation between their level of stress and health issues. They
particularly studied the impact of abuse and household dysfunction in the lives of children,
examining their psychological, physical, and sexual encounters. They found a significant
relationship between the number of childhood exposures and the following disease conditions:
ischemic heart disease, cancer, chromic bronchitis, history of hepatitis or jaundice, skeletal
fractures, and poor self-rated health (Felitti et al. 250). Their results were shocking;
approximately 67 percent of the participants had at least once ACE, and 12.6 percent had four or
more ACEs. Felitti and Anda also claimed that ones amount of adverse experiences correlates
with his or her engagement in risky behaviors- such as smoking, alcoholism, and unprotected
sex. However, even if they werent involved in such behaviors, they are still twice as likely to
have heart disease. Its not just about risky behaviors; the reality is that these adverse experiences
affect the bodys immune, digestive, and hormonal systems, thus influencing how the brain
develops. These problems all stem from a stress response system on overdrive, diminishing the
Director of the Center on the Developing Brain at Harvard University, Jack P. Shonkoff,
explains how toxic stress physically alters the architecture of the developing brain. The plasticity
of the brain during the first five years of life is what makes childhood adversity so detrimental.
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Early childhood experiences influence the maturation of the brain; it is much easier to build a
strong foundation than it is to fix behavioral issues later (Shonkoff and Bales 25). During
childhood, the brain is constantly making neurological connections, and pruning the synapses
that it doesnt use. The events occurring in a persons life help determine what connections are
strengthened or die; if ones environment is dangerous, those synapses either dont connect to
begin with or develop abnormally. In other words, if a child doesnt learn emotional regulation
or social scripts early in life, he or she will suffer from extreme difficulty in developing
interpersonal skills in adulthood. If a child grows up in a toxic environment, he or she will have a
brain that has been adapted to have attachment issues and to overreact to the most minor of
complications. The public generally views child development as some combination of genes,
fate, free will, parents, and environment that is stirred up within the mystery of the proverbial
black box (Shonkoff and Bales 24). We fail to realize that child development is a societal
problem. When a persons stress response system is permanently activated, the amygdala and
hippocampus- parts of the brain responsible for fear conditioning- are underdeveloped.
Heightened stress also stunts the maturation of the prefrontal cortex- the region of the brain
responsible for impulse control, focusing attention, and logical decision making. These
detrimental effects impair ones ability to learn and establish healthy relationships.
A perfect example of this is Sarah, a seven-year-old girl living in Trenton, New Jersey-
her name has been changed to protect her privacy. She is one of eight children, raised by a single
mother who cant afford to support her family. Trenton was once a thriving city, but it has been
destroyed by the drug trade and gang violence. Homelessness and prostitution are prevalent on
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the streets, and violence permeates into the lives of its citizens- Trenton is no place for a little
girl to grow up. Sarah is a product of her environment; her previous adverse experiences have
left her with the incapacity to regulate her emotions. She is constantly pent up, overreacting to
The problem isnt her personality; she cant focus in school because her brain is busy
preparing to react to threats from her environment. Often times, children living in poverty have
difficulties learning because their brains simply arent there. Studies have concluded that
multiple adverse experiences significantly impair a childs learning ability, putting them at a
disadvantage in the classroom, workplace, and community (Shonkoff et al. 5). Their findings
have even been supported by experiments with primates and rodents, strengthening the belief
that brain development- especially in regards to the prefrontal cortex- is the core problem.
Humans experiencing chronic stress have been shown to perform poorly on tasks related to
prefrontal cortex functioning (such as working memory or shifting attention), and their ability to
Schools are packed with children with misdiagnosed learning disorders like attention
deficit disorder (ADD) and attention deficit/hyperactivity disorder (ADHD), with the root of the
problem stemming from a toxic environment. Twenty years ago, teachers reported that they had
two or three of these children in their classroom. Now we hear that they have six or seven
(Karr-Morse et al. 38). Sarah falls into this category; she is unable to listen, focus, or regulate her
emotions. A day doesnt go by where she is isnt restless at her desk or picks a fight with another
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child. In addition to reacting to violence, she is often the instigator. These children are desperate
for any type of structure in their lives; they need consistency, attachment, comfort, and
discipline. Their experience with poverty and violence has led them to adjust their emotions,
healthy life, but there is little discussion on why this happens or what we can do to change it. The
American Dream is based on the idea that if you work hard enough, you will succeed in life.
Education is seen as the key to achieving a high economic and social status, but how will that
dream play out for children like Sarah? How will she be able to find employment when the
education system has failed her? Economists suggest that the single strongest indicator of
mortality is income level (Isaacs and Shroeder 1140). Poverty contributes to a lack of control
over ones life circumstances, increased social isolation, and the anxiety brought about by a
subjective feeling of being of low social status (all of which can be compounded by racism)
(Isaacs and Shroeder 1141). Social inequality is what fosters toxic stress, ultimately leading to
Society expects people living in poverty to pick themselves up by their own bootstraps,
attributing their situation is an indicator of their work ethic. By believing that mental illness is
simply the result of ones individual behavior, we fail to understand that people have diseases
because of their toxic environments and adverse experiences. In a community filled with poorly
educated low-income citizens, economic hardship isnt the sole determinant of poor health;
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distributive egalitarianism wont solve this problem as much as tissues help a cold. Lack of
income goes hand-in-hand with violence, seriously impacting ones psychological health. It even
puts people at high risk for mental health issues that often correlate with drug abuse and
alcoholism. This, in turn, disrupts education, and even promotes things like teen pregnancy and
unemployment, leading to further neglect for the future generations who will fall victim to this
cyclical problem. Poverty is often seen as a one-dimensional problem, but few realize just how
complex the issue is. The toxic stress resulting from living in a dangerous environment
Although a low socioeconomic status is one of the greatest indicators of toxic stress, we
cant just simply alleviate the income gap, as this is only natural in a capitalistic society.
However, I believe that we should be focusing our attention on equalizing our capabilities
professor of philosophy at the University of College London, Increasing a persons income and
wealth may be a relatively ineffective way of improving his or her capabilities if the physical and
social world remains unwelcoming (Wolff 8). Unfortunately, our society is so infatuated with
the idea of wealth and status that the poor live in an extremely unwelcoming and judgmental
world. The discrimination due to our social differences has been rooted in the history of our
nation; people of different genders, religions, and races were once believed to be members of
different subspecies of the human population. Our differences have defined our dignity, and this
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When a person lacks autonomy over ones environment, their vulnerability is what leads
to their isolation. Wolff also notes the importance of affiliation, and of emotions, which will
often depend on the nature of ones connection to others as part of individual well-being
(Wolff 14). Above all, we must ensure that everyone is equally regarded as entitled to a
worthwhile place in society, and not merely a fair share of resources. The relational
egalitarianism that Wolff suggests is imperative for the mitigation of toxic stress. As previously
mentioned, people who have had adverse experiences are able to avoid toxic stress if they have
stable relationships. This is what separates toxic from tolerable stress-positive, stable, and
reliable connections act as a buffer for children from the uncertain, dangerous environment in
How do we foster healthy relationships in these toxic households? you may ask. A
comprehensive body of research conducted by Ignacia Arrubarrena and Joaquin de Paul from the
University of the Basque Country, claims that perhaps our only hope in eliminating this problem
is through early childhood interventions. Their research evaluated various early intervention
programs, usually home visiting services starting at pregnancy or early childhood. The most
successful program was the Nurse-Family Partnership Program, a home intervention program
performed by specialized nurses who provide caregivers and children support. They focus on
improving parental skills with increased communication and educating families on the issues of
maltreatment and abuse. The program lasts two years, starting at birth. They help the children
develop by fostering stable relationships between family members, and they even encourage
adults by helping them complete their education and find employment. The results are
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promising, with consistent effects on prenatal health behaviors, parental care of the child, child
maltreatment, child health and development, maternal life course, and criminal involvement of
The Human Capital Theory explains that improving the early development of our
children is a lucrative investment towards advancing our society and economy. The term human
capital encompasses the productive capacities embodied in people and may include knowledge,
health, experience, skills, and other characteristics (Kilburn and Karoly 1). Investments in our
nations youth are much more efficient than attempting to resolve the implications of toxic stress
later. For example, public investments in adult job training and substance abuse prevention have
been largely unsuccessful. Implementing programs that target the younger generation allows
children living in poverty to experience healthy development; this, in turn, prepares them to be
productive citizens.
Economists claim that a growing body of program evaluations shows that early
childhood programs have the potential to generate government savings that more than repay their
costs and produce returns to society as a whole that outpace most public and private
investments (Kilburn and Karoly 11). The Nurse-Family Partnership Program is a perfect
example of this. In the evaluations of the program, researchers found that that participating
children visited the ER 0.54 fewer times between the ages of two and four than did
nonparticipants (Kilburn and Karoly 14). Multiply .54 by the average cost of an ER visit: $432
(Machlin 2) and the average reduction is $228. This data was collected in 2003, so using a price
inflator to convert this information results in a value of 295 (2016) dollars. Monetary gains from
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early childhood intervention would also be seen in the reduction of crime and addiction. We can
either pay now to prevent toxic stress from destroying our children or pay even more to fix their
Toxic stress is one of the deadliest public health issues that those in poverty face, and yet
our silence fuels its perpetration. America needs a wake-up call. We must rise beyond our
socioeconomic challenges in order to secure a promising future for every child in our nation.
Poverty and inequality are at the root of this crisis, and it is imperative that we do our best to
provide equal opportunities for all of our citizens. Once we recognize the importance of healthy
childhood development, we will not only improve the lives of millions of people, we will save
billions of dollars that are spent on health care. With increased advocacy on toxic stress for our
pediatricians, educators, parents, and politicians, we will one day see a world where at-risk
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Families: Theoretical and Empirical Bases Supporting Their Social and Economic
Felitti, Vincent J., and Robert F. Anda. "Relationship of Childhood Abuse and Household
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Isaacs, Stephen L., and Steven A. Schroeder. Class The Ignored Determinant of the Nations
Karr-Morse, Robin. Scared Sick: The Role of Childhood Trauma in Adult Disease. N.p.: Basic,
Kilburn,, Rebecca, and Lynn Karoly. "What Does Economics Tell Us About Early Childhood
Policy?" The Economics of Early Childhood Policy: What the Dismal Science Has to Say
About Investing in Children. The RAND Corporation, 2008. Web. 30 Apr. 2016.
Machlin, Steven R. Expenses for a Hospital Emergency Room Visit, 2003. Issue brief no. 111.
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Families: Theoretical and Empirical Bases Supporting Their Social and Economic
of Human Health and Disease. American Academy of Pediatrics, n.d. Web. 4 Apr. 2016.
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Tough, Paul. "The Poverty Clinic." The New Yorker. N.p., 14 Mar. 2011. Web. 1 Apr. 2016.
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Momentous Institute (momentous). The Behavior Isnt the #kid - Its a Symptom of Whats
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