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. 2023 Feb;64(2):293-297.
doi: 10.1016/j.amepre.2022.08.012. Epub 2022 Sep 27.

The Cognitive Burden of Poverty: A Mechanism of Socioeconomic Health Disparities

Bradley M Appelhans  1
Affiliations

The Cognitive Burden of Poverty: A Mechanism of Socioeconomic Health Disparities

Bradley M Appelhans. Am J Prev Med. 2023 Feb.
No abstract available

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Conflict of interest statement

Conflict of Interest Statement: The author has no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. Parallel pathways to socioeconomic health disparities.
Poverty is both a socioeconomic condition and a psychological phenomenon, and these facets affect health through distinct mechanisms. Public health approaches to reducing socioeconomic disparities have traditionally focused on addressing tangible consequences of poverty, including the impact of personal material disadvantage and systemic and environmental constraints on health behavior (solid lines). Far less effort has been directed toward alleviating the cognitive burden of poverty (dashed lines). Daily experiences of stress, cognitive demands, and scarcity lead to dynamic changes in executive function and present bias that have downstream effects on health behaviors. As the tangible and psychological components of poverty influence health in parallel, interventions that eliminate systemic and environmental constraints are likely necessary, but not sufficient, to reduce socioeconomic health disparities.
Figure 2.
Figure 2.. Hypothetical classification of poverty-related exposures on the dimensions of cognitive burden and potential to impose tangible constraints on health behavior.
The public health community is most familiar with aspects of poverty that contribute to socioeconomic health disparities by imposing tangible constraints on health behavior (localized in the lower-right quadrant). Yet, other aspects of poverty affect health behavior primarily by imposing a cognitive burden (upper-left quadrant), or represent both a source of cognitive burden and a tangible constraints on health behavior (upper-right quadrant). Though there is still a strong need for research characterizing the cognitive burden of various poverty-related exposures, interventions targeting poverty exposures along both dimensions will be needed to reduce socioeconomic health disparities.
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