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The Effects of Poverty on the Mental Health of Children and Youth

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Little Girl with Ragged Teddy bear and Suitcase

Just five years ago, headlines across the United States (U.S.) celebrated a historic drop in child poverty - thanks largely to the COVID-19 pandemic-era expansion of the Child Tax Credit, which nearly cut the rate in half. Today, however, as we mark January as National Poverty in America Awareness Month, the picture looks starkly different. The child poverty rate has nearly tripled1,

and families across the country are struggling more than ever to make ends meet. As we explore the effects poverty has on the mental health and well-being of children and youth, it is essential to recognize how growing up in poverty exposes them to persistent stress, insecurity, and hardship that profoundly shape their mental health and long-term well-being. Poverty creates constant, chronic stress in a child’s life, and this ongoing stress distinctly shapes their developing brain, emotions, and behaviors in ways that increase the risk of mental health challenges over time. Poverty usually does not harm mental health through one single event, but through daily, repeated stressors like food and housing insecurity, unsafe neighborhoods, and parents under intense pressure. This kind of unrelenting stress overloads a child’s stress-response system, making anxiety, depression, and behavior problems more likely both in childhood and later life.

Poverty affects mental health through multiple overlapping pathways that begin early and often persist throughout childhood. Millions of children and youth are affected by a lack of access to food, stable housing, educational opportunities, and mental and physical health care. This causes a myriad of mental health challenges for children and youth, including depression, anxiety, disruptive behaviors, and emotional dysregulation.2

Recent estimates indicate that approximately 10 million children in the U.S. live in households with incomes below the official poverty line, meaning they struggle to meet basic needs such as food, housing, and health care. Using Census data and national analyses, child poverty in 2024 was estimated at roughly 13-14%, with even higher rates in several Southern states and for children in single-parent or large families.3 Black, Latinx, and Indigenous children experienced poverty at roughly three times the rate of non-Latinx White children, reflecting structural inequities in employment, housing, and access to safety-net programs. Deep poverty - families surviving on less than half the poverty threshold as defined by the Centers for Disease Control and Prevention (CDC) - affects several million children and is associated with severe material hardship such as unstable housing, food insecurity, and utility shutoffs.4

Chronic physiological stress responses can disrupt brain development. Children growing up in poverty are more likely to show changes in brain areas involved in stress regulation, learning, and emotion (such as the hippocampus and amygdala), which are linked with higher rates of depression and other difficulties. Early childhood is a particularly vulnerable time because of rapid brain development and dependence on caregivers. These developmental impacts can appear as problems with attention, emotional control, coping skills, and school performance, all of which are closely tied to mental health.5 National surveillance data indicate that U.S. adolescents are experiencing very high levels of distress, even with some modest improvements in recent years. In 2023, about 40% of adolescents reported persistent feelings of sadness or hopelessness during the previous year, about 20% said they had seriously considered attempting suicide, about 18% had at least one major depressive episode in the past year, and about 3% reported a suicide attempt. Although some measures of poor mental health and suicidality among teens declined slightly between 2021 and 2023, current levels remain far higher than a decade ago and are especially elevated among girls and LGBTQ+ youth.6,7

Empirical studies following children over time show that the proportion of childhood spent in poverty is associated with higher levels of externalizing behaviors, learned helplessness, and biological markers of chronic stress in adolescence and young adulthood. Other research finds that economic hardship is linked to internalizing symptoms such as sadness and worry, sleep and concentration problems, and lower self-esteem in school-aged children. 8

Longitudinal studies show that what matters most is not just when poverty occurs, but how long it lasts and how deep it is. When poverty deepens – as in deep poverty - the developmental risks intensify due to more severe deprivation and instability. Research using repeated measures of household income finds that exposure to poverty at any age in childhood contributes to worse mental health by early adolescence, supporting a cumulative burden rather than a single sensitive period. In other words, each year spent in poverty adds to the risk of later depression, anxiety, and lower self-esteem, even when later income improves.9

Economic strain alters family dynamics in ways that also directly affect children’s mental health. Children and youth growing up in persistently low-income households are more likely to experience parental stress, harsher or inconsistent parenting, and fewer enriching experiences, all of which can undermine emotional regulation and social skills. Parents facing job insecurity, low wages, or unaffordable housing often report high levels of stress, depressive symptoms, and conflict with partners, which can reduce their emotional availability to children. This can lead to more unsupervised time for children, disrupted routines, and difficulty accessing school events or health appointments, all of which are associated with behavior problems and academic struggles. At the same time, low-income parents frequently have fewer supports - such as paid time off, flexible schedules, or quality childcare – all factors that could buffer caregiver stress.10

Poverty often clusters geographically, and many children experiencing poverty also live in neighborhoods with high crime, under-resourced schools, and limited access to safe parks or youth programs. Young people in these communities are more likely to witness violence, experience bullying, or feel unsafe at school. Recent national data show that, even as some indicators of sadness and suicidality have improved, school-based violence and safety-related absenteeism have risen, with particularly high rates among marginalized youth. Children and adolescents experiencing both poverty and high neighborhood adversity face a double burden that compounds risk for internalizing and externalizing problems, substance use, and involvement with the juvenile justice system.11

Children and youth living in poverty encounter multiple barriers to getting timely, effective mental health services. Even when they are eligible for public insurance, the  may live in areas with few child mental health providers, long wait lists, or limited access to specialists. Transportation barriers, parents’ work schedules, language differences, and stigma about mental illness can further reduce the likelihood that children receive evaluation and treatment.12 Due to these gaps in access, children and adolescents experiencing depression, anxiety, ADHD, or trauma-related disorders may face delayed or inaccurate diagnoses, leaving their conditions unrecognized for long periods. Untreated mental health conditions can impair learning, social relationships, and physical health and may increase the risk of self-harm or substance use during adolescence.13

Stark racial and ethnic disparities persist in both poverty and mental health outcomes. Black, Latinx, and Indigenous children and youth face substantially higher poverty rates than their non-Latinx White peers and are more likely to attend underfunded schools and live in neighborhoods with greater exposure to violence and environmental hazards. These structural inequities compound with experiences of discrimination and racism - chronic stressors that further undermine mental health.14

National surveys indicate that mental health burdens are not evenly distributed. Female and LGBTQ+ high school students report higher rates of poor mental health, bullying, and suicidal thoughts and behaviors compared with their peers, suggesting that gender- and identity-based discrimination compound the effects of economic hardship. At the same time, Black, Indigenous, and People of Color (BIPOC) and immigrant youth may face additional barriers to care, including limited culturally and linguistically appropriate services.15

The mental health impacts of poverty show up clearly in school performance and later life trajectories. Children growing up in low-income households are at higher risk for developmental delays, learning difficulties, and lower academic achievement, in part due to chronic stress, reduced access to early education, and fewer learning materials at home. Emotional and behavioral problems related to stress, anxiety, or trauma can disrupt classroom behavior, peer relationships, and attendance, increasing the risk of grade repetition and school dropout.16

Despite these risks, many children in poverty demonstrate remarkable resilience, especially when certain protective factors are present. Strong, stable relationships with caring adults -parents, relatives, teachers, or mentors - can buffer the impact of economic stress and help children develop healthy coping skills. Participation in quality early childhood programs, after-school activities, or community organizations can also support emotional regulation, social competence, and a sense of belonging.17

Policies that raise family incomes, stabilize housing, and improve neighborhood safety are likely to produce meaningful improvements in children’s emotional wellbeing, school engagement, and long-term life chances. Broader anti-poverty strategies - including increased minimum wages, housing assistance, food benefits, and investments in early childhood education - are consistently associated with improvements in family wellbeing and child health outcomes. When combined with efforts to expand school- and community-based mental health services, particularly in high-poverty areas, these approaches can reduce both the prevalence and severity of mental health problems among children and youth.18

For mental health practitioners and school staff, it is critical to recognize poverty as a central social determinant of mental health rather than simply an economic background variable. Screening for social needs such as food insecurity, housing instability, and caregiver stress can help identify children whose mental health is at risk and connect families with available resources. Trauma-informed, culturally responsive care is especially important for children facing both economic hardship and discrimination and/or community violence.

Schools that invest in trauma-informed practices, social-emotional learning, and culturally responsive mental health supports can play a powerful role in mitigating the mental health impacts of poverty. When mental health care is accessible, non-stigmatizing, and integrated into settings where children already spend time, it becomes more likely that emerging problems will be identified and addressed early. Given the large number of U.S. children currently living in poverty and the high levels of distress among adolescents, coordinated policy and practice responses remain urgent priorities.

REFERENCES:

  1. Child Poverty Nearly Triples to 13% Over Three Years
  2. Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination
  3. Data on Poverty in the United States
  4. Issue Brief: U.S. Child Poverty in 2024
  5. Poverty and Developing Brain
  6. Data Summary & Trends Report for Dietary, Physical Activity, and Sleep Behaviors
  7. New Reports Examine Trends in Youth Mental Health
  8. Childhood Poverty, Cumulative Risk Exposure, and Mental Health in Emerging Adults
  9. Childhood Poverty and Psychological Wellbeing: The Mediating Role of Cumulative Risk Exposure
  10. How Poverty Affects Children’s Development
  11. Data Summary & Trends Report for Dietary, Physical Activity, and Sleep Behaviors
  12. Mental Healthcare Disparities in Low-Income U.S. Populations: Barriers, Policy Challenges, and Intervention Strategies
  13. Poverty is Not Just an Indicator: The Relationship Between Income, Poverty, and Child Well-Being
  14. A Guide to Toxic Stress
  15. Social safety nets may blunt effects of poverty on children's mental health

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