Why poverty is a disease

Original author: Christian H. Cooper
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According to the description of my achievements today, you would never have guessed that I grew up in poverty and hunger.

My last salary for the year was over $ 700,000. I am a member of the Truman National Security Society [ engaged in the search and promotion of future leaders of the American nation - approx. trans. ] and a member of the Council on Foreign Relations . My publisher recently released my latest series of books on the quantitative distribution of global finance.

And all this is not enough for me. I constantly feel like " hit or run"I am waiting for a dirty trick, or the onset of hungry days. I even decided not to have children, because, despite all the successes, I don’t feel safe financial cushion. The minimum state of the account in which I am ready to think about children is a very big number If you were personally acquainted with me, you could catch the signs of stress, self-doubt, anxiety and depression, and hear about Tennessee.

Not a single resident of Tennessee will tell you that he is just from Tennessee. He will definitely add: Eastern, Western or Middle. My life began in East Tennessee, in the small town of Rockwood in the Appalachia region . I was the oldest of four children in a family whose income did not allow me to keep one. Each Pentecostal church of this heroin outback smelled the same: a heavy mixture of cheap detergent and even cheaper oil, with a small amount of forgotten hope. One of these abandoned churches was, in fact, my children's home and school.


The training class consisted of one room in which 20 people, from kindergarten to 12th grade, were trained according to the “ accelerated Christian training ” manual."We were handed out booklets that we had to read on our own. We ourselves put down marks for homework. There were no lectures, and I did not have a teacher. Sometimes the preacher’s wife gave out tests. We were not allowed to do anything. movies, no music. It could have been years, during which nothing happened that would distinguish one year from another. There was no talk about any social events.

I spent all my time pondering simple questions. Where did my next dinner ? Will i have tomorrow e ektrichestvo? I watched my mom tries to hide in shame coupons for foodat the checkout of the grocery store. I remember when, at eight years old, I was in a state of panic because of the constant uncertainty about absolutely all aspects of life, from food to clothing and learning. I knew that my life could not be normal. Something was wrong with the tiny microcosm in which I was born. I just did not know what.

Growing up, I thought I understood what was wrong there. I have always believed that my upbringing made me cautious and prudent. But over the past few decades, many new things have emerged. We have learned that the stress associated with poverty can change your biology in ways that we never imagined before. It can reduce the surface of the brain, shorten telomeres and longevity, increase the chances of obesity and the propensity for excessive risk.

And now there is information about the fact that these changes can be even deeper - down to the level at which our bodies collect themselves, changing the types of cells from which they are made, perhaps even to the expression of the genes with which the body plays, like a Rubik's cube thrown into a washing machine. If the research results are confirmed, it will mean that poverty is not just a socio-economic condition. It will be a set of related symptoms that can be prevented and treated, and even inherited. In other words, the results of poverty begin to resemble the symptoms of the disease very much.

The word "disease" carries a negative connotation. I do not mean that poor people are bad or spoiled. I mean that poor people are sick, and everyone else tells them that their condition is a necessary, temporary, and even positive part of modern capitalism. We tell the poor that they have a chance to break free simply by working hard enough; that we are all equally involved in a system that distributes equally rewards and punishments. We point to rare stories “from the poor to the rich,” as it happened to me, and it all fits into the pattern of meritocracy [ lit. - “the power of the worthy,” - approx. trans. ].

But my virtues are irrelevant to how I escaped from there.

We may not remember the year 1834 as a record year, but it was such in the field of organic chemistry. It was then that Jean Baptiste Dumas and Eugene Peligo were distilled from heated sawdust and analyzed a clear liquid, which they called methylene, and we call it methanol , wood alcohol. It is based on a methyl group consisting of one carbon atom bound to three hydrogen atoms. And as it turned out 150 years later, the methyl groups play a crucial role in gene expression .

In the fall of 1991, Aaron Razin and Howard Tsedar published an unusual work, DNA Methylation and Gene Expression, in which they showed that the work of gene expression very much resembles a snake tightly coiled aroundthe staff of Asclepius . [Razin, A. & Cedar, H. DNA methylation and gene expression. Microbiological Reviews 55, 451-458 (1991)] On the strong weaves of our genetic code, there are methyl groups that control how tightly our genetic code is wrapped around special proteins called histones . The tighter the part of the code is twisted, the less likely it is to influence something, that is, the less likely it is to “express”. This is one of the pillars of the epigenome : your human appearance is determined not only by DNA, but also by which part of it your epigenome allows for expression.

Six years later, Michael Mini, a professor at McGeale University who specializes in stress biology, published a revolutionary result along with colleagues: the quality of maternal care affects rat epigenomes, glucocorticoid stress receptors in the hippocampus, and the reaction of the hypothalamic-pituitary-adrenal axis (HPA) ) to stress. [Liu, D., et al. Maternal care, hippocampal glucocorticoid receptors, and hypothalamic-pituitary-adrenal responses to stress. Science 277, 1659-1662 (1997)] Similar effects were later found in zebra hornas , which, like people, are socially monogamous and in which both parents raise children. Levels of messenger RNAglucocorticoid and mineralocorticoid receptors in birds deprived of mothers were reduced, and therefore in adult birds, stress hormones remained elevated for much longer. The researchers wrote that the epigenetic mechanisms may be responsible for these changes - but they have not proven this. [Banerjee, SB, Arterbery, AS, Fergus, DJ, & Adkins-Regan, E. Deprivation of the hypothalamic-pituitary-adrenal axis of zebra finches. Proceedings of the Royal Society B 279, 759-766 (2012)]


In human children, epigenetic changes in the expression of stress receptor genes, leading to an increased response to stress and mood problems, have been associated with abuse in childhood. [McGowan, PO, et al. Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience 12, 342-348 (2009)] And last year, researchers at Duke University found that "low socioeconomic status during adulthood is associated with an increase in methylation of the nearest promoter of the serotonin transporter," resulting in the almond-shaped bodysusceptibility to “threat reactivity”. [Swartz, JR, Hariri, AR, & Williamson, DE] Molecular Psychiatry 22, 209-214 (2017)] And although the predisposition to high levels of stress has its advantages (for example, learning under stress can be accelerated [Champagne, DL, et al. Maternal care and hippocampal plasticity: Evidence for experience-dependent structural plasticity, altered synaptic functioning, and differential responsiveness to glucocorticoids and stress. Journal of Neuroscience 28, 6037-6045 (2008)]), the main essence of these studies is that chronic stress and uncertainty in childhood leads to the fact that in adulthood stress is more difficult to handle.

On the one hand, epigenetics offers an intriguing presentation of our life, going backwards down to the main “program” that makes you who you are. But in this area there are fundamental contradictions. Last June, a team of researchers from the Albert Einstein College of Medicine at the University of Bristol and the European Institute of Bioinformatics published a paper that described how this area was polluted by misinterpretation of research results. For example, researchers often confuse the cause with the effect (diseases can lead to epigenetic markers, and vice versa); falsify or misinterpret statistics; mixing of variables leads to a visible correlation of parameters; does not take into account the great variability of the epigenome from cell to cell.

John Grilli, one of the co-authors of the study, believes that some notable results in this area, including those that Mini received, suffer from these problems. "During the Mini study, it was believed that if I observe a change in DNA methylation in the cells of rats that my mother did not lick, or in the cells of children from a lower socioeconomic group, or anyone else, then I would learn how people reprogrammed under the influence environmental conditions ". But a change in DNA methylation explains not only whether a cell has been reprogrammed or not. They are also associated with proportions of subtypes of cells, each of which has its own epigenomes found in the compared organisms. Grilli et al. Call this a meta-epigenome.

But Grilli notes that even if this molecular mechanism is not reprogramming cells through methylation, but a shift in the cell subtype, there is still something to think about. “Even if you find a change in the proportions of, say, cell subtypes in peripheral blood, which is associated with such things as low socioeconomic status, it will be a very interesting discovery,” he says. “Then we will again return to the question of defining what epigenetics is.” It is possible that the shift in cell subtypes is inherited, although this does not include reprogramming cells through methylation. Tim Spector from King’s College, London, for example, found variants of DNA sequences associated with variations of cell subtypes.

The study of the biological effect of stress associated with poverty is still in its early stages. At the same time, it has already given us many mechanisms capable of providing such effects, many of which contain an inherited component. If, for example, a pregnant woman is exposed to the stress of poverty, her fetus and gametes of the fetus may suffer from this, with the result that these effects extend at least to her grandchildren. Or maybe further.


Studies of mice and fruit flies have shown that epigenetic features similar to those mentioned by Mini, can be inherited and preserved for at least dozens of generations. The effects of such things as diet and prenatal stress are inherited not only through the modification of histones , but also through DNA methylation andnon-coding RNA [Lim, JP & Brunet, A. Bridging the transgenerational gap with epigenetic memory. Trends in Genetics 29, 176-186 (2013)]. In a study from 2014, scions of a mouse trained to fear a certain smell also feared this smell, although they had not felt it before. This effect has been maintained for two generations of the generations. Nature Neuroscience 17, 89-96 (2014)]. In humans, the inherited effects of stress were observed for at least three generations in people whose ancestors suffered from mass starvation (the hungry winter of 1944 in the Netherlands[Heijmans, BT, et al. Persistent epigenetic differences associated with prenatal exposure to famine in humans. Proceedings of the National Academy of Sciences 105, 17046-17049 (2008)]), food interruption ( Everkalik experiment[Pembrey, M., Saffery, R., Bygren, LO, & Network in Epigenetic Epidemiology. Human transgenerational responses to early life, health and biomedical research. Journal of Medical Genetics 51, 563-572 (2014)]) and during the Holocaust. The consequences of smoking or chewing tobacco by parents at a young age can be transmitted to their children depending on the gender, which proves the presence of epigenetic effects in people [Pembrey, ME, Bygren, LO, & Golding, J. The nature of human transgenerational responses. In Jirtle, RL & Tyson, FL (Eds.) Environmental Epigenetics in Health and Disease Springer Publishing, New York, NY (2013)]. According to observations from 2014, “several studies of people indicate the existence of epigenetic effects on the male line,

Even at the current stage, we can extract some information from science. First, the stresses associated with poverty have biological consequences that last a lifetime. Secondly, there is evidence that these effects can be inherited, either through effects on the fetus, or through epigenetics, through cell subtypes, or in some other way.

And this scientific evidence compels us to revise the cornerstone of American mythology and our policies aimed at the poor: the opportunity to get upstairs without any help. Stories about people who have made themselves, escaped from their surroundings through hard and hard work. The support of the platform of meritocracy, where the awards supposedly rightly fall to those who deserve them the most.

What kind of independent exit from the environment or fair distribution can we talk about if poverty injures the participants of the “competitions”? Especially if it is also transmitted through generations? And the ugly consequence of the “self-exiting” hypothesis, suggesting that people who did not get out of difficult circumstances deserve them, makes even less sense in the light of the gloomy biology of poverty. When the shotgun of a starting pistol sounds, the poor find themselves far behind the starting line. I was definitely there, despite my current success.

So how did I get out of there? By chance.

It would be very easy to tell my story, explaining everything with talents and hard work, because that's what feeds us all, from Hollywood to politicians. But that would not be true. My flight took place thanks to a sequence of surprisingly unlikely events, none of which were under my control.

By the age of 14, for 8 years I had been trying to teach myself with the help of photocopied booklets, without textbooks, lesson plans, help, or at least a teacher. I desperately tried to get out and was terribly afraid of becoming the same as the people around me. So I picked up the phone book and started calling vocational schools, colleges, everyone and everything who could give me the opportunity. Accidentally and unexpectedly, I came to the president of a community college [a two-year college that trains mid-level specialists to work in the local community - approx. trans. ] Sherry Hope. When I first met her, I was probably 12 years old, and even at that age I could understand that my story was not unique to her.

In the same college, I met Bruce Cantrell, a professor who replaced my father when I was 15, and I was poor. He also grew up in poverty, but as a result, he became a people. We did not particularly talk about our experience, but somehow we immediately found a common language. A few years later he went into politics and made me the manager of his election campaign. We won, and I received an invaluable education in the real and arrogant politics of Rohan County. I will forever be grateful to Bruce and Sherry. With their help, I finally got a college degree.

Did I take the initiative? Of course. Many interpreted my escape from poverty as confirmation of the existence of a meritocracy, justifying the entire system. But the backwoods are filled with people who are just as desperately trying to get out of there as I, and are taking the same inventive measures. So I - the exception, confirming the rule - the rule that escape from poverty is possible only by chance, and not because of certain advantages.

I have relatives and friends, as smart and hardworking as I myself, and about the same, or with the best, education. But none of them got out of poverty. One of them also went to community college, but only after he witnessed how his best friend committed suicide under the influence of drugs. It turned out to be a one-way ticket to life, filled with emotional issues. Another was lucky to get into an accredited free secondary school, where they give much more knowledge than in the course of “accelerated Christian education”. He became a heroin addict. For them, the path to education did not, as for me, wonderfully free from obstacles. They have not become, like me, the head of a company trading Wall Street derivatives. They do not write, like me, about poverty. They live in it. And today I can count about 20 relatives and friends who have said goodbye to life through weapons or heroin. I have no doubt that this year their number will increase.


Why do so few people escape poverty? I can testify by experience - not due to the fact that some have more dignity than others. This is because being a poor man means taking big risks. The asymmetry of the results for the poor is so huge, because being poor is very expensive. Imagine that you lost your job, because your telephone did not work, or you did not pass the exam, because you spent a whole day in intensive care because of an illness that would be eliminated by timely treatment. Such simple misfortunes can trigger a whirlpool of failures from which one cannot escape. The reality is that if you are poor, and made only one mistake - you are finished. Life turns into a gamble with death in the form of loss.

Now imagine that your brain is designed to multiply the subjective feeling of stress by 10. As a result, you focus on short-term plans. Those lucky enough to get acquainted with the calculus of the poor by birth, it seems that the poor once and again fail to make optimal decisions. But the choice of the poor in their circumstances is very reasonable. You can not talk about optimal solutions, designed for a long period, if you have two days of food left. Stress acquires a completely new meaning, and it is very difficult to get rid of it.

The standard American myth of meritocracy misjudges stories like mine. The accumulated social capital of American institutions — a stable transfer of power, the rule of law, entrepreneurship — of course, creates economic wonders every day. But these institutions are primarily suitable for exponential growth of capital, where it already exists, and not for creating new capital, where society needs it. Stories like mine are considered archetypes, and we all unreasonably believe that the way to reach the speed of escape exists for entire segments of the population. But here I am presenting a story of success from the type “from rags to riches”, and I declare that this story is a myth. The term “meritocracy” was invented in 1958 to mock the very idea of ​​getting rewards for dignity. We forgot to laugh

It’s time we take a different attitude to poverty and take into account new scientific data describing it.

Take education. One of the most active researchers of the link between poverty and academic achievement, as well as subsequent economic problems, is Roland Fryer from Harvard. Together with his colleagues, he may not need the help of the whole village for this: increasing the achievements of the poor ”[ an allusion to the saying“ raising a child is necessary for the whole village ”, meaning that the child is raised by the entire local community - approx. trans. ] focused on reducing the difference in achievement between rich and poor, using a variety of schooling strategies.

But the standard measure of difference in achievement — progress in mathematics — is a symptom, not a cause. When support for social programs for schoolchildren ceases, their positive effect diminishes, and we become skeptical about the eradication of poverty. But academic success is not the main problem. The problem is uncertainty and stress. When the national assessment of educational progress in 2011 did not find a single city in America, where more than at least 25% of eighth-graders from black or Latin American families would have mastered and read at the level of their class, we should blame for this, or conclude that we lost in the neurobiological race even before we tested these children?


We must use the knowledge gained by science about poverty, and not ignore it. Poverty eradication programs, such as conditional cash benefits, reward parents or guardians for specific actions, such as tracking school attendance or preventing health. They encourage stress relief and long-term planning, and this goes far beyond just passing exams — they provide exactly the sense of confidence that the brain-afflicted brain needs. In a 2009 paper, Leah Fernald and Megan Ganer showed that such programs reduced cortisol levels in saliva and the risk of mental and physical illness throughout life [Fernald, LCH & Gunnar, MR . Social Science & Medicine 68, 2180-2189 (2009)]. There should be more such programs. For example, the so-called long-term care programs for a child: they are engaged in the development of children from birth and the first three years of their growth [in the United States, a federal law gives a mother the right to take unpaid maternity leave for 12 weeks, starting no earlier than 2 weeks before the expected date of birth, provided that the expectant mother has worked in the company for more than a year - approx. trans. ].

Our new scientific understanding of the effects of poverty can change the health care of adults. In 2009, Michael Mini, Gustavo Turetsky, Moishe Zif and their colleagues took samples of the hippocampus from suicide victims who had experienced child abuse, and tested DNA methylation that controls the expression of the NR3C1 gene. They found increased methylation in the promoter region of NR3C1, which other studies directly associated with a decrease in protein expression called neurotrophic brain factor(BDNF). BDNF is among the most active neurotrophic factors that drive the growth and development of new neurons even in adulthood. And the expression level can be inherited. In a 2015 study, a link was found between NR3C1 and a decrease in BDNF expression in infants whose mothers reported symptoms of prenatal depression [Braithwaite, EC, Kundakovic, M., Ramchandani, PG, Murphy, SE, & Champagne, FA Maternal prenatal depressive symptoms predict infant NR3C1 F and BDNF IV DNA methylation. Epigenetics 10, 408-417 (2015)].

It may be that BDNF is your best friend if you are an adult and want to change your neurobiology. It can open the way to a change in the structure of the brain in precisely those areas that have suffered the most from early stress and poverty: the prefrontal cortex, the hippocampus, and the entire hypothalamic-pituitary-adrenal axis. And these parts of the brain control long-term memory, emotions, and deferred rewards. All these are signs of people coping better with their studies in their youth and reaching more in maturity [Xu, X., et al. A significant association between the BDNF promoter methylation and the risk of drug addiction. Gene 584, 54-59 (2016)] [Kheirouri, S., Noorazar, SG, Alizadeh, M., & Dana-Alamdari, L. Elevated brain-derived neurotrophic factor correlates negatively with severity and duration of major depressive episodes. Cognitive and Behavioral Neurology 29, 24-31 (2016)]. Small doses of ketamine have an effect similar to fast antidepressants, and this is directly related to an increase in BDNF levels [Haile, CN, et al. Plasma brain derived neurotrophic factor (BDNF) and response to ketamine in treatment-resistant depression. International Journal of Neuropsychopharmacology 17, 331-336 (2014)].

I would try this treatment myself. But my main interest in the study of poverty is elsewhere. It stems from anxiety about the future.

We are on the edge of a cliff and we urgently need to reconsider our understanding of poverty and inequality. Western neo-liberals tell us tales that if you work hard, then everything will be fine. And if nothing is formed, then the victim is blamed for everything, and they leave him no choice. Brexit, Le Pen and Hillary Clinton's defeat are examples of problems stemming from inequality and poverty. Already uncovered forks Piketty [ French economist who wrote a popular book about economic inequality in the US and Europe - approx. trans.], and the march of global turmoil can be stopped only by applying measures that oppose the speckled deck, which everyone who is born in poverty, including me, receives and hates.

I am sure that the Italian party “Five Stars Movement” this year will launch a referendum on secession from the EU, and that Marine Le Pen has every chance of winning the French election [ not won, but is going to participate in the parliamentary elections - approx. trans. ]. The EU can take the blame for the defeat of globalists and fall apart in two years.

Such trends are accelerated by the belief that the poor could not grasp the opportunities created by the globalized market. It is time to strangle this myth - and the emerging empirical scientific studies of poverty can help us in this if we give them the attention they deserve.

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