From Frontiers in Neuroscience, this interesting article looks at the body of research investigating associations between socioeconomic status (SES) and brain development in children. Previous studies have found significant links between low SES and changes (deficits) in brain structure, especially in areas related to memory, executive control, and emotion. Brito and Noble review the studies examining links between structural brain development and SES disparities of the magnitude typically found in developing countries.

[The image above is from another study on the same basic topic.]

As a kind of short-hand summary of the article, the researchers found six key concepts:

KEY CONCEPT 1. Socioeconomic status (SES)
Refers to an individual's access to economic and social resources, as well as the benefits and social standing that come from these resources. Most often measured by educational attainment, income, or occupation.

KEY CONCEPT 2. Poverty
Comparison of a household's income with a threshold level of income that varies with family size and inflation. Households below the poverty threshold are considered “poor.” Households above this threshold are considered “not poor” even if the amount of money between “poor” and “not poor” is diminutive. Poverty guideline for a family of four in 2014 is $23,850.

KEY CONCEPT 3. Income-to-Needs
The ratio of total family income divided by the federal poverty level for a family of that size, in the year data were collected. A family living at the poverty line would have an income-to-needs of ratio of 1. In 2012, 20.4 million people reported an income below 50% of their poverty threshold, including 7.1 million children under the age of 18.

KEY CONCEPT 4. Cortical thickness
Defined in neuroimaging studies as the shortest distance between the white matter surface and pial gray matter surface.

KEY CONCEPT 5. Cortical volumes
The most commonly used outcome in studies of socioeconomic disparities in brain structure. Cortical volume is actually a composite of cortical thickness and surface area, two genetically and phenotypically distinct morphometric properties of the brain.

KEY CONCEPT 6. Surface area
The area of exposed cortical surface or convex hull area (CHA) and the area of cortex hidden in sulci.

Even though this article looks at income disparity in the developing countries, the United States has some of the greatest income disparities on the planet. You can bet this is having the same impact on our poorest children as they found in their review of the literature.

Full Citation:
Brito NH, and Noble KG. (2014, Sep 4). Socioeconomic status and structural brain development. Frontiers in Neuroscience; 8:276. doi: 10.3389/fnins.2014.00276

Socioeconomic status and structural brain development

Natalie H. Brito and Kimberly G. Noble

• Department of Pediatrics, Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA

Abstract

Recent advances in neuroimaging methods have made accessible new ways of disentangling the complex interplay between genetic and environmental factors that influence structural brain development. In recent years, research investigating associations between socioeconomic status (SES) and brain development have found significant links between SES and changes in brain structure, especially in areas related to memory, executive control, and emotion. This review focuses on studies examining links between structural brain development and SES disparities of the magnitude typically found in developing countries. We highlight how highly correlated measures of SES are differentially related to structural changes within the brain.

Introduction

Human development does not occur within a vacuum. The environmental contexts and social connections a person experiences throughout his or her lifetime significantly impact the development of both cognitive and social skills. The incorporation of neuroscience into topics more commonly associated with the social sciences, such as culture or socioeconomic status (SES), has led to an increased understanding of the mechanisms that underlie development across the lifespan. However, more research is necessary to disentangle the complexities surrounding early environmental variation and neural development. This review highlights studies examining links between structural brain development and SES disparities of the magnitude typically found in developing countries. We do not include studies examining children who have experienced extreme forms of early adversity, such as institutionalization or severe abuse. We also limit this review to findings concerning socioeconomic disparities in brain structure, as opposed to brain function.

KEY CONCEPT 1. Socioeconomic status (SES)

Refers to an individual's access to economic and social resources, as well as the benefits and social standing that come from these resources. Most often measured by educational attainment, income, or occupation.

SES is a multidimensional construct, combining objective factors such as an individual's (or parent's) education, occupation, and income (McLoyd, 1998). Neighborhood SES is also often considered (Leventhal and Brooks-Gunn, 2000), as are subjective measures of social status (Adler et al., 2000). In 2012, 46.5 million people in the United States (15%) lived below the official poverty line (United States Census Bureau, 2012) and numerous studies have reported socioeconomic disparities profoundly affecting physical health, mental well-being, and cognitive development (Anderson and Armstead, 1995; Brooks-Gunn and Duncan, 1997; McLoyd, 1998; Evans, 2006). In turn, SES accounts for approximately 20% of the variance in childhood IQ (Gottfried et al., 2003) and it has been estimated that by age five, chronic poverty is associated with a 6- to 13-point IQ reduction (Brooks-Gunn and Duncan, 1997; Smith et al., 1997). Disparities in cognitive development outweigh disparities in physical health, possibly contributing to the propagation of poverty across generations (Duncan et al., 1998).

KEY CONCEPT 2. Poverty

Comparison of a household's income with a threshold level of income that varies with family size and inflation. Households below the poverty threshold are considered “poor.” Households above this threshold are considered “not poor” even if the amount of money between “poor” and “not poor” is diminutive. Poverty guideline for a family of four in 2014 is $23,850.

Evidence suggests multiple possible, and non-mutually-exclusive, explanations for these findings. Socioeconomically disadvantaged children tend to experience less linguistic, social, and cognitive stimulation from their caregivers and home environments than children from higher SES homes (Hart and Risley, 1995; Bradley et al., 2001; Bradley and Corwyn, 2002; Rowe and Goldin-Meadow, 2009). Additionally, individuals from lower SES homes report more stressful events during their lifetime, and the biological response to stressors has been hypothesized as one of the underlying mechanisms for health and cognitive disparities in relation to SES (Anderson and Armstead, 1995; Hackman and Farah, 2009; Noble et al., 2012a).

In turn, these experiential differences are likely to have relatively specific downstream effects on particular brain structures (see Figure 1 for one theoretical model). For example, disparities in the quantity and quality of linguistic stimulation in the home have been associated with developmental differences in language-supporting cortical regions in the left hemisphere (Kuhl et al., 2003; Conboy and Kuhl, 2007; Kuhl, 2007). In contrast, the experience of stress has important negative effects on the hippocampus (Buss et al., 2007; McEwen and Gianaros, 2010; Tottenham and Sheridan, 2010), the amygdala (McEwen and Gianaros, 2010; Tottenham and Sheridan, 2010), and areas of the prefrontal cortex (Liston et al., 2009; McEwen and Gianaros, 2010)—structures which are linked together anatomically and functionally (McEwen and Gianaros, 2010). As discussed below, different components of SES may differentially relate to these varying experiences, and thus may have varying associations with particular structures across the brain.

FIGURE 1

Figure 1. Hypothesized mechanisms by which SES operates to influence structural and functional brain development.

Measures of parental SES are often used as indicators of children's family or home conditions, but these distal measures may not fully account for children's experiences. For example, while a parent may be highly educated, unforeseen circumstances, such as a recession, may cause short- or long-term unemployment and inadequate income, leading to reduced resources and increased family stress experienced by the child. Studies examining an individual's own SES may more accurately represent the individual's current experience during adulthood, but may possibly discount the environmental experiences that shaped neural development as a child. Some studies have included measures of both childhood and adult SES (see Table 1), attempting to obtain a complete measure of SES development, but retrospective SES relies on the individual's memory of past events, and therefore may be biased. Overall, accurate and complete measures of SES are often difficult to obtain and these complications render it difficult to disentangle precise associations between specific socioeconomic indicators and outcomes of interest. Despite this, even approximate assessments of SES have, across multiple independent laboratories, been shown to predict clinically and statistically significant differences in brain structure and function, signifying the prominent association between environmental factors and brain development.

TABLE 1

Table 1. Studies reporting on associations between SES and structural brain development. [click link for full-size image]

SES Variables Reported in Structural Imaging Studies

Although many studies have reported a high degree of correlation between various components of SES, different socioeconomic factors reflect different aspects of experience and should not be used interchangeably (Duncan and Magnuson, 2012). For example, families with greater economic resources may be better able to purchase more nutritious foods, provide more enriched home learning environments, or afford higher-quality child care settings or safer neighborhoods. In contrast, parental education may influence children's development by shaping the quality of parent–child interactions (Duncan and Magnuson, 2012). The notion that these SES components might differentially influence development is supported by the neuroscience literature, in which whole-brain structural analyses (Lange et al., 2010; Jednoróg et al., 2012) and studies with a priori testing of regions of interest (Hanson et al., 2011; Noble et al., 2012a; Luby et al., 2013) have indicated that different SES components may be associated with different brain structural attributes. Additionally, SES disparities tend not to be global, but rather, are disproportionately associated with differences in the structures of the hippocampus, amygdala, and the prefrontal cortex (see Table 1).

Income

Household or family income is usually calculated as the sum of total income, typically measured monthly or annually. Although income can be considered a continuous variable, many studies ask participants to select what category of income they fall into. For example, a participant may indicate that they earn between $30,000 and $60,000 dollars per year, and researchers often take the midpoint of the participant's estimate (i.e., $45,000), thereby reducing variability between participants. Income is one of the more volatile of the SES markers, as family circumstances frequently fluctuate across time, resulting in varying levels of income throughout childhood and adolescence (Duncan, 1988; Duncan and Magnuson, 2012). Income-to-Needs (ITN) is a similar marker of SES, in which total family income is divided by the official poverty threshold for a family of that size. Hanson et al. (2011); Noble et al. (2012a) and Luby et al. (2013) all find significant positive correlations between income/ITN and hippocampal size, with children and adolescents from lower SES families having smaller hippocampal volumes. Examining income-related differences in amygdala volumes, we find some discrepancies across studies. While both Hanson et al. (2011) and Noble et al. (2012a) find no association between income/ITN and amygdala volume, Luby et al. (2013) report a significant positive correlation, where children from lower income homes also have smaller amygdala volumes. The families in the latter study reported lower family income than the families in the other two studies; thus it may be possible that, unlike the hippocampus, substantial income insufficiency is necessary to observe structural differences in amygdala volumes.

KEY CONCEPT 3. Income-to-Needs

The ratio of total family income divided by the federal poverty level for a family of that size, in the year data were collected. A family living at the poverty line would have an income-to-needs of ratio of 1. In 2012, 20.4 million people reported an income below 50% of their poverty threshold, including 7.1 million children under the age of 18.

Education

Parental education or educational attainment is usually measured by participants reporting their highest level (or their parents' highest levels) of education (e.g., college degree). While family income has been associated with resources available to the family and levels of environmental stress (Evans and English, 2002), parental education has been more closely linked to cognitive stimulation in the home (Hoff-Ginsberg and Tardif, 1995). Compared to parents with lower levels of education, parents with higher levels of education tend to spend more time with their children (Guryan et al., 2008), use more varied and complex language (Hart and Risley, 1995; Hoff, 2003), and engage in parenting practices that promote socioemotional development (Duncan et al., 1994; McLoyd, 1997; Bradley and Corwyn, 2002). Again, like income/ITN, we find some inconsistencies across studies when examining links between parental education and children's brain structure. Luby et al. (2013) and Noble et al. (2012a) find no significant correlations between parental education (measured as the average or highest level of education of any parents or guardians living in the home) and hippocampal volumes. Hanson et al. (2011) report a significant association between right hippocampal volumes and paternal, but not maternal, education levels. There are differences across studies in reported amygdala volumes as well. Whereas Noble et al. (2012a) find a negative correlation between parental education and amygdala volumes, Luby et al. (2013) and Hanson et al. (2011) find no association. These differences may be due in part to how parental education was measured (average parental education vs. separate indicators for mothers and fathers) and/or how parental education was coded (continuously vs. categorically).

Examining the relation between brain structure and one's own educational attainment in adulthood (as opposed to parental education), both Gianaros et al. (2012) and Piras et al. (2011) found positive associations between educational attainment and increases in white matter integrity using diffusion tensor imaging (indexed by increases in fractional anisotropy and decreases in mean diffusivity, respectively). Whereas Gianaros and colleagues found widespread associations, Piras and colleagues found that, once controlling for age, only microstructural changes in the hippocampi significantly correlated with educational attainment. Noble et al. (2012b) also found no simple correlation between reported educational attainment and either hippocampal or amygdala volumes in adulthood. Educational attainment did, however, moderate the association between age and hippocampal volume. Specifically, as has been reported previously, age was quadratically related to hippocampal volume, with the volume of this structure tending to increase until approximately the age of 30, at which point volume starts to decline (Grieve et al., 2011). Although this quadratic relation between hippocampal volume and age was present across the entire sample, the volumetric reduction seen at older ages was more pronounced among less educated individuals, and was buffered among more highly educated individuals. Differences in hippocampal structure between higher and lower educated individuals may therefore be most apparent in the later stages of the lifespan.

Occupation

Occupations generally reflect education, earnings, and prestige (Jencks et al., 1988), and have been extensively studied as an important aspect of SES as they are directly related to both education and income. Chiang et al. (2011) found that occupational status, measured using the Australian Socioeconomic Index (SEI), a 0–100 scale based on an individual's occupational category, was not related to white matter integrity. However, the authors did find an interaction between occupational status and white matter integrity, controlling for subjects' age and sex. Specifically, higher SEI was associated with higher heritability white matter integrity in the thalamus, left middle temporal gyrus, and callosal splenium.

SES Composite Measures

Some studies have combined different SES markers to create average or composite measures. Cavanagh et al. (2013) used indicators of early life SES (number of siblings, number of people per room, paternal social class, parental housing tenure, and use of car by family) and current SES (current income, current social class, and current housing tenure) to predict cerebellar gray matter volume. Both composite measures positively predicted cerebellar structure, where current SES explained significant additional variance to early life SES, but not vice-versa. Staff et al. (2012) also measured both childhood SES (indexed by paternal education and childhood home conditions) as well as adult SES (indexed by the individual's educational attainment, occupational status, and neighborhood deprivation). These authors reported a significant association between hippocampal volume and childhood SES, after adjusting for the individual's SES as an adult more than 50 years later. These results may suggest that early life conditions may have an effect on structural brain development over and above conditions later in life.

The Hollingshead scale (Hollingshead, 1975) is a commonly used measure of SES, which combines occupation and education (Two-Factor Index) or occupation, education, marital status, and employment status (Four-Factor Index). Duncan and Magnuson (2003) have argued that aggregating these SES measures is faulty as fluctuations within each measure of SES differentially affect parenting and child developmental outcomes. Imaging studies using these composite measures of SES have found significant correlations between composite scores and regions in the medial temporal lobe and frontal lobe (Raizada et al., 2008; Jednoróg et al., 2012), but without knowing associations to specific SES markers, it is difficult to compare these studies with other structural imaging studies.

Neighborhood SES

Of note, SES can describe a single participant, the participant's family or even the participant's neighborhood. The neighborhood context is associated with various health outcomes (Pickett and Pearl, 2001) as it is another source of potential exposure to stressors (e.g., violence) or protection from them (e.g., community resources, social support). Some studies have found correlations between neighborhood disadvantage and cognitive outcomes independent of individual level SES (Wight et al., 2006; Sampson et al., 2008), whereas others have not (Hackman et al., 2014). Studies examining neighborhood SES and brain structure have also had mixed findings. Gianaros et al. (2007, 2012) have used census tract level data (median household income, percentage of adults with college degrees or higher, proportion of households below federal poverty line, and single mother households) to create composite indicators of community SES. Although community SES was not associated with total brain volume or gray matter volumes in regions of interest (Gianaros et al., 2007), community SES was positively associated with white matter integrity independent of self-reported levels of stress and depressive symptoms (Gianaros et al., 2012). Similarly, Krishnadas et al. (2013) found that neighborhood SES, indexed using the Scottish Index of Multiple Deprivation, was related to cortical thickness, with men living in more disadvantaged areas demonstrating more cortical thinning in areas that support language function (bilateral perisylvian cortices) than men living in more advantaged areas.

KEY CONCEPT 4. Cortical thickness

Defined in neuroimaging studies as the shortest distance between the white matter surface and pial gray matter surface.

Subjective Social Status

Finally, subjective social status is another marker of SES used in some research. In these studies, participants are typically asked to indicate on a drawing of a ladder where they believe they rank in terms of social standing among a particular group. In past studies, lower social ladder standings have been correlated with negative physical and mental health outcomes (Adler et al., 2000; Kopp et al., 2004; Hu et al., 2005), even after accounting for objective measures of education, income, and potential reporting biases (Adler et al., 1994). Gianaros et al. (2007) found that subjective social status was not correlated with hippocampal or amygdala volumes, but was significantly associated with reduced gray matter volume in the perigenual area of the anterior cingulate cortex (pACC). This finding may be understood by recognizing that the pACC is a region in the brain involved in experiencing emotions and regulating behavioral and physiological reactivity to stress. Measures of subjective social status may not take into account objective measures of SES, but relate more to the individual's experience of disadvantage.

Words of Caution in Selecting SES Variables

Collecting and utilizing multiple independent measures of SES is necessary to accurately assess structural brain changes throughout development. SES is too complex to be captured by a single indicator or even a composite measure. Each measure of SES is its own distinct construct with varying associations with experience and cognitive development. However, while SES variables are not interchangeable, they are nonetheless highly correlated. It is therefore essential to avoid model multicollinearity in statistical analyses. This may be accomplished by first carefully considering which variables are most appropriate for testing particular hypotheses, and then confirming low variance inflation factors (VIF) within the model. Increasing sample size, centering variables, and utilizing residuals are additional methods to avoid inappropriate analysis and interpretation.

As a final word of caution, many of the SES indicators referenced above are based on studies completed in Western countries. Further work will be necessary to explore the generalizability of findings across different countries and cultures (Minujin et al., 2006; Lipina et al., 2011).

Covariates, Mediators, and Moderators

When examining SES disparities in brain structural development, additional demographic factors must be considered as well. First and foremost, the age of the participant must be taken into account, as brain structural volumes change significantly across childhood and adolescence (Paus et al., 1999; Lenroot and Giedd, 2006). Further, the timing of volumetric growth and reductions vary across different brain structures (Grieve et al., 2011). Inconsistencies in results across studies highlighted above may therefore be due to variability in the age ranges of the samples studied. Caution is advised when generalizing results reported within a narrow-age-range sample, as SES disparities in brain structure may vary substantially as a function of age.

Several studies include relatively wide age ranges, recruiting, for example, both children and adolescents in their imaging samples (Lange et al., 2010; Hanson et al., 2011; Noble et al., 2012a; Lawson et al., 2013). Two additional studies have taken a lifespan approach to examining SES and structural brain development (Piras et al., 2011; Noble et al., 2012b). Incorporating wide age ranges into a study allows researchers to consider whether results vary as a function of participant age. For example, both Noble et al. (2012b) and Piras et al. (2011) examine associations between subcortical structures and educational attainment in a wide age range of participants. Piras et al. (2011) found that microstructural changes in the hippocampus, but not changes in gross volume in this structure, were significantly predicted by education levels. However, due to a large negative correlation between education and age, the decreases in microstructure may have been more closely related to older age than greater education. As discussed above, Noble et al. (2012b) reported that higher levels of educational attainment buffered against age-related reductions in hippocampal volume, signifying that the association between age and hippocampal volume is not constant across all levels of education. Of course, distinctions between development and decline are, in some respects, arbitrary, and may be more appropriately classified according to functional rather than structural measures.

Sex is another important demographic characteristic to consider. Volumetric variation in brain structures increase within and between males and females during puberty (Sowell et al., 2003). Sex differences have been reported for cortical thickness. Using a longitudinal sample of participants ages 9–22 years, Raznahan et al. (2010) observed differences in cortical maturation, with males demonstrating a thicker cortex in frontopolar regions at younger ages and subsequent greater cortical thinning than females during adolescence. It has also been reported that females demonstrate more rapid cortical thinning than males in specific cortical areas (right temporal, left temporoparietal junction, and left orbitofrontal cortex) corresponding to the “social brain” (Mutlu et al., 2013). It will be important in future work to better understand how the links between SES variables and structural brain development may vary by sex, and/or a combination of sex and age.

In addition, studies have reported that families living in chronic poverty have differential outcomes based on when and for how long poverty was experienced (National Institute of Child Health and Human Development Early Child Care Research Network, 2005). While the brain is most malleable in early childhood, it nonetheless retains a substantial degree of plasticity throughout the lifespan, and the extent to which the timing and duration of socioeconomic disadvantage are associated with brain structural differences is virtually unexplored in the neuroscience literature to date.

Finally, it is important to consider environmental exposures and experiences that may account for links between distal socioeconomic factors and brain structural differences. For example, Luby et al. (2013) recently reported that links between income and hippocampal volume were mediated by caregiving support/hostility and stressful life events. Of course, there are many potential experiential correlates of SES that have not been well studied in the context of SES disparities in brain development, including nutrition, exposure to environmental toxins, safety of the play environment, or quality of the child's linguistic environment. In order to develop interventions that effectively target the SES gap in achievement, it will be essential to try to understand the particular component(s) of the environment that are most influential in explaining disparities.

Volume vs. Cortical Thickness/Surface Area

Differences in findings across studies may also be accounted for by the techniques used to measure morphometry. Most studies examining SES differences in brain structure have reported cortical volumes as their outcome of interest (but see Jednoróg et al., 2012; Liu et al., 2012; Krishnadas et al., 2013; Lawson et al., 2013). However, cortical volume is a composite measure that is determined by the product of surface area and cortical thickness, two genetically and phenotypically independent structures (Panizzon et al., 2009; Raznahan et al., 2011). Though the cellular mechanisms are not fully understood, it has been hypothesized that symmetrical cell division in the neural stem cell pool contribute to exponential increase in the number of radial columns that result in surface area, without changes to cortical thickness. In contrast, asymmetrical cell division in founder cells is independently responsible for a linear increase in the number of neurons in the radial column, leading to changes in cortical thickness but not surface area (Rakic, 2009). As such, these two properties of the cortical sheet develop differentially; cortical surface area tends to expand through childhood and early adolescence and decrease in adulthood, whereas cortical thickness tends to decrease rapidly in childhood and early adolescence, followed by a more gradual thinning and ultimately plateauing (Schnack et al., 2014). Cortical thinning is related to both synaptic pruning and increases in white matter myelination, resulting in a reduction of gray matter as measured on MRI (Sowell et al., 2003). These maturational changes occur concurrently and together contribute to the development of the mature human brain.

KEY CONCEPT 5. Cortical volumes

The most commonly used outcome in studies of socioeconomic disparities in brain structure. Cortical volume is actually a composite of cortical thickness and surface area, two genetically and phenotypically distinct morphometric properties of the brain.

KEY CONCEPT 6. Surface area

The area of exposed cortical surface or convex hull area (CHA) and the area of cortex hidden in sulci.

Thus, studies in which the dependent measure is cortical volume may not adequately reflect the complexities of morphometric brain development. Indeed, cross-sectional comparisons of cortical volume are poor indicators of brain maturation (Giedd and Rapoport, 2010), whereas cortical thickness has been shown to be a more meaningful index of brain development (Sowell et al., 2004; Paus, 2005) and has been associated with both cognitive ability (Porter et al., 2011) and behavior (Shaw et al., 2011). For example, IQ has been correlated with the trajectory of cortical thickness, such that, during childhood, more intelligent children have thinner cortices than children with lower IQ, with this association strengthening through adolescence. In contrast, by middle adulthood, a thicker cortex is related to higher IQ (Schnack et al., 2014). Importantly, IQ has also been independently correlated with the trajectory of surface area development, such that more intelligent children exhibit greater surface area during childhood, though surface area expansion is completed earlier and then decreases more quickly in more intelligent adults (Schnack et al., 2014). Together, these findings suggest that both surface area and cortical thickness may be critical in accounting for individual differences in cognitive abilities, and that these factors must be considered independently rather than lumping them into a single composite measure of cortical volume.

In summary, when considering associations between experience and brain morphometry, cortical thickness and surface area should be assessed separately, rather than reporting on the composite metric of cortical volume (Winkler et al., 2010; Raznahan et al., 2011). Research investigating cortical complexity and its association with SES variables will be vital to further understanding how environmental influences over the life course influence structural brain development.

Conclusions

Children living in socioeconomic disadvantage are more likely to experience cognitive delays and emotional problems (Brooks-Gunn and Duncan, 1997), but the underlying causal pathways between disadvantage and developmental outcomes are not clear. The nascent field of socioeconomic disparities in brain structure is an exciting one, which holds promise in helping to understand this question. However, while progress has been made in understanding how socioeconomic disparities may affect brain development, there are many avenues for further research. Careful social science approaches to assessing individual socioeconomic factors must be combined with cutting-edge neuroscientific approaches to measuring precise aspects of brain morphometry. Consideration of how results interact with demographic factors such as age and sex are critical. Differences in exposures and experiences that may mediate socioeconomic disparities in brain development must be rigorously assessed to help identify or confirm underlying mechanisms.

Although this review has focused on SES disparities in brain structure as opposed to function, it is readily acknowledged that the two approaches are complementary. While a structural approach lends itself to greater spatial resolution as well as, arguably, more precision in understanding proximal experience-dependent mechanisms, it is limited in terms of functional interpretations. Ultimately, linking both structural and functional imaging to cognitive outcomes is essential for examining associations between anatomy, physiology, and behavior. Brain structural measures can be viewed as mediators between SES and cognition, or as outcome variables in their own right; having clear theoretical pathways ensures accurate interpretation of results and implications, and will help inform the design of effective policies, emphasizing early and targeted interventions.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgment

The authors are grateful for funding from the Robert Wood Johnson Foundation Health and Society Scholars program and the GH Sergievsky Center.

References at the Frontiers site

Author Biography

 
Natalie H. Brito, is a Robert Wood Johnson Health and Society Scholar at Columbia University. She received her PhD in Psychology with a concentration in Human Development and Public Policy from Georgetown University. Dr. Brito's research focuses on how early environmental variations shape the trajectory of cognitive development. She has published work examining multiple language exposure and memory development. Currently, she is connecting her previous work in bilingualism with research into socioeconomic disparities.

 
Kimberly G. Noble, is a developmental cognitive neuroscientist and pediatrician in the Department of Pediatrics and the G.H. Sergievsky Center at Columbia University. She received her undergraduate, graduate, and medical degrees from the University of Pennsylvania, and completed post-doctoral training at the Sackler Institute for Developmental Psychobiology at Weill Cornell Medical College. Dr. Noble's research focuses on socioeconomic disparities in child neurocognitive development. She is interested in understanding the time course with which socioeconomic disparities in brain development emerge, the mechanisms via which exposures and experiences contribute to specific neurocognitive outcomes, and in applying this knowledge to the development of public health-focused interventional strategies.

Inequality Begins at Birth by Jeff Madrick (NYRB)

Yes. Yes, it does.

This article comes from The New York Review of Books - in essence, this article is about the battle for universal early education in America, and an argument in its favor. The argument is based on relatively recent "biological evidence that a high-stress environment for very young children does not simply affect cultural and psychological conditions that predispose the poor to failure; it can also affect the architecture of the brain, changing the actual neurological functioning and quantity of brain matter."

If we want to reduce poverty and violence in this country, it starts with early education and improved conditions for our children.

Inequality Begins at Birth

Jeff Madrick
June 26, 2014


Alex Webb/Magnum Photos - Mound Bayou, Mississippi, 1976
Over the past year, the lack of universal pre-kindergarten for American four-year-olds has become a national issue. In 2013, President Obama proposed to fund an ambitious new nationwide pre-kindergarten program through a new cigarette tax. That plan failed to gain support, but Bill de Blasio gave new urgency to the issue when he swept into the New York mayor’s office promising universal pre-K for all city children—which will begin in the fall. Even as these efforts are being made, however, new research is making it increasingly clear that educational disparities start much earlier.

The value of universal access to early education has long been recognized: it improves the life chances of disadvantaged children and is crucial to keeping a level playing field for all. The United States has fallen well short of this goal. In most of Europe there is universal, good-quality preschool for three- and four-year-olds. In America, recent data show that fewer than half of all three- and four-year olds are enrolled in some form of preschool. Head Start, the main federal program, provides preschool funding for only about two fifths of poor children in this group.

Moreover, America has the second highest child poverty rate out of the thirty-five nations measured by the United Nation Children’s Fund (only Romania is worse). Twenty-three percent of American kids are poor by international standards, compared to 10 percent in the UK and 7 or 8 percent in the Nordic countries. According to studies on the US population, the poorest children are those five and under—indeed, they are the poorest demographic group in the nation. Many of these kids live in deep poverty, with family income less than half of the poverty line. Poverty rates for black and Latino children are especially high.

Scholars have long documented that children who grow up poor face greater obstacles to social development and good health, obstacles that often remain with them the rest of their lives. They are more likely to have chronic diseases like asthma or attention deficit disorder, few of them graduate from high school, their wages are lower, and they often end up on welfare. Poor teenage women have more unwanted births.

But neurological evidence from recent years strongly suggests that the causes of these poor outcomes are neither solely cultural nor a function of a weak gene pool, as commentators like Charles Murray, author of The Bell Curve, once claimed. As Dr. David Keller made clear at a recent conference on child poverty in Washington, D.C. called “Inequality Begins at Birth” (primarily sponsored by the think tank I direct, The Bernard L. Schwartz Rediscovering Government Initiative at the Century Foundation), there is new biological evidence that a high-stress environment for very young children does not simply affect cultural and psychological conditions that predispose the poor to failure; it can also affect the architecture of the brain, changing the actual neurological functioning and quantity of brain matter.

In other words, pre-K is not enough. What is concerning, moreover, is that these findings have been known for some time but are not getting adequate attention. In fact, the original documentation was published back in 2000 in a vanguard article by Harvard’s Center on the Development of the Child, and corroborating studies have multiplied since then.

Indeed, two studies completed in 2013 relate neural deterioration directly to poverty. A group of researchers from six universities measured the brain activity of adults who had been poor at age nine and found that the areas that control emotions were physically underdeveloped. A Washington University study found that poor children who are nurtured adequately, thus avoiding constant stress, usually have normally developed brain tissue, while those with less nurturing have less white and grey matter and smaller control centers, such as the hippocampus.

What’s been discovered is that human beings have a chemical reaction to stress that at first protects them from damage. But the defense is limited. Should a young child, whose brain is still forming, be bombarded by constant stress—from violence at home, lack of food, parental drug abuse, and, not least, chronic lack of attention or nurturing—the overloaded mechanism fails and the brain is adversely affected.

Dr. Jack P. Shonkoff, who runs Harvard’s Center on the Developing Child, has produced numerous articles with colleagues describing the result of studies on animals and, increasingly, on children. Under stress, the body produces two hormones that are protective, adrenaline and cortisol. But when stress becomes excessive—what the field now describes as “toxic stress”—the excessive hormonal activity damages neural connections, undermines immune responses, and changes the parts of the brain that directly affect memory, learning, and emotional control.

These studies generally concur that persistent neglect and inadequate nurturing are primary causes of brain deterioration. Evidence based on a wide variety of studies of children, including children in foster care around the world, clearly shows, usually with the use of MRIs, the detrimental consequences for neural connections and brain size of seriously inadequate nurturing.

Sociological research, in turn, shows how common child neglect is among the poor. Poor parents are fraught with anxieties about providing adequate food and transportation, and often the safety of their communities and the stability of their families. Some may simply be irresponsible, or use drugs, but numerous ethnographies of the poor, by the Children’s Defense Fund, independent scholars, and others, show that these parents, including single mothers, care about their children as much as parents of greater means. The issue is rather that they often can’t get jobs that allow time for them to spend with their children and lack the resources, time, or freedom from anxieties to cope. Studies also show that the quality of prenatal care can affect early childhood development and that pregnant women on drugs or in depression can also affect the newborn child’s neurological growth.

What is most fascinating about the recent discoveries is that they split the difference between those who put the onus on the gene pool, like disciples of Murray, and those who put it on culture. Genes do in fact matter, it turns out, but the parental and cultural environment, researchers find, can improve neural capacities or prevent deterioration. Dr. Keller, an MD and researcher, is president of the Academic Pediatric Association. As he puts it, “the new research is not pure Darwin, there is a bit of Lamarck here.”

Medical and science professionals now virtually all agree that the earlier a positive intervention is made in a child’s life—including home visitations by professionals, parent counseling, treatment for substance abuse, and relatively new programs, such as reading to toddlers even before they have language skills—the better. Pediatricians, including the giant American Academy of Pediatrics, are developing plans to use pediatric visits as a platform for more extensive intervention when undue stress is evident. One favorite program is a free book with every shot.

What concerns me most, however, is that our political leaders and legislators have until now largely overlooked the connection between poverty, poor educational attainment, and even neural malfunctions—and the extent to which effective poverty reduction itself can correct the problem. Economists Janet Gornick and Markus Jantii analyzed data across nations and concluded that child poverty is far lower in European nations, not because their economy produces higher wages for lower income workers, but because of more robust social programs. Most of these nations, and many in Latin America, for example, provide direct cash allowances for parents with children.

More and better paying jobs are vital to combating child poverty and the problems it leads to. A full employment economy, with good jobs, is still possible with substantial fiscal stimulus, especially including public investment in infrastructure.

But social programs are critical. Contrary to the widespread cynicism about social programs and welfare, the US knows how to reduce poverty. As Robert Greenstein of the Center for Budget and Policy Priorities notes, the federal safety net, including Medicaid, Food Stamps, the Earned Income Tax Credit, and the Child Tax Credit, kept 41 million people out of poverty in 2012, including 9 million children. Without government benefits, today’s poverty rate would be 29 percent. Instead, using the best measures of poverty, which include government transfers and tax credits, the rate has dropped from about 26 percent in the late 1960s to 16 percent today. In other words, the War on Poverty begun in the 1960s worked.

But amid growing inequality between the very rich and the rest of society and decreasing social mobility at all levels, the challenge for low-income Americans is great. Our current general poverty rates—especially among young children—are still dangerously high. Particularly disturbing, child poverty rates, after rising during the recession, have not fallen in the recent economic recovery.

I’d begin a new war on child poverty by developing a federal system of cash allowance to poor families with children, as so much of the world now does. Now, aid is mostly limited to purchases of food or dependent on getting a job, which for many in this group these days is especially hard. But in a political environment in which Congress seeks even to cut back food stamps, persuading our legislators of the moral and economic good sense of direct cash outlays will take a great deal of work.

The research is now undeniable. Inequality in America begins at birth, or, for those born to women who are ill during pregnancy or do not have adequate prenatal care, even before. Through no fault of their own, up to one quarter of American children start off well behind, and another quarter live in families that earn only twice the poverty line—about $48,000 a year for a family of four. Armed with the unambiguous findings of twenty-first-century neuroscience, we can no longer just tell children raised poor to study harder and find jobs as they grow up. A nation that needs all its citizens to be productive workers, and that promises a fair and dignified life to all, regardless of race or color, must now turn its attention to its enormous pool of poor children.

How Trauma Affects The Brain Of A Learner (NPR)

From NPR and KPCC Public Radio in Southern California, this is an excellent set of articles on how to change the way we teach children such that we acknowledge the impact trauma has on learning.

It's great to see that happening - it needs to be something that happens everywhere there is poverty and violence - it's the children in those communities who suffer most.

How Trauma Affects The Brain Of A Learner

by Anya Kamenetz

June 15, 2014 

 

Chronic stress can cause deficiencies in the pre-frontal cortex, which is essential for learning.

  
Our public media colleagues over at KPCC, Southern California Public Radio, have a fascinating  two-part report on the efforts of schools in the Los Angeles area to address the effects of "toxic stress" on student learning.

"As researchers work to solve one of the most persistent problems in public education – why kids in poor neighborhoods fail so much more often than their upper-income peers – more and more they're pointing the finger at what happens outside the classroom.

Shootings. Food insecurity. Sirens and fights in the night. Experts are finding that those stressors build up, creating emotional problems and changes in the brain that can undermine even the clearest lessons."

Eighty percent of the students in the Los Angeles Unified School District are in poverty. Scientists are zeroing in on how it can affect their developing brains.

"Studies show chronic stress can change the chemical and physical structures of the brain.

'You see deficits in your ability to regulate emotions in adaptive ways as a result of stress,'said Dr. Cara Wellman, a professor of neuroscience and psychology at Indiana University.

Dendrites, which look like microscopic fingers, stretch off each brain cell to catch information. Wellman's studies in mice show that chronic stress causes these fingers to shrink, changing the way the brain works. She found deficiencies in the pre-frontal cortex – the part of the brain needed to solve problems, which is crucial to learning.

Other researchers link chronic stress to a host of cognitive effects, including trouble with attention, concentration, memory and creativity."

Responding in part to this research, Camino Nuevo, a network of eight charter schools, dedicates resources to creating what it calls a "continuum of integrated support" for students. One fourth of students at the schools see counselors to help them build social and emotional skills. The schools hold group sessions for parents to help them deal with stress in their lives too, and employ full-time parent liasions to help families access health care, mental health, housing, legal, or immigration services. To pay for all this, the schools privately raise about $1.6 million in outside funds. They also tap into MediCal and work with private providers to integrate services right within the school.

Blanca Ruiz is a Mexican immigrant and single mother with a child, Luis, at a Camino Nuevo middle school.

"Since she started counseling at the school, Ruiz lost fifty pounds and saved money to buy a reliable car.

Last year, Ruiz moved her kids 15 miles east to a house in El Monte with a tiny porch and big lemon tree. But there was no way she was changing schools.

She still drives Luis to Camino Nuevo in MacArthur Park every day on her way to work. Sometimes she'll bring him a special treat of KFC for lunch...

Luis's sixth grade teacher, Sarah Wechsler, keeps a close eye on him. She tracks even the smallest details, like how often she encourages him. She wants to make sure positive reinforcements far outpace stern talk.

Wechsler said in the last year, she's seen Luis completely turn around and take ownership of his schoolwork."

At LAUSD public schools, it's a different story. Resource constraints mean just one percent of the school population can access mental health services. Read the rest of the series here.

Here is the remainder of the story linked to at the end of the NPR piece.

Teaching Through Trauma: How poverty affects kids' brains

Annie Gilbertson | June 2nd, 2014

Maya Sugarman/KPCC

Training in self control starts early at Camino Nuevo. Karina Rodriguez leads preschoolers through a motor skills exercise, asking them to start and stop based on musical cues. Students will be exposed to 14 years of curriculum designed to address academic and soft skills.

Teaching Through Trauma: the first in a series of stories on poverty in Los Angeles schools. Read Part Two here.

New research shows the mere fact of being poor can affect kids' brains, making it difficult for them to succeed in school.

Los Angeles public schools — where more than 80 percent of students live in poverty — illustrate the challenges for these students. Less than half of third graders in L.A. Unified read at grade level and 20 percent of students will have dropped out by senior year.

But researchers also offer hope. They said the right interventions can make a difference. And one school in MacArthur Park is battling biology by helping children with life as well as school — to growing success.

Children living in poor neighborhoods are more likely to suffer traumatic incidents, like witnessing or being the victims of shootings, parental neglect or abuse. They also struggle with pernicious daily stressors, including food or housing insecurity, overcrowding and overworked or underemployed, stressed-out parents.

Untreated, researchers have found these events compound, affecting many parts of the body. Studies show chronic stress can change the chemical and physical structures of the brain.

“You see deficits in your ability to regulate emotions in adaptive ways as a result of stress,” said Dr. Cara Wellman, a professor of neuroscience and psychology at Indiana University.

Dendrites, which look like microscopic fingers, stretch off each brain cell to catch information. Wellman’s studies in mice show that chronic stress causes these fingers to shrink, changing the way the brain works. She found deficiencies in the pre-frontal cortex – the part of the brain needed to solve problems, which is crucial to learning.

Other researchers link chronic stress to a host of cognitive effects, including trouble with attention, concentration, memory and creativity.

For students in many Los Angeles public schools, those chronic stressors are everywhere.

Growing up hearing gunshots

Take MacArthur Park, where Census surveys show the child poverty rate is double the California average. The neighborhood’s namesake grassy square is so crime-ridden that many parents refuse to let their children play outside.

The Los Angeles Police Department arrested 3,000 juveniles in the neighborhood in 2011 alone, the most recent data available. Most were for theft — but 14 were taken in on suspicion of homicide.

Kids here deal with parents being deported, siblings being locked up or social workers being called in to take kids away from neglectful or abusive parents. They often live in cramped, crowded apartments with two or more families.

Ana Ponce herself grew up an immigrant in MacArthur Park and thought: it’s time to change how a school tries to reach students.

“We had this understanding that we can not teach kids that are not ready to learn because they were preoccupied with all of the barriers they encountered on their way to school - or all of their fears they had leaving school,” she said.

In the early 2000s, Ponce joined the leadership of a small charter school called Camino Nuevo in her neighborhood. It has since grown to a network of eight schools.

A different approach

At a recent 7 a.m. meeting, Camino Nuevo elementary and middle school teachers clustered into groups, sounding a lot like social workers. Their task: to figure out how to “use positivity and relationships to reverse some of the negative effects of poverty.”

Sarah Wechsler reported a dramatic improvement in one of her students, whose mother was recently deported.

“We’ve loved him, and we’ve replaced his mom the best we can,” she said. “And he’s done all his work this week.”

Ponce said she sees the school’s job as improving the lives of students’ entire families.

Staff helps parents enroll younger siblings in preschool and hooks parents up with healthcare providers. School sites have a full-time parent liaison to provide referrals for those struggling with housing, employment or legal problems.

In group sessions, parents are taught how to participate in their children’s education and relate better to them.

 

Tracking wellbeing

Camino Nuevo’s teachers are trained to track not just academic progress but also overall wellbeing.

If academics slip, they offer reading or math tutoring. In the same way, when emotional or behavior issues bubble-up, a student is referred to a counselor to develop those equally vital emotional skills.

Most schools in L.A. Unified only provide counseling for the most serious mental disorders, targeting resources to the less than 1 percent of the student population – those diagnosed with a serious emotional disturbance. (Read more on this in the second part of our series.)

At Camino Nuevo, about one in four students receives one-on-one counseling or group interventions. They don’t just talk about their problems at home, but also learn how to process emotions and make better decisions.

“They need the place to - you know – detox, so to speak. To let go. To get all this out, and to learn about themselves,” said Gloria Delacruz-Quiroz, head of mental health at Camino Nuevo.

Research shows that not all children who experience trauma will struggle emotionally. Those who feel they have support from an adult seem to do better.

Ninety-seven percent of students at Camino graduate high school, compared to 68 percent district-wide, where the rate slips even further for Latino and low-income students.

To pay for it, the school taps MediCal, California’s version of Medicaid.

The charter school created a system where its own staff works alongside private counseling service providers - including the Los Angeles Childhood Development Center and Didi Hirsch Mental Health Services – right at the schools.

The services aren’t free. Camino Nuevo scrapes together $1.6 million to cover what the providers cannot, plus a smattering of other services school leaders term their "continuum of care," which include not just counseling but things like after school programs and field trips.

A single mother

Camino Nuevo’s Burlington middle school campus is around the corner from where Blanca Ruiz works long hours at a nail salon.

Since she came here from Mexico years ago, she often felt she was barely keeping it together. She was sharing an apartment with her two kids and several roommates. Sometimes the stress would overwhelm her kids.

“I’m a single mother who came here with very low self-esteem, very unfocused, and with severe economic problems,” she said in Spanish. “If I was insecure, my kids would feel the same way.”

Her son Luis acted out. He got bad grades. He refused to do what his mom said and that enraged her.

“She screams because I don’t want to listen to her,” he said.

In class, sometimes Luis would stare off at his desk, checked out; other times he’d become disruptive, start talking, get up and walk around. He expressed no interest in learning and made it difficult for other students in class to stay on task.

“Sometimes I forgot, or sometimes I would decide not to do my work,” he said flatly.

In fifth grade, he was sent to the principal’s office for ignoring his teacher’s instructions. The principal suspended him from school.

Written off?

Rather than write him off, the staff at Camino Nuevo got him to meet with a mental health counselor at the school. He also received tutoring everyday to catch up in math.

His mom went to the school’s group sessions for parents.

“I think it helped me because if you want to help your kid, you have to be emotionally stable, a clear mind and more positive,” she said.

Since she started counseling at the school, Ruiz lost fifty pounds and saved money to buy a reliable car.

Last year, Ruiz moved her kids 15 miles east to a house in El Monte with a tiny porch and big lemon tree. But there was no way she was changing schools.

She still drives Luis to Camino Nuevo in MacArthur Park every day on her way to work. Sometimes she’ll bring him a special treat of KFC for lunch.

A turnaround

Luis’s sixth grade teacher, Sarah Wechsler, keeps a close eye on him. She tracks even the smallest details, like how often she encourages him. She wants to make sure positive reinforcements far outpace stern talk.

Wechsler said in the last year, she’s seen Luis completely turn around and take ownership of his schoolwork.

“You want to be your own man, don’t you?” she said, smiling at Luis with encouragement.

Luis still has days where he feels unfocused, and Wechsler allows him to take breaks or move to another desk. On a recent school day, Luis chose the table facing a wall. Without distraction, he hunkered down to divide fractions.

As the school year was drawing to a close, evidence of Camino Nuevo’s work – and Luis’s - became evident in one unmistakable way: He finally reached grade level in math.

How does that make him feel?
“Proud,” he said.

Annie Gilbertson, Education Reporter
Follow @AnnieGilbertson on Twitter
More from Annie Gilbertson

CORRECTION: An earlier version of this story misidentified Ana Ponce as a founder of Camino Nuevo and misstated its current number of campuses. KPCC regrets the errors.
 

World's Richest People Meet, Muse On How To Spread The Wealth (NPR)

I heard this story on NPR's All Things Considered the other day coming home from work. I wasn't sure whether to be amazed or to laugh. Everyone sounds so authentic - it must have taken years for them to learn how to sound like that. But maybe I am just hyper-cynical (well, okay, there's no "maybe" about it), and maybe they really are trying to solve the horrendous wealth distribution issues we face today. But I doubt it.

They do have a catchy name, however, with the "inclusive capitalism" thing. Still, the 250 people in the room were worth a combined $30 trillion, roughly one-third of the total investable wealth in the world (like the top 1% of the 1%). It's hard to think they want to give up that power so that the other 99.9% can live safer, healthier, easier lives.

I would love to see these people embrace a compassionate capitalism, instilling some social and relational ethics into the capitalist model.

Below the NPR story is some information from the Inclusive Capitalism Initiative, including a link to their founding blueprint (i.e., mission statement).

World's Richest People Meet, Muse On How To Spread The Wealth

by Ari Shapiro
All Things Considered | May 27, 2014
3 min 49 sec

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Prince Charles talks to Lynn Forester de Rothschild (left), organizer of the Conference on Inclusive Capitalism, and Christine Lagarde, head of the International Monetary Fund, before Tuesday's conference. The 250 corporate and financial leaders who attended control some $30 trillion, about a third of the world's investable assets.
WPA Pool/Getty Images
Talk of economic mobility and the wealth gap is hardly new. From the Occupy movement to President Obama's re-election campaign, income inequality has been in the spotlight for years.

Even so, the "inclusive capitalism" conference in London on Tuesday broke new ground. Not because of the conversation, but because of the people having it.

The 250 people from around the world invited to attend this one-day conference do not represent "the 99 percent," or even the 1 percent. It's more like a tiny fraction of the 1 percent.

"We have $30 trillion of assets under management in the room," says conference organizer Lynn Forester de Rothschild, who runs E.L. Rothschild, a major investment firm she and her husband, of the storied Rothschild banking family, founded in 2003.

That amount — $30 trillion — is roughly one-third of the total investable wealth in the world. If money is power, then this is the most powerful group of people ever to focus on income inequality.

"If this bulk of capital decides that they are going to invest in companies that aren't only thinking about the short-term profit," says Rothschild, "then we will see corporate behavior change."

The titans of commerce and finance didn't necessarily fly to this meeting in London out of a sense of ethics or moral duty, though that may be a motivation for some. For many, says Rothschild, it's a sense of self-preservation. Capitalism appears to be under siege.

"It's true that the business of business is not to solve society's problems," she says. "But it is really dangerous for business when business is viewed as one of society's problems. And that is where we are today."

Prince Charles kicked off the morning's proceedings.

"What is so impressive about today's gathering is that every one of you, ladies and gentlemen, is so well-placed to take the kind of action needed to create a new form of inclusive capitalism," he told the conference.

Defining Inclusive Capitalism

That phrase, "inclusive capitalism," is deliberately broad. People talked about it as valuing long-term investment over short-term profits. Some mentioned environmental stewardship; others focused on treating workers well.

Christine Lagarde, who runs the International Monetary Fund, said it is a way to rebuild trust in the financial system.

"So the big question is, how can we restore and sustain trust?" she asked in her keynote speech. "First and foremost, by making sure that growth is more inclusive and that the rules of the road favor the many and not just the few."

She said this will be a hard slog, because there will be winners and losers, "and the likely losers are those who have the biggest voice, because they have the largest means."

Later in the day, the group heard speeches from former U.S. President Bill Clinton and Bank of England chief Mark Carney.

Critics suggest this may all be optics. The conference delegates didn't sign on to a specific action plan, or even publicly endorse a set of values.

"I suspect the return on investment in this conference is astonishingly low," says Scott Winship of the Manhattan Institute, a conservative-leaning think tank. "It sort of surprises me that you have a bunch of people in the investment community who view this as having a significant return on investment in some way, whether the return is in people patting them on the back and saying, 'Thanks for caring about us,' or in actual changes to policies."

Conference organizer Rothschild says there will be follow-up with all of the delegates, but she made a conscious decision not to ask for any commitments up front.

"Even for me," she says laughing, "I thought that would be a little pushy."

* * * * * * * * * *

Who we are

The Inclusive Capitalism Initiative (ICI) is a non-profit organisation that seeks practical ways to renew capitalism to make it an engine of economic opportunity and shared prosperity through the adoption of inclusive business practices.

The Initiative was originally conceptualised as The Henry Jackson Initiative for Inclusive Capitalism in 2011 by The Henry Jackson Society think-tank in response to the financial crisis, which highlighted the serious dislocations caused by developments in capitalism over the last 30 years: worldwide increases in income inequality, large-scale corporate and financial scandals and the fraying of public trust in business, historically high and persistent unemployment and short-term approaches to managing and owning companies.

Towards a More Inclusive Capitalism, the founding blueprint for the Initiative, was co-authored by a Task Force of British and American business leaders and senior policy makers. The Task Force was co-chaired by Dominic Barton, Global Managing Director, McKinsey & Company, and Lady Lynn Forester de Rothschild, CEO, E.L. Rothschild.
The Conference on Inclusive Capitalism: Building Value, Renewing Trust

The Conference on Inclusive Capitalism on 27 May 2014 has been created by The Inclusive Capitalism Initiative in order to bring together global leaders from the top institutional investors, asset managers, corporations, sovereign wealth funds and financial institutions to define concrete steps that all of modern capitalism’s stakeholders can take to renew trust and deliver better social and economic outcomes for all.