A sobering fact to consider: the likelihood that any of us will achieve a state of sustained well-being as adults is bounded quite early in life by factors entirely beyond our control. Where one is born, when, and to whom establishes guardrails for a path of development to which merit or effort contributes but modestly. Of all the disadvantageous contingencies to which one might be exposed in early life, poverty is among the most punishing. Its effects are known to be pervasive, long lasting, and protean in their manifestations.1,2 Those who start out life poor grow less well,3 are subject to more frequent and grave episodes of illness,4 attain lesser levels of academic advancement, experience cognitive challenges unlike their more fortunate counterparts,5 earn less money,6 acquire fewer assets, develop adult-onset chronic illnesses at higher rates,7 marry less often, and die earlier.8 Despite voluminous documentation of these associations, there is yet much that remains to be explained about the pathways through which poverty exerts these pernicious influences and, in particular, its impact on cognitive development. In this issue of Pediatrics , Hamadani and colleagues contribute to our understanding of this dynamic through their study of a cohort of children in rural Bangladesh.9 The authors enrolled 2853 singleton children born between May 2002 and December 2003 and collected data on their parents, their growth parameters over the succeeding 64 months, the material resources available to their families, and information about the richness of the environments in which they were … Address correspondence to Andrew D. Racine, MD, PhD, Montefiore Medical Center, 111 East 210th St, Bronx, NY 10467. E-mail: aracine{at}montefiore.org
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