Growing up poor has long been associated with reduced educational attainment and lower lifetime earnings. Some evidence also suggests a higher risk of depression, substance abuse and other diseases in adulthood. Even for those who manage to overcome humble beginnings, early-life poverty may leave a lasting mark, accelerating aging and increasing the risk of degenerative disease in adulthood.
Today, more than one in five American children live in poverty. How, if at all, to intervene is almost invariably a politically fraught question. Scientists interested in the link between poverty and mental health, however, often face a more fundamental problem: a relative dearth of experiments that test and compare potential interventions.
So when, in 1996, the Eastern Band of Cherokee Indians in North Carolina’s Great Smoky Mountains opened a casino, Jane Costello, an epidemiologist at Duke University Medical School, saw an opportunity. The tribe elected to distribute a proportion of the profits equally among its 8,000 members. Professor Costello wondered whether the extra money would change psychiatric outcomes among poor Cherokee families.
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