It’s Not Just About Bad Choices - NYTimes.com

"Too often, I believe, liberals deny that poverty is linked to bad choices. As Phillips and many other poor people acknowledge, of course, it is.

Self-destructive behaviors — dropping out of school, joining a gang, taking drugs, bearing children when one isn’t ready — compound poverty. Researchers have often found that very poor families worldwide spend more of their income on alcohol than on educating their children. And, in central Kenya, a government study published a few years ago found that men there, on average, spent more of their salaries on alcohol than on food.

Yet scholars are also learning to understand the roots of these behaviors, and they’re far more complicated than the conservative narrative of human weakness.

For starters, there is growing evidence that poverty and mental health problems are linked in complex, reinforcing ways. In the United States, a Gallup poll a few years ago found that people living in poverty were twice as likely to have been diagnosed with depression as other Americans. One study in 2010 found that 55 percent of American babies living in poverty in 2001 were raised by mothers showing signs of depression.

The journal JAMA Psychiatry last year estimated that millions of low-income Americans suffer from parasitic infections such as toxocariasis and toxoplasmosis that, in turn, are associated with cognitive impairment or mental health disorders.

“I estimate 12 million Americans living in poverty suffer from at least one neglected parasitic or tropical disease,” says Dr. Peter Hotez, the author of that study. “The media places so much emphasis on imaginary infectious disease threats, when millions of people in poverty, mostly people of color, have neglected infections that are almost completely ignored.”