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Editorial
October 15, 2003

Poverty and Child Mental HealthNatural Experiments and Social Causation

Author Affiliations

Author Affiliation: Social, Genetic and Developmental Psychiatry Research Centre Institute of Psychiatry, King's College, London, England.

JAMA. 2003;290(15):2063-2064. doi:10.1001/jama.290.15.2063

Most social scientists have tended to assume that poverty predisposes to mental disorder, on the grounds that numerous studies have shown statistical associations between the two.1,2 However, as Costello et al3 point out in this issue of THE JOURNAL, causal inference is problematic in the absence of experimental evidence because of the crucial need to differentiate between social selection and social causation.4,5 In other words, does the statistical association reflect the tendency for individuals with mental disorder to drift into or remain in poverty, or does the experience of poverty itself predispose to mental disorder?

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