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E. Jane Costello, PhD, Gordon P. Keeler, MS and Adrian Angold, MRCPsych

The authors are with the Developmental Epidemiology Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.

Correspondence: Requests for reprints should be sent to E. Jane Costello, PhD, Center for Developmental Epidemiology, Box 3454, Duke University Medical Center, Durham, NC 27710 (e-mail: jcostell{at}psych.mc.duke.edu).

Objectives. This study examined the effect of poverty on the prevalence of psychiatric disorder in rural Black and White children.

Methods. A representative sample of 541 Black children and 379 White children aged 9 to 17 was drawn from 4 predominantly rural counties. Structured interviews with parents and children collected information on psychiatric disorders, absolute and relative poverty, and risk factors for psychiatric disorder.

Results. Three-month prevalence of psychiatric disorder was similar to that found in other community samples (20%). Federal criteria for poverty were met by 18% of the White and 52% of the Black families. Black and White children were exposed to equal numbers of risk factors overall, but the association between poverty and psychopathology was stronger for White children (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1, 4.2) than for Black children (OR = 1.5; 95% CI = 0.9, 2.6). Family history of mental illness, poor parenting, and residential instability mediated this association in both groups.

Conclusions. In this rural sample, poverty was only weakly associated with child psychiatric disorders. Risk factors for both racial/ethnic groups were family mental illness, multiple moves, lack of parental warmth, lax supervision, and harsh punishment.

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