為什么貧窮如疾病

By+Christian+H.Cooper

On paper alone you would never guess that I grew up poor and hungry. My most recent annual salary was over $700，000. I am a Truman National Security Fellow and a term member at the Council on Foreign Relations.1 My publisher has just released my latest book series on quantitative finance in worldwide distribution.

None of it feels like enough. I feel as though I am wired for a permanent state of fight or flight， waiting for the other shoe to drop.2 Ive chosen not to have children， partly because—despite any success—I still dont feel I have a safety net. If you knew me personally， you might get glimpses of stress， self-doubt， anxiety， and depression.

In my childhood， I spent a lot of my time pondering3 basic questions. Where will my next meal come from？ Will I have electricity tomorrow？ I became intimately acquainted with the embarrassment of my mom trying to hide our food stamps4 at the grocery store checkout. I remember panic setting in as early as age eight， at the prospect of a perpetual uncertainty about everything in life，5 from food to clothes to education. I knew that the life I was living couldnt be normal. Something was wrong with the tiny microcosm6 I was born into. I just wasnt sure what it was.

As an adult I thought Id figured that out. Id always thought my upbringing had made me wary and cautious， in a “lessons learned” kind of way. Over the past decades， though， that narrative has evolved. Weve learned that the stresses associated with poverty have the potential to change our biology in ways we hadnt imagined. It can reduce the surface area of your brain， shorten your telomeres and lifespan， increase your chances of obesity，7 and make you more likely to take outsized risks.

Now， new evidence is emerging suggesting the changes can go even deeper—to how our bodies assemble themselves， shifting the types of cells that they are made from， and maybe even how our genetic code is expressed， playing with it like a Rubiks cube thrown into a running washing machine.8 If this science holds up， it means that poverty is more than just a socioeconomic condition. It is a collection of related symptoms that are preventable， treatable—and even inheritable.9 In other words， the effects of poverty begin to look very much like the symptoms of a disease.

That word—disease—carries a stigma10 with it. By using it here， I dont mean that the poor are （that I am） inferior11 or compromised. I mean that the poor are afflicted， and told by the rest of the world that their condition is a necessary， temporary， and even positive part of modern capitalism.12 We tell the poor that they have the chance to escape if they just work hard enough； that we are all equally invested in a system that doles out13 rewards and punishments in equal measure. We point at the rare rags-to-riches stories like my own， which seem to play into the standard meritocracy template.14endprint

But merit has little to do with how I got out.

I have relatives and friends who are as bright and hardworking as I am， with roughly the same kind of educational path or better. But none of them made it out of poverty. They would not， as I did， find the path to graduation curiously free of obstacles. They would not become， as I did， head of a derivatives15 trading desk on Wall Street. They are not， as I am， writing about poverty. They are still living it.

Why do so few make it out of poverty？ I can tell you from experience it is not because some have more merit than others. It is because being poor is a high-risk gamble. The asymmetry16 of outcomes for the poor is so enormous because it is so expensive to be poor. Imagine losing a job because your phone was cut off， or blowing off an exam because you spent the day in the ER dealing with something that preventative care would have avoided completely.17 Something as simple as that can spark a spiral of adversity almost impossible to recover from.18 The reality is that when youre poor， if you make one mistake， youre done. Everything becomes a sudden-death gamble.

Its time for us to update our response to poverty to take into account the new science that describes it.

We should leverage19 the lessons of the science of poverty rather than ignore them. Poverty alleviation programs encourage stress alleviation and long-term planning that is far upstream of doing well on an exam20—they provide exactly the kind of certainty that the poverty-stricken brain needs. Such programs lowered salivary cortisol levels and reduced lifetime risk for a range of mental and physical disorders.21 There should be more programs like these， for example， the so-called wholechild policies， which focus on the long-term development of children starting from birth while reducing uncertainty during the first three years of childhood development.

We stand at the precipice22 if we dont re-evaluate our understanding of poverty and inequality. The narrative in the neo-liberal23 west is that if you work hard， things work out. If things dont work out， we have the tendency to blame the victim， leaving them without any choices. Brexit， Le Pen， and the defeat of Hillary Clinton are examples of the cracks that result from inequality and poverty， symptoms of my childhood experience writ large.24

It is high time that we abandoned the blind belief that the poor have failed to seize the opportunities that the market or globalization has created. This myth deserves to be taken off life support—and the emerging， empirical25， and carefully observed science of poverty can help us do so if we pay it the attention it deserves.endprint

1. Truman National Security Fellow：

杜魯門國家安全項目成員；Council on Foreign Relations： 美國外交關系協會，是美國對外政策宣傳與研究機構，每年提供會員培訓項目（Term Member Program）。

2. 我感到焦躁不安，仿佛一直處在或戰或逃的狀態，隨時等待著壞消息的降臨。wired： 極度緊張的；fight or flight： 戰斗或逃跑反應，指面對壓力或緊急情況時身體做出的防御、掙扎或者逃跑的反應；wait for the other shoe to drop： 等待不可避免的、糟糕的事發生。

3. ponder： 仔細思考。

4. food stamp： 發給失業者或貧民的食品券，糧票。

5. set in： 來臨，降臨；prospect： 前景，可能發生的事；perpetual：永久的，無期限的。

6. microcosm： 縮影，微觀世界。

7. telomere： // 端粒，是染色體末端的一小段DNA-蛋白質復合體，在控制細胞生長及壽命方面具有重要作用；obesity： 肥胖，肥胖癥。

8. 如今新證據的出現表明，我們在生理上會發生更深層次的變化，諸如我們身體的構造、細胞的構成類型，甚至是基因表現出的性狀——就像是將魔方扔進洗衣機玩弄一樣。express： 在表型中表現（某一基因的性狀）；Rubiks cube： 魔方。

9. symptom： 癥狀，征兆；inheritable：可遺傳的。

10. stigma： 污名，恥辱。

11. inferior： 低級的，下等的。

12. afflict： 使受折磨，使苦惱；capitalism： 資本主義。

13. dole out： 發放，發給。

14. rags-to-riches： 貧窮到富裕的，白手起家的；meritocracy：/

/英才制度；template： 樣板，榜樣。

15. derivative： 金融衍生品工具，指由商品、股票或債券等衍生而來的交易，如期貨。

16. asymmetry： // 不對稱（性）。

17. blow off： 缺席，取消；ER： 急診室（emergency room）；preventative care： 預防保健。

18. spiral： 螺旋式上升（或下降）；adversity： 苦難，禍患。

19. leverage： v. 利用，控制。

20. 脫貧項目提倡緩解壓力和長期規劃，使得其在考驗中表現十分突出。alleviation： 減輕，緩和；upstream： 上游的。

21. salivary： // 唾液的；cortisol：// 皮質醇，在壓力狀態下，皮質醇可幫助維持身體正常生理機能。

22. precipice： // 險境。

23. neo-liberal： 新自由主義的。新自由主義是一種政治與經濟哲學，強調自由市場的機制，反對國家對國內經濟的干預以及對商業行為和財產權的管制。

24. Brexit： 英國脫歐；Le Pen： 瑪麗娜·勒龐（Marine Le Pen， 1968— ），曾任“國民陣線”領導人，有“法國最危險的女人”之稱，在2017年法國總統大選中敗給埃馬紐埃爾·馬克龍；Hillary Clinton： 希拉里·克林頓，美國第67任國務卿，在2016年總統大選中敗給特朗普；crack：（想法、制度或機構中的）缺點，問題；writ large： 擴大的，更大程度（或規模）的。

25. empirical： 經驗主義的，以觀察或實驗為根據的。endprint