Intended for healthcare professionals


Breadlines, brains, and behaviour

BMJ 2013; 347 doi: (Published 12 November 2013) Cite this as: BMJ 2013;347:f6750
  1. Theresa M Marteau, director 1,
  2. Peter A Hall, associate professor2
  1. 1Behaviour and Health Research Unit, University of Cambridge, Cambridge CB2 0SR, UK
  2. 2Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
  1. tm388{at}

Targeting executive functioning and environments may loosen the link between demography and destiny

The first annual report of the Commission on Social Mobility and Child Poverty published last month notes that the number of children starting life in poverty in the United Kingdom is high and increasing.1 Given the links between poverty, brain development, and behaviour, these children start life with a higher chance than their more fortunate peers of behaving in ways that will harm their health and reduce their life expectancy. An understanding of these links offers some novel targets for intervention.

Evidence is emerging that our capacity to resist environments that tempt us (often without awareness) to overeat, smoke, drink excessively, or be physically inactive is influenced by the strength of our “executive functioning.” This is a theorised control network linked to the prefrontal cortex that regulates behaviour and thought.2 Its core functions include inhibition of impulsive responses and focused attention. The strength of this behavioural control network is increasingly linked to environments in the early years of development, particularly poverty.3 This association probably contributes to higher rates of smoking, drinking, poor diet, and physical inactivity in more deprived populations. In turn, …

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