Last week the American Academy of Pediatrics (AAP) took an important step in recognizing the tremendous impact of child poverty and other social determinants of health in child development. They also recognized the critical role pediatricians can and should play in identifying and helping to address the needs of patients impacted by poverty.

We applaud their leadership and urge other health care providers to take similar steps that will mitigate disparities in health outcomes.

The AAP released a policy statement  that includes, for the first time, the recommendation that pediatricians routinely screen children for poverty risk factors. The AAP policy statement also includes numerous public policy recommendations that underscore the importance of pediatric involvement in child advocacy at local, state, and federal levels “to ensure all children have access to a high-quality medical home and to eliminate child health disparities.”

Poverty and child health became a strategic priority for the AAP in 2013 in response to the growing number of children living in poverty. A leadership workgroup was formed to develop a strategic plan to help address the effects of poverty and accompanying social determinants of health on all children. The workgroup identified four areas for the AAP to address.  These include:

• Raising awareness about the impact of poverty on child health and development and the strategies that work to mitigate the health effects of poverty.
• Supporting pediatricians in addressing poverty within their practice and engaging parents in the effort, including screening for risk factors within social determinants of health during patient visits and implementing integrated medical home programs.
• Supporting pediatricians in identifying and collaborating with community to address the health impacts of child poverty, and improve population health through program, policy and infrastructure changes.
• Advocating for policies at the national, state, and local levels that help lift families out of poverty and that ameliorate the impact of poverty on the health of children.

The Wisconsin Chapter of the AAP has also made this a strategic priority of their chapter and posted a “Pediatrician’s Guide to Poverty Resources” on their website, including a number of Wisconsin-specific resources.

Policy developments such as the Children’s Health Insurance Program (CHIP) and the Affordable Care Act have brought about great progress in closing gaps in access to health care.  That progress has been a critical yet insufficient step in reducing the alarming disparities in health – including the racial and ethnic disparities – because social and economic factors play an even more important role than access to health insurance in determining health outcomes.

The new AAP documents are a big step in acknowledging that health care providers can and should pay more attention to some of the root causes of the health problems they are trying to remedy.  We urge other health care providers to also tackle this problem.  Hospitals and health care systems need to make cost-effective investments in community health that will help close the child and adult health disparities that continue to plague our communities.

Sashi Gregory and Jon Peacock