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Laying the groundwork for the future, AAP tackles challenges of 2010-’20 :

October 1, 2020

Editor’s note: This is the final installment in a series highlighting the AAP’s 90th anniversary. For previous articles, visit  http://bit.ly/AAP90thAnniversary.

In the last decade leading up to its 100th anniversary, the AAP faced new and old challenges as it marked milestones.

 The Affordable Care Act (ACA), a central priority, significantly boosted health coverage for children, although its future remained in peril. Bright Futures guidelines were the benchmark for preventive care in the ACA. The Children’s Health Insurance Program was reauthorized in 2015, after lapsing for months; funding expired again in 2017 but was extended in 2018 through 2023. Medicaid expansion in some states also helped bring more health services to underserved children.

AAP headquarters in Itasca, Ill.

A new Headquarters of the Future in Itasca, Ill., took shape, and AAP staff moved into the facility (https://bit.ly/3hQL9or), which was designed to enable growth, foster innovation and better serve the Academy for years to come. Helping to shepherd development of the new home for pediatrics was then-CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP.

Crises spur AAP efforts

A host of events tested the country: terrorist attacks, school shootings, the COVID-19 pandemic and measles outbreaks, separation and detention of immigrant children, racial strife and a divided nation. Hurricanes, floods and wildfires flared in certain regions.

As it has since its 1930 founding, the AAP responded with advocacy and resources.

Policy statements and reports addressed toxic stress, gun violence, e-cigarettes/vaping, opioids, media use, abusive head trauma, drowning and inequities. Guidance was issued regularly on aspects of COVID-19.

The AAP launched or improved the following: a child health data registry, revamped Neonatal Resuscitation Program, a FamilY Partnerships Network, member access to the latest news and research via Gateway, digital transformation, interactive Periodicity Schedule, AAP Mentorship program, HealthyChildren.org en Español, virtual meetings, pediatrician wellness efforts, the Institute for Healthy Childhood Weight and new AAP books, educational programs and other products and services.

The Academy received a grant to operate the Head Start National Center on Health, which provides training and technical assistance to help some of the nation’s neediest children. 

Advocacy and legislative efforts

When the National Institutes of Health finally took steps to require inclusion of children in research via the 21st Century Cures Act, it marked the culmination of decades of AAP advocacy. Among other successes, the AAP led efforts to improve payment to pediatricians, counsel about firearms, promote gun violence prevention research, implement policies to cut e-cigarette use, improve funding to strengthen the pediatric workforce, and gain emergency funding to support practices during the pandemic. It successfully pushed for a recall of deadly infant inclined sleepers.

The AAP spoke out against family separation and detention of immigrant children at the border.

In 2018-’19, AAP leaders, including President Colleen A. Kraft, M.D., M.B.A., FAAP, spoke out extensively and made several visits to see detained children and families at the border. A 2017 policy statement drew attention to the care needed for children in immigrant families.

Dr. Kraft also testified before Congress, as did current President Sara “Sally” H. Goza, M.D., FAAP.

“We just have to keep focusing on what we know is right for children,” noted Dr. Goza at the time. “(The AAP) is for the health and well-being of all children. We can’t turn our back on this.”

The AAP continues to draw attention to the needs of vulnerable children and families.

“In the 90-year history of the AAP, advancing child health has often meant fighting for social justice,” said AAP CEO/Executive Vice President Mark Del Monte, J.D., who in 2019 became the first nonphysician to hold the position.

In addition to national efforts, AAP chapters took stands against harmful policies impacting their states, such as vaccine exemptions, lack of children’s access to Medicaid services and discrimination against transgender children and adolescents.

Policy themes

Many policy statements and reports carried overlapping guidance on how to better identify and help children overcome disparities related to poverty, separation, food insecurity, housing instability, exposure to toxins, violence and toxic stress.

Former AAP President Benard P. Dreyer, M.D., FAAP (2016), has long made poverty a priority of his work.

“Almost half of pediatric patients are poor or in financial distress, and pediatricians should support the Academy’s mission statement for all children,” he reminded attendees of the 2016 AAP National Conference & Exhibition.

In that year, the AAP Blueprint for Children recommended what the next U.S. presidential administration needed to do to improve the lives of children and make it a national priority (http://bit.ly/2dyjxT2).

“Every child and adolescent needs access to the conditions that foster healthy and safe development,” the document stated.

An AAP Five-Year Strategic Plan (https://bit.ly/3jAtZf3) was issued in 2017 under Fernando Stein, M.D., FAAP, the first Latin American AAP president. Goal #1 reflects the core strengths of the Academy: advancing child health through policy, education and advocacy.

An equity agenda was established in 2019 under Kyle E. Yasuda, M.D., FAAP, the first Asian American AAP president, to promote diversity and inclusion in the organization and throughout child health. Later, task forces and other groups were established, an anti-racism policy was released and the AAP apologized for discriminating against the first two Black members, Drs. Roland Scott and Alonzo deGrate Smith. At the 2020 Annual Leadership Forum, leaders unanimously voted to hold a referendum to allow members to vote on including a broad-based anti-discrimination statement in AAP bylaws.

What is striking and inspiring is the constancy of the mission, Del Monte often says, as the AAP continues to advance child health through scientific and medical advances.

That commitment, AAP leaders insist, is fully aligned with what the founders envisioned 90 years ago.

Other AAP accomplishments

The AAP also achieved the following:

  • Saw membership grow from 62,109 in 2010 to 69,677 in 2019, as new categories were added.
  • Approved activities for Maintenance of Certification parts 2 and 4.
  • Launched Hospital Pediatrics and the Pediatrics On Call podcast.
  • Celebrated Red Book’s 75th anniversary.
  • Released a new edition of Bright Futures.
  • Partnered with then-first lady Michelle Obama’s Let’s Move initiative.
  • Released a customizable emergency plan for managing allergy and anaphylaxis.
  • Hosted a summit on gun injury prevention.
  • Added three new elected positions to the board of directors.
  • Advocated for completion of the 2020 Census.
  • Saw the first pediatrician elected to Congress (Kimberly Schrier, M.D., FAAP).
  • Encouraged a Get Out the Vote campaign to prioritize children’s interests in the 2020 election.

Visit the AAP Gartner Pediatric History Center at https://bit.ly/pediatrichistorycenter

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