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Letter from the President: We have solutions that can prevent, ameliorate poverty :

March 9, 2016
Dr. DreyerDr. DreyerThree years ago, the AAP Board of Directors voted unanimously to make Poverty and Child Health a strategic priority in the Agenda for Children. That started a journey that led to today's release of a major policy statement,, and technical report,, about child poverty. Both will be published in the April issue of Pediatrics and have received widespread national attention because they add the voice of pediatricians to one of the most significant problems facing our country and its children. This new AAP policy:
  • identifies the immediate and potentially lifelong health effects of poverty in children;

  • empowers pediatricians with the tools to screen for poverty risk factors and connect families to community resources that address those concerns;

  • describes interventions pediatricians can use in their practice to improve children’s futures (such as Reach Out and Read); and

  • identifies important government programs that need to be maintained and expanded to help poor families.

It also brings together a portfolio of policies we’ve released over the last several years to address important aspects of child poverty: Early Childhood Adversity, Toxic Stress and the Role of the Pediatrician; Providing Care for Immigrant, Migrant, and Border Children; Providing Care for Children and Adolescents Facing Homelessness and Housing Insecurity; Medicaid; Children’s Health Insurance Program: Accomplishments, Challenges, and Policy Recommendations; Literacy Promotion: An Essential Component of Primary Care Pediatric Practice, and Promoting Food Security for All Children.

With almost half of U.S. children poor or near-poor, we pediatricians see the negative impact of poverty on children every day. It causes, underlies or exacerbates many of the issues affecting the health and well-being of children, including:

  • increased infant mortality;

  • low birthweight and subsequent health and developmental problems;

  • chronic disease frequency and severity;

  • food insecurity, poor nutrition and growth;

  • increased accidental injury and mortality;

  • lower immunization rates;

  • increased obesity and its complications;

  • markedly increased toxic stress and its lifelong impact;

  • problems with early brain and child development;

  • mental health problems;

  • poorer academic achievement and increased rates of high school dropout;

  • teen pregnancy and substance abuse; and

  • higher rates of teen/young adult criminal behavior and incarceration.

Childhood poverty is associated with lifelong — even intergenerational — hardship. And the irony is poverty is expensive, costing the U.S. economy more than $500 billion a year in low productivity and poor health in addition to increasing crime and incarceration rates. But it doesn’t have to be that way.

Frederick Douglass once said: “It is easier to build strong children than to repair broken men,” and research confirms he was right. Study after study shows giving children a healthy start pays off in their long-term health, well-being and productivity, which is not just important for children and their families but for society as a whole. That’s why we’re asking Congress to:

  • Build on investments in programs that help lift families out of poverty, like the Earned Income Tax Credit and Child Tax Credit. These programs work! Without these critical supports, it’s estimated that nearly one in three children would live in poverty instead of one in five.
  • Support increases in the minimum wage that better approximate a “living wage” for families.
  • Protect and expand federal anti-poverty and safety net programs, including those that provide health care, early education, quality child care, affordable housing and home visiting, as well as critical nutrition assistance like the Special Supplemental Nutrition Program for Women, Infants, and Children, the Supplemental Nutrition Assistance Program, and school and summer meals.

  • Invest in programs addressing early childhood education and parenting support, which have been shown to improve a child’s long-term health, well-being and productivity and yield a return on investment as high as 14% per year.

  • Fund interventions in pediatric practice such as Reach Out and Read.

Poverty is a serious, non-communicable disease that is found in every community. Fortunately, we have solutions we know work to prevent and ameliorate poverty and an army of those who care for (and about) children — parents, teachers, social workers, community and government agencies, and policy-makers — to help us make a real difference.

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