Authors of a new report are calling for transformation of the health care system to address what they say is a crisis of worsening child health.
“There’s a lack of dedicated and sustained public attention to the needs of children and youth,” said James M. Perrin, M.D., FAAP, AAP past president (2014) who co-chaired the report committee. “…Without dedicated and sustained policy and funding prioritization of children at the federal, state and local levels, the nation will continue to lag behind other industrialized countries.”
The report Launching Lifelong Health by Improving Health Care for Children, Youth, and Families is from a National Academies of Sciences, Engineering, and Medicine (NASEM) committee and was co-sponsored by the AAP.
"AAP is proud to sponsor this far-reaching report that proposes a road map to finally focus the nation on the health needs of children," said AAP President Benjamin D. Hoffman, M.D., FAAP. "These visionary recommendations have the potential to transform the health care system for generations to come.”
The 510-page report notes that despite advances in science and technology, children increasingly are suffering from chronic diseases, mental health conditions and disparities, and many lack access to adequate preventive care. The report lays out five policy change goals.
- Elevate the importance of child and adolescent health for the nation through continuous public focus on children and youth.
- Finance health care systems for all children, emphasizing prevention and health promotion.
- Strengthen community-level health promotion and disease prevention.
- Ensure co-creation and co-design of programs and structures with youth, family and community voices and leadership.
- Implement measurement and accountability to ensure equitable achievement of these goals.
Each goal has specific recommendations for action. The committee is calling for experts to create a framework that integrates health programs among health care, education, labor, child welfare and justice systems and for new legislation to be assessed as to its impact on child health and equity.
It also calls for reforms to Medicaid and the Children’s Health Insurance Program (CHIP) that would ensure comprehensive coverage for all children and their parents as well as a shift from fee-for-service financing models to those that emphasize prevention. The AAP called for many of the same reforms in its 2023 policy Principles of Child Health Care Financing.
“The current financing and payment mechanisms emphasize diagnosis and treatment rather than prevention and health promotions,” said Dr. Perrin, chair of the AAP Committee on Child Health Financing and professor of pediatrics at Harvard Medical School. “Secondly, Medicaid and CHIP, two incredibly important programs that provide health care to many many children in this country, are critical but underfunded and also have significant state variations.”
Improving child health will benefit society, as children are the next generation of workers, child bearers and caretakers, authors said.
“Without changes, the next 10 years will see larger numbers of people entering adulthood with chronic illness and disability and worse mental health, leaving fewer adults capable of productive work,” according to the report.
But achieving the goals in the report will require long-term structural change, according to committee Co-chair Tina L. Cheng, M.D., M.P.H., FAAP, a member of the AAP Committee on Pediatric Research and the AAP Task Force on Diversity and Inclusion. She also serves as chief medical officer and director of the Cincinnati Children’s Research Foundation at Cincinnati Children’s Hospital Medical Center.
“Effective reform requires leadership and incentives at all government levels with sustained focus on children and families,” Dr. Cheng said. “Short-term fixes will not build what is needed. But it needs to be a dynamic system responsive to new science and societal needs.”
NASEM will hold a summit on Oct. 15 to begin work on implementing the recommendations. For more information and to register, visit https://bit.ly/3ZzC7ET.
