Health equity and social determinants of health have become popular terms over the past 10 years. But they were barely on our national radar when, nearly a century ago, our Academy’s founders spoke of how social and economic conditions influenced a child’s health and why the profession of pediatrics needed to form an organization to address all aspects of child welfare.
It was radical, at the time, for physicians to say they were not content to merely “stay in their lane.” But our founders had a vision. And they knew all too well that pediatricians can only partially address population health issues in the exam room. To truly advance child health and achieve health equity, we also must employ complementary public health strategies.
Throughout our history, the Academy has joined forces with public health professionals to great effect. Recent examples include our responses to the Flint water contamination crisis, measles outbreaks and the Zika virus. Our actions helped stem these crises and secure the social, economic, educational and environmental resources needed to prevent them from happening again.
The AAP continues to lead the movement to increase collaboration between the fields of clinical medicine and public health not only to address emerging crises but to push for upstream changes.
This was the basis of our advocacy that ended a two-decade freeze on gun violence research with the Firearm Injury and Mortality Research Agreement, which included $25 million in funding for the Centers for Disease Control and Prevention and National Institutes of Health. And it set the model for the Academy’s Gun Safety and Injury Prevention Initiative, through which teams of health care, public health, law enforcement, education, faith and community leaders are tackling the root causes of gun violence and educating families about firearms and safe storage.
Less well-known has been the Academy’s leading role in an effort to communicate and address the risks climate change poses to child health. With nearly 90% of its health consequences felt by children, climate change is important to us as pediatricians. The AAP recently joined 70 other medical and public health organizations to put forth a climate agenda for policymakers and government officials. And we’re partnering with ecoAmerica to engage leaders from multisector agencies and organizations to host a National Children’s Health and Climate Leadership Forum on April 22, 2020, which also is the 50th anniversary of Earth Day.
These types of collaborations also are helping stem the teen e-cigarette epidemic, end vaccine exemptions and inform parents and the public that immunizations are safe and effective. They also are part of our Equity Agenda, which articulates our ideal that all children have — and all systems of care maintain — health equity. Our Equity Agenda lays out an ambitious approach to equipping all pediatricians with what they need to build equitable health systems and address the root causes of disparities across race/ethnicity, gender, sexual orientation or religion. It also serves as a guide for how we approach public health as well as how we address bias and discrimination in our own organization.
We need to learn hard lessons from where we started. It took us 15 years from our founding before admitting the first African American physicians, Dr. Roland Scott and Dr. Alonzo deGrate Smith, and even when we did, the discussion was not something we can be proud of today. We will consider our past as we implement the Equity Agenda. We have things we need to set right as we articulate the vision for the future.
The changes we want to see start with leadership, and leadership starts with each of us. Whether you’re an experienced or aspiring leader, there’s an urgent need and strong desire for pediatrician leadership both inside and outside the clinical setting. To encourage more of our pediatricians, pediatric medical subspecialists and surgical specialists to become leaders and changemakers, the Academy has launched a Pediatric Leadership Initiative that is open to members at every stage of their careers and reflects our commitment to equity, diversity and inclusion.
The initiative involves:
- Increasing access to the Academy’s Young Physicians Leadership Alliance and the Women’s Wellness through Equity and Leadership project.
- Expanding our in-person and online learning experiences to include training focused on new areas like academics, global health or systems change.
- Partnering with the American Association for Physician Leadership (AAPL) to offer our members discounts on AAPL courses.
Evidence shows that leadership skills and management practices improve patient health outcomes. If we prepare ourselves to lead and get involved early on, we can make the changes we need to see and navigate a better way forward for patient care and public health.
