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Candidates discuss how to approach social determinants of health :

October 5, 2018

Child health is impacted by factors outside the health care system. How should the AAP approach social determinants of health and, as president, how would you prioritize?

George C. Phillips, M.D., M.B.A., FAAP

Overland Park, Kan.

As pediatricians, we understand how social determinants of health profoundly impact children, with effects that traverse the entire lifespan. The AAP leads efforts to address social determinants of health, as evidenced by the numerous policy statements, toolkits and other publications dedicated to this topic. We have made poverty a strategic child health issue, and we have advocated for appropriate solutions through federal policy, such as the Earned Income Tax Credit. The AAP must seek partners in science and public policy to advance the work in this field by demonstrating cost-effective, evidence-based strategies to build a healthier and more economically stable society.

The Department of Health and Human Services’ Healthy People 2020 initiative incorporated targets for social determinants of health, aligning them with population health goals. The AAP’s Healthy People 2020 grants effectively leverage charitable contributions to enable chapters to work toward those goals. At the local level, the AAP should train pediatricians to participate in community needs assessments as champions for children’s needs. The AAP must also preserve and strengthen the Community Access to Child Health grant program so that more pediatricians can build programs that address the most significant social determinants of health in their own communities.

The AAP leads the way in identifying social determinants of health challenges and the solutions that can strengthen communities and improve health outcomes for all children. We must continue to develop partnerships, tools and resources that empower our organization and our members to effect change as national and local champions for children and families.

Sara “Sally” Goza, M.D., FAAP

Fayetteville, Ga.

Social determinants of health can either be strengths or risks affecting the ability for children to have healthy development. Health is influenced by access to social and economic support; high-quality education; safety in the home, neighborhood and school environment; healthy food; and access to health care. It is a tangled web of many factors that pediatric providers must sort through to influence the health trajectory of their patients.

As AAP president, I would address this in a multifaceted way.

First, I would promote programs within our AAP to help pediatric providers and the health teams they lead to identify families strengths and needs and be equipped to address them. Some programs that exist are Community Access to Child Health grants, Healthy People 2020 grants and partnerships with public health. These must be continued while we look for new and innovative ways to do even more.

Secondly, we must continue advocacy for programs that lift children out of poverty and decrease adverse childhood events. Social programs that already exist such as Earned Income Tax Credits, the Supplemental Nutrition Assistance Program, Head Start, Medicaid and the Children’s Health Insurance Program must be protected. We must advocate for new programs that will help families succeed in our country like increased minimum wage and paid family leave.

As we all know in advocacy, if pediatricians are not at the table, children will be on the menu. As president, I will remain vocal in our commitment to ensure that all children have what they need to reach their full potential and be safe, happy and healthy.

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