Almost half of young children in the U.S. live in poverty or near poverty, an important social determinant of health. In its recently released policy statement Poverty and Child Health in the United States, the Academy recommends pediatricians screen for risk factors during patient encounters.
With support from the Friends of Children Fund Healthy People 2020 grants, five AAP chapters have been engaged in a variety of efforts to support the health and well-being of children living in poverty.
California Chapter 1Rhea Boyd, M.D., FAAP (far right), AAP volunteer research assistants and the One Degree team are working on a pilot project using technology to connect low-income patients and families to community services.
Connecting patients and families to community and social services can ameliorate some of the effects of poverty, but making that happen in a consistent and efficient way can be challenging.
AAP California Chapter 1 developed a pilot program in San Francisco and Alameda Counties to help medical homes refer low-income families to community resources using web-based technology developed by One Degree (www.1deg.org). The aim is to have patients and families connect directly with the services they need instead of clinic staff serving as gatekeepers of resource information.
“Our goals for the pilot are admittedly ambitious,” said Rhea Boyd, M.D., FAAP, one of the principal investigators for the project. “Together with One Degree, we are exploring a common infrastructure to track real-time social needs; disseminate local resources through an integrated, data-informed process; and enable low-income communities to drive how systems understand and respond to their needs.”
California Chapter 4
In collaboration with community stakeholders, AAP California Chapter 4 is working to tackle food insecurity among patients and their families with a multifaceted strategy. Foremost among these is teaching pediatricians to implement a short food insecurity screening tool and to develop and distribute a community resource guide for use during patient encounters.
As part of its educational efforts, the chapter hosted a continuing medical education forum focused on how physicians can address food insecurity in the clinical setting. To complement these efforts, the chapter is creating a mobile-friendly site linking to the Waste Not Orange County Coalition, which facilitates the donation and distribution of wholesome surplus food to local food pantries.
New York Chapter 3
Data collection and fact-finding were the first steps AAP New York Chapter 3 took as it prepared to address concerns facing homeless children. A needs assessment of homeless children from birth through 5 years in New York City was conducted, with a focus on health and developmental status and access to related services.
Utilizing these data, the chapter is partnering with the New York City Department of Homeless Services and other community groups to conduct fact-finding meetings with homeless families, community pediatricians, managed care organizations and government agencies to gain insight on the following key questions: How can health and developmental services be provided to the youngest children in homeless shelters? Can high-quality infant care and parenting support be incorporated as a core service of shelters? Can a medical and developmental passport be developed for each child and kept by her parent to keep track of key information?
The project team aims to pilot a screening and intervention program with pediatricians and other health professionals who care for homeless children as a springboard for a sustained effort to improve the health and well-being of the city’s young children who are homeless.
Oklahoma has the highest birthrate in the nation among 18- and 19-year-olds and is second in the U.S. for 15- to 19-year-olds. The chances of growing up in poverty for children born to teen mothers are significant and increase with factors like marital status and failure to complete high school.
To support teen parents and their children, the AAP Oklahoma Chapter initiated a program of individual services, education assistance and life coaching. During pregnancy, teens meet with a teen advocate to focus on personalized long-term success planning. New parents-to-be are matched with services to support family stability and development of healthy relationships, successful parenting, father engagement, educational achievement/completion, money management, and job training and mentoring.
Connecting pediatricians with local public health agencies to support summer food programs is the focus of AAP Vermont Chapter efforts to address child poverty in the state. Pediatricians will work with local programs to educate children and families at summer food sites about ways to reduce hunger through improved nutrition and food security strategies. The chapter aims to reach more than 600 children through participation in 20 summer meal programs.
“Access to a summer food program is a wonderful opportunity to provide children who live in a food insecure household access to a healthy meal that might otherwise not be available,” said chapter Executive Director Stephanie Winters. “We have been able to involve local pediatricians, nurses and public health partners in this important initiative to offer helpful resources to families in need.”
The Friends of Children Fund Healthy People 2020 Grant Program supports innovative AAP chapter efforts to establish community- and state-level partnerships to address pediatric public health issues. For more information, contact Hope Hurley, in the AAP Division of Chapter and District Relations, at 800-433-9016, ext. 7933, or firstname.lastname@example.org.