Editor’s Note: Dr. Emmanuel (Manny) Aryee (he/him) is a pediatric resident at Children’s Hospital of Milwaukee and this year’s Editorial Fellow at Pediatrics. -Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics
If you are what you eat, are you also where you live?
It is not a surprising fact that where a child grows up can affect their access to healthy food, secure and reliable recreational spaces for play and exercise, good water and air quality, safe housing, and proximity to health care. A child’s zip code can be a big predictor of their health.
Quantifying the impact of the environment and neighborhood on a child’s health has, however, not been an easy endeavor.
One valuable tool that has emerged as a way to achieve this is the Child Opportunity Index (COI). The COI is a composite measure of the resources and opportunities available to children in their neighborhoods, including factors like education, health, and socioeconomic conditions.
In an article scheduled for early release in Pediatrics this week, Jordan Tyris, MD, and colleagues at Children’s National Hospital and Eunice Kennedy Shriver NICHD perform a meta-analysis to synthesize associations between the COI and pediatric health (10.1542/peds.2024-067873).
The authors found that lower COI is associated with:
- Increased mortality in children.
- Increased all-cause emergency department utilization and hospital readmissions >30 days.
- Adverse health outcomes across different areas of children's health, including physical health, mental health, and access to care.
This article, which includes a video abstract, concludes by suggesting that we move beyond simply identifying place-based health disparities and shift our focus toward co-creating community-engaged strategies that address the root causes of these disparities.
As a bonus, this article has an accompanying commentary by Dr. Michael Warren of the US Department of Health and Human Services and Dr. Morgan McDonald of the Milbank Memorial Fund that underscores the importance of the neighborhood in pediatric health (10.1542/peds.2024-069739). They encourage pediatricians to:
- Move beyond the bedside and engage with community partners to address social needs.
- Advocate for policy changes that will strengthen community resources.
- Participate in community and public health programs like Healthy Start, WIC, SNAP, and home visiting programs.
Check out both articles to learn about the many ways the neighborhood can affect a child’s health and what you can do to help address it.
