More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association’s Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty’s negative impact on child health and well-being. The present article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. Attention is paid to both facilitators of and barriers to successful redesign strategies. We also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health. In addition, ways in which practices can advocate for families in their communities and nationally are identified. Finally, given the relative dearth of evidence for many poverty-focused interventions in primary care, areas that would benefit from more in-depth study are considered. Such a focus is especially relevant as practices consider how they can best help families mitigate the impact of poverty-related risks in ways that promote long-term health and well-being for children.
Skip Nav Destination
Article navigation
March 2016
Special Article|
March 01 2016
Determinants of Health and Pediatric Primary Care Practices
Andrew F. Beck, MD;
aDepartment of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
Address correspondence to Andrew F. Beck, MD, MPH, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 7035, Cincinnati, OH 45229. E-mail: andrew.beck1@cchmc.org
Search for other works by this author on:
Megan M. Tschudy, MD;
Megan M. Tschudy, MD
bDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland;
Search for other works by this author on:
Tumaini R. Coker, MD;
Tumaini R. Coker, MD
cDepartment of Pediatrics, David Geffen School of Medicine and Mattel Children’s Hospital, Los Angeles, California;
Search for other works by this author on:
Kamila B. Mistry, PhD;
Kamila B. Mistry, PhD
bDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland;
dAgency for Healthcare Research and Quality; Rockville, Maryland
Search for other works by this author on:
Joanne E. Cox, MD;
Joanne E. Cox, MD
eDivision of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts;
Search for other works by this author on:
Benjamin A. Gitterman, MD;
Benjamin A. Gitterman, MD
fDepartment of Pediatrics, Children’s National Health System; Washington, District of Columbia
Search for other works by this author on:
Lisa J. Chamberlain, MD;
Lisa J. Chamberlain, MD
gDepartment of Pediatrics, Lucile Packard Children’s Hospital, Palo Alto, California;
Search for other works by this author on:
Aimee M. Grace, MD;
Aimee M. Grace, MD
hOffice of US Senator Brian Schatz (D-HI) and George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;
Search for other works by this author on:
Michael K. Hole, MD;
Michael K. Hole, MD
eDivision of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts;
Search for other works by this author on:
Perri E. Klass, MD;
Perri E. Klass, MD
iDepartment of Pediatrics, New York University School of Medicine, New York, New York;
Search for other works by this author on:
Katherine S. Lobach, MD;
Katherine S. Lobach, MD
jDepartment of Pediatrics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York;
Search for other works by this author on:
Christine T. Ma, MD;
Christine T. Ma, MD
kDepartment of Pediatrics, UCSF Benioff Children's Hospital Oakland, Oakland, California;
Search for other works by this author on:
Dipesh Navsaria, MD;
Dipesh Navsaria, MD
lDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;
Search for other works by this author on:
Kimberly D. Northrip, MD;
Kimberly D. Northrip, MD
mDepartment of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky; and
Search for other works by this author on:
Matthew D. Sadof, MD;
Matthew D. Sadof, MD
nDepartment of Pediatrics, Baystate Children’s Hospital, Springfield, Massachusetts
Search for other works by this author on:
Anita N. Shah, DO;
Anita N. Shah, DO
aDepartment of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
Search for other works by this author on:
Arthur H. Fierman, MD
Arthur H. Fierman, MD
iDepartment of Pediatrics, New York University School of Medicine, New York, New York;
Search for other works by this author on:
Address correspondence to Andrew F. Beck, MD, MPH, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 7035, Cincinnati, OH 45229. E-mail: andrew.beck1@cchmc.org
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2016) 137 (3): e20153673.
Article history
Accepted:
December 17 2015
Citation
Andrew F. Beck, Megan M. Tschudy, Tumaini R. Coker, Kamila B. Mistry, Joanne E. Cox, Benjamin A. Gitterman, Lisa J. Chamberlain, Aimee M. Grace, Michael K. Hole, Perri E. Klass, Katherine S. Lobach, Christine T. Ma, Dipesh Navsaria, Kimberly D. Northrip, Matthew D. Sadof, Anita N. Shah, Arthur H. Fierman; Determinants of Health and Pediatric Primary Care Practices. Pediatrics March 2016; 137 (3): e20153673. 10.1542/peds.2015-3673
Download citation file:
0 Comments
Comments Icon
Comments (0)
Sign in
Don't already have an account? Register
Pay-Per-View Access
$25.00