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- Rachel Stein Berman, MD, MPH*,†
- Milani R. Patel, MD*,†,‡
- Peter F. Belamarich, MD*,†
- Rachel S. Gross, MD, MS*,†
- *Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
- †Division of Academic General Pediatrics, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY
- ‡Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY
AUTHOR DISCLOSURE
Drs Berman and Patel have disclosed no financial relationships relevant to this article. Dr Belamarich has disclosed that he serves as site investigator for Centers for Disease Control and Prevention (CDC) grant 6 NH23IP000950-03-01, a multisite human papillomavirus vaccination performance improvement project. Dr Gross has disclosed that she serves as site principal investigator for the National Institutes of Health/National Institute of Child Health and Human Development through K23 Mentored Patient-Oriented Research Career Development Award K23HD081077. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- AAP:
- American Academy of Pediatrics
- APA:
- Academic Pediatric Association
- EITC:
- Earned Income Tax Credit
- SNAP:
- Supplemental Nutrition Assistance Program
- WIC:
- Special Supplemental Nutrition Program for Women, Infants, and Children
Practice Gap
Pediatricians should screen for and address poverty and poverty-related social determinants of health because they have clear negative effects on children’s health and well-being. This task requires coordination of services beyond the medical home. Pediatricians may also advocate at local and federal levels to further serve patients living in poverty.
Objectives
After completing this article, readers should be able to:
Define social determinants of health and understand their effect on children’s health.
Access tools to screen for poverty and poverty-related social determinants of health.
Describe evidence-based interventions that address poverty and poverty-related social determinants of health.
Outline government policies and programs for impoverished families for which pediatricians may advocate.
Case Scenario
A 13-year-old girl has an appointment with her pediatrician for follow-up of her asthma. She had gone to the emergency department 3 times in the 10 days before the appointment for cough and difficulty breathing. Each time, she was given nebulizer treatments, improved, and was discharged home. She was also treated with oral corticosteroids and azithromycin. Her symptoms have persisted up to the day of the appointment. Her mother reports complete compliance with her inhaled medications, oral corticosteroids, and antibiotic. On further questioning, her mother reports that she, the patient, and the patient’s younger brother are living in a shelter. …
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