Child poverty and health

DSC_0398Pediatricians have declared war on child poverty. In a recent groundbreaking report, the American Academy of Pediatrics, which represents 64,000 pediatricians, have announced new recommendations to screen for poverty in order to help reduce its health effects. Now, not only will a pediatrician ask “Where does it hurt?” but also “Do you have safe and secure housing? Do you get enough to eat? Do you live in overcrowded conditions?” and so on.

From a recent article from the Washington Post:  The recommendations are the result of a years-long effort on the part of the AAP’s Poverty and Child Health Leadership Workgroup, which formed when the academy officially made child poverty a focus of its broader agenda in 2013. In its newly released policy statement and technical report, the group highlights what it calls the “lifelong hardship” faced by kids who grow up in poverty.

Those health effects can be severe: Research shows that among other things, poor children have higher rates of chronic illnesses like diabetes and asthma, lower immunization rates, and a higher chance of dying in infancy. That’s not to mention “toxic stress” — heightened physiological responses that activate when children encounter stressful situations. Children in poverty often lack the supportive relationships and structural conditions to regulate that stress response, which can in turn endanger their health for a lifetime.

The AAP’s new recommendations encourage pediatricians to screen for poverty-related health risk factors by asking about basic needs, then refer families to resources related to things like nutrition and housing. But it encourages them not to stop there. Rather, the policy statement urges them to participate in programs that help children develop resilience and advocate for public policies that support child health and reduce poverty, like increased health-care access, job training programs and a higher minimum wage.

“We as a country, as a society, chronically underinvest in those aspects of children’s’ lives that make them healthy,” says Andrew Racine, senior vice president and chief medical officer at Montefiore Medical Center, professor of clinical pediatrics at the Albert Einstein College and chair of the workgroup. Currently, more than one in five children in the United States live below the federal poverty line, which was $24,008 for a family of four in 2014.

Read the full report from the American Academy of Pediatrics.

How our Local Health Experts Respond

The Success Equation asked some of our local pediatricians how they feel about the recommendations from the American Academy of Pedaitrics, and how they think it will affect our community and their patients. Here are all of their responses in full.

Dr. Laurie PulverDr. Laurie Pulver is a pediatrician at ABC Pediatrics in Asheville. She writes: Pediatricians and other care providers see the negative effects of poverty on children’s health every day. We are experienced in recognizing and treating conditions linked to and exacerbated by poverty, however, we often feel overwhelmed by the scope of the problem and powerless to do what we typically do best: prevention and health promotion.

Thankfully, the AAP has recently provided an evidence-based blueprint that targets the root causes of poverty and promotes safety net programs proven to reduce the negative effects of poverty on children’s health. I plan to continue my work to improve the health of individual patients in the clinic setting while working on a larger scale to advocate for public policies that support all children and mitigate the effects of poverty on child health, including initiatives that increase access to healthcare, healthy food, and safe and affordable housing.

Dr. Adrienne CoopeyDr. Adrienne Coopey is a pediatric psychiatrist at Mission Children’s Hospital.
She writes: 
“The AAP’s statement  “Poverty and Child Health in the US” shows how pediatricians are putting into action the over 25 years of research confirming that childhood adversity leads to poor overall health and wellbeing.  Pediatricians are the first people to intimately know a child outside of their family.  They have the opportunity to recognize Adverse Childhood Experiences (ACEs), prevent ACEs, and support a family’s resilience to avoid the detrimental effects of adversity.  Pediatricians’ embracing their role in preventing and ameliorating childhood adversity, like poverty, gets us one step closer to a healthier community.”


Dr. Olsen HuffDr. Olsen Huff is recognized as one of the leading experts in pediatric care in our state. His work with and for children has been recognized by The Lewis Hine Award from the National Child Labor Council, the Order of the Long Leaf Pine, North Carolina’s highest civilian award, the American Academy of Pediatrics special recognition award for advancing dental care to low income children, and the Founders Award from Mission Hospital. He writes:  “Children hurt for a variety of reasons. Broken bones, bruised knees, ear aches, stomach aches -a long list easily recognized by the pediatricians who seek to soothe their pain and help heal their wounds. But there is a more serious and even deadly kind of pain that goes largely un-recognized and seldom addressed in the doctor’s office. That is the pain of poverty. The Academy of Pediatrics however, through a new plan to acquaint its members with this pain, is  doing something about it. By bringing the pain of poverty into every day practice, pediatricians are now seeking ways to treat one more childhood pain.”

Melissa BakerMelissa Baker is the Leading Clinical & Community Connections for Healthcare Transformation for MAHEC. She writes: “We are at an exciting pivotol point in public health; scientific evidence is illustrating- and health care systems are recognizing- the many factors that influence long term health in our population. This means physicians are paying more attention to the social, environmental, and behavior factors that lead to poor health. The recent recommendations by the American Academy of Pediatrics that pediatricians screen for poverty underscores the importance of addressing these factors. Poverty related stress can leave a lasting imprint on a child’s health. Our local pediatricians really care about kids. Given that 1 in 4 children in Buncombe County live in poverty, that means that families may now get help from their child’s doctor to find and connect to resources that will assist parents in caring for their child’s health. That means healthier kids turning into healthier adults!”

Success Equation Logo_ No TaglineThe Success Equation: Under the umbrella of Children First/Communities In Schools, the Success Equation is an initiative that unites community to reduce and prevent the root causes of poverty, so all children can thrive. Get involved! Learn about action steps, volunteer opportunities and help share these messages by going to