How to Make Pediatric Care More Available to Children from Unprivileged Communities
Pediatric care is essential for the health and well-being of children, especially those who live in poverty or face other social disadvantages. However, many children in rural areas and low-income neighborhoods lack access to quality pediatric care, which can lead to worse health outcomes, higher costs, and lower quality of life. In this blog post, we will discuss some of the barriers and challenges that prevent children from receiving adequate pediatric care, and some of the possible solutions and strategies that can improve the availability and accessibility of pediatric services for children from unprivileged communities.
Barriers and Challenges
According to a study published in Pediatrics in 2021, the number of hospitals with inpatient units for pediatric care decreased by 19%, and the number of beds in those units decreased by 12%, between 2008 and 2018. The closures and loss of beds were especially steep in rural areas than in urban areas. Nearly one in four children would now have to travel farther to access inpatient hospital care than they did a decade ago [1]. This situation can pose significant risks and hardships for children and families who need urgent or specialized care, such as for asthma, pneumonia, viral infections, or other serious illnesses.
Another study published in Pediatrics in 2016 found that almost half of young children in the United States live in poverty or near poverty, which is associated with adverse health outcomes across the life course. Poverty can affect children’s physical health, socioemotional development, educational achievement, and genomic function and brain development [2]. Poverty can also limit children’s access to preventive and primary care, such as immunizations, screenings, dental care, and mental health services. Moreover, poverty can expose children to toxic stress, environmental hazards, poor nutrition, and violence, which can further compromise their health and well-being [2].
Children with special health care needs (CSHCN) are another vulnerable group that faces challenges in accessing pediatric care. CSHCN are defined as “those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally” [3]. According to a report by the American Academy of Pediatrics (AAP), CSHCN are more likely to experience health disparities and inequities than their peers without special needs, due to factors such as race/ethnicity, income, insurance status, language barriers, geographic location, and social determinants of health [3]. CSHCN may also encounter difficulties in finding providers who are trained and equipped to meet their complex and diverse needs, coordinating care across multiple settings and systems, and affording the costs of care [3].
Solutions and Strategies
To address the gaps and barriers in pediatric care for children from unprivileged communities, several solutions and strategies have been proposed and implemented by various stakeholders, including policymakers, health professionals, researchers, advocates, and families. Some of these include:
– Expanding Medicaid coverage and eligibility for low-income children and families, which has been shown to improve access to care, utilization of services, health outcomes, and financial security [2].
– Supporting the medical home model of care delivery for CSHCN, which is based on principles of family-centeredness, comprehensiveness, coordination,
continuity,
accessibility,
quality,
and
equity [3]. The medical home model can enhance the quality and efficiency of care for CSHCN by providing them with a consistent source of primary care that integrates preventive,
acute,
and
chronic
care
services,
and
links
them
to
other
community-based
resources
and
supports [3].
– Increasing the supply and distribution of pediatric providers in rural areas and underserved communities, through incentives such as loan repayment programs,
scholarships,
grants,
and
telehealth
technologies [1].
– Promoting community-based interventions that address the social determinants of health for children living in poverty or facing other disadvantages. These interventions may include programs that provide food security,
housing stability,
early childhood education,
violence prevention,
and
family support [2].
– Advocating for policies and programs that reduce child poverty and its effects on child health. The AAP has recommended several measures that can help achieve this goal,
such as increasing the minimum wage,
expanding the earned income tax credit,
strengthening child care subsidies,
and
implementing universal preschool [2].
Conclusion
Pediatric care is vital for the health and well-being of children from unprivileged communities. However,
many barriers and challenges prevent these children from receiving adequate pediatric care,
which can have negative consequences for their physical,
socioemotional,
and
educational development.
By implementing solutions and strategies that improve the availability and accessibility of pediatric services for these children,
we can help them achieve their full potential and thrive in their communities.
Bibliography
[1] Cushing A, Chung PJ, Flori H, et al. Trends in the Availability of Inpatient Pediatric Care in the United States. Pediatrics. 2021;147(6):e2020040128. doi:10.1542/peds.2020-040128
[2] Council on Community Pediatrics. Poverty and Child Health in the United States. Pediatrics. 2016;137(4):e20160339. doi:10.1542/peds.2016-0339
[3] American Academy of Pediatrics Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics homework help – write my nursing thesis, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006;118(1):405-420. doi:10.1542/peds.2006-1231
