Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (AF Beck, MD Klein, AM Sims, AN Shah, CL Riley, RS Kahn, and NI Unaka), Cincinnati, Ohio.
Boston Medical Center and Boston University School of Medicine (LE Marcil), Boston, Mass.
Acad Pediatr. 2021 Nov-Dec;21(8S):S200-S206. doi: 10.1016/j.acap.2021.04.010.
Poverty affects child health and well-being in short- and long-term ways, directly and indirectly influencing a range of health outcomes through linked social and environmental challenges. Given these links, pediatricians have long advocated for poverty reduction in both clinical settings and society. Pediatricians and others who work in pediatric settings are well-suited to address poverty given frequent touchpoints with children and families and the trust that develops over repeated encounters. Many pediatricians also recognize the need for cross-sector engagement, mobilization, and innovation in building larger collaborative efforts to combat the harmful effects of poverty. A range of methods, like co-design, community organizing, and community-engaged quality improvement, are necessary to achieve measurable progress. Moreover, advancing meaningful representation and inclusion of those from underrepresented racial and ethnic minority groups will augment efforts to address poverty within and equity across communities. Such methods promote and strengthen key clinical-community partnerships poised to address poverty's upstream root causes and its harmful consequences downstream. This article focuses on those clinical-community intersections and cross-sector, multi-disciplinary programs like Medical-Legal Partnerships, Medical-Financial Partnerships, clinic-based food pantries, and embedded behavioral health services. Such programs and partnerships increase access to services difficult for children living in poverty to obtain. Partnerships can also broaden to include community-wide learning networks and asset-building coalitions, poised to accelerate meaningful change. Pediatricians and allied professionals can play an active role; they can convene, catalyze, partner, and mobilize to create solutions designed to mitigate the harmful effects of poverty on child health.
贫困以短期和长期的方式直接或间接地影响一系列健康结果，通过相关的社会和环境挑战影响儿童的健康和福祉。鉴于这些联系，儿科医生长期以来一直在临床和社会环境中倡导减少贫困。儿科医生和其他在儿科环境中工作的人非常适合解决贫困问题，因为他们与儿童和家庭有频繁的接触点，并且随着反复接触建立了信任。许多儿科医生也认识到需要跨部门参与、动员和创新，以建立更大的协作努力，抗击贫困的有害影响。需要一系列方法，如共同设计、社区组织和社区参与式质量改进，以取得可衡量的进展。此外，推进具有代表性和包容性的工作，包括代表性不足的少数族裔群体，将增强在社区内解决贫困问题和实现公平的努力。这些方法促进和加强了关键的临床-社区伙伴关系，为解决贫困的上游根本原因及其下游的有害后果做好准备。本文重点介绍了这些临床-社区的交叉点以及跨部门、多学科的项目，如医疗法律伙伴关系、医疗金融伙伴关系、诊所内食品储藏室和嵌入式行为健康服务。这些项目和伙伴关系增加了获得服务的机会，使生活在贫困中的儿童难以获得这些服务。伙伴关系也可以扩大到包括社区范围的学习网络和资产建设联盟，为加速有意义的变革做好准备。儿科医生和相关专业人员可以发挥积极作用；他们可以召集、促进、合作和动员，以制定旨在减轻贫困对儿童健康的有害影响的解决方案。
