Source: Kuo AA, et al. Pediatrics. 2018. doi:10.1542/peds.2017-3848

January 22, 2018
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AAP: Partnership needed between pediatricians, public health

Source: Kuo AA, et al. Pediatrics. 2018. doi:10.1542/peds.2017-3848

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The collaboration between pediatricians and those within the public health sector is essential for improving child outcomes such as mental health and obesity, according to a policy statement published by the AAP.

“An important strategy for addressing child health is to think about the whole population of children,” Alice A Kuo, MD, PhD, MBA, from the David Geffen School of Medicine at the University of California, Los Angeles, told Infectious Diseases in Children. “For example, before there were seat belt laws, pediatricians had to educate families one by one about how important it is to use seat belts and car seats. Once child health advocates were able to get laws enacted, millions of children were safer.”

“Pediatricians are essentially front-line public health clinicians,” she continued. “We just need to figure out better ways to communicate the information from the front line to the practitioners working at the population level.”

Kuo and colleagues suggest that both pediatricians and those in the public health sector are in a unique position to address multiple childhood conditions within the community setting because 19.7% of children lived below the federal poverty level in 2015, and between 2011 and 2014, nearly one in three children and teenagers had overweight or obesity. Of these children, 17% were obese.

Furthermore, nearly one in five may be experiencing a mental disorder without diagnosis, and in 2017, approximately 4.8% of children were uninsured. The collaboration of these two fields may be able to provide early detection and ensure that prevention measures have been attempted.

The researchers note that although pediatricians are not required to have proficiency in public health duties, awareness of public health data and resources they can provide their patients can assist in maintaining population health. Kuo and colleagues also note that it is equally as important for the pediatrician to be involved with promotion of public health through assessment of children’s health status, guiding families to the necessary services and developing policy.

It is suggested that pediatricians step outside of the office to promote public health. This step can be completed by serving on advisory boards and school boards, assisting with school-based clinics and partnering with health-promotion projects within their community.

To ensure effective collaboration between pediatricians and those in the public health sector, Kuo and colleagues suggest that the following factors should be maintained:

  • A common goal to promote health within the community;
  • Participation within the community to define and address their needs;
  • Unity to lead these initiatives;
  • Sustainability; and
  • Disclosure and collaboration for data and analyses of relevant information.

    The researchers recommend the following for pediatricians:

  • Stay up to date on requirements for the reporting of infectious diseases, outbreaks and adverse events related to vaccines to those in the public health sector;
  • Use resources and recommendations created by groups in the public health sector, including local and state health departments, the CDC and its Advisory Committee, the United States Preventive Services Task Force, the Maternal and Child Health Bureau and the National Academy of Medicine;
  • Promote population-based approaches to health care within their institutions; and
  • Include curricula on public and population health when training pediatric residents.

    Kuo and colleagues also endorse the following suggestions for collaboration:

  • Partner on prevention and health-promotion measures that focus on chronic diseases and disabilities;
  • Include families for the support of healthy environments for children, where learning, playing and living in a healthy manner are promoted.
  • Consider disaster planning and where children and adolescents fit in to their community’s plan, especially if they have special health care requirements;
  • Provide relevant and valuable information, including immunization messages, to families within the community.

“The best way to better communicate is to form a relationship,” Kuo said. “Get to know someone in the public health department, especially in the maternal and child health unit. Understand the initiatives related to child health that your public health department is working on, and get involved with your local AAP chapter. They have support to work on child health issues at a population level and likely have the relationship with the public health department already.” – by Katherine Bortz

Disclosure: Kuo has no relevant financial disclosures. Please see the full study for a full list of other authors’ relevant financial disclosures.