Health Equity and Children's Rights

,

doi:10.1542/peds.2010-0235

Cited by 73 publications

(14 citation statements)

References 70 publications

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“…18 The emphasis on closing disparities in services across race and ethnicity has been a priority for a number of professional groups, including the American Academy of Pediatrics. 19 System-wide emphasis on increasing access has been paired with attention to understanding and addressing disparities in service utilization. 20 Improved awareness of the need to treat physical and MH conditions should increase provision of services to children involved with CW services and, hopefully, place greater emphasis on consistent screening for all youth.…”

Section: Introductionmentioning

confidence: 99%

For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade

Stein

Hurlburt

Heneghan

et al. 2016

Academic Pediatrics

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Background Children referred to child welfare (CW) due to suspected maltreatment are vulnerable and need many services, particularly minority children. Objective To assess whether service use has improved over the past decade and whether racial-ethnic disparities in service use have decreased. Methods We used two national data sets (the National Survey of Child and Adolescent Well-Being I and II) collected a decade apart to assess changes over time in health, education, mental health (MH), dental services and overall service use. Results In NSCAW II, more children were young, had lower child behavior checklist (CBCL) scores, and were Hispanic. We found significant increases in dental services, a decrease in special education services and a decrease in MH services on the bivariate level (all p<.01). A large proportion of the change in MH services occurred in school settings, but the pattern continued when examining only those services delivered outside of school. The greatest decrease occurred for children with CBCL scores <64. However, in multivariate analyses, older children, white non-Hispanic children and children placed out of the home were significantly more likely to receive MH services. Rates of MH services controlling for CBCL scores showed no improvement over the decade, nor was there a decrease in racial and ethnic disparities Conclusion These data show no change in MH services over time for children referred for CW evaluation, but improvement in dental services. Racial and ethnic disparities persist. MH services decrease occurred predominantly among children whose MH symptoms are below the clinical range.

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Section: Introductionmentioning

confidence: 99%

For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade

Stein

Hurlburt

Heneghan

et al. 2016

Academic Pediatrics

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“…Using a children’s health framework (Daston et al 2004; Landrigan et al 2004), in the present review we summarize children’s vulnerability to climate-related environmental hazards, emphasizing that the disproportionate impacts will exacerbate existing issues of environmental justice (Council on Community Pediatrics and Committee on Native American Child Health 2010; Landrigan et al 2010). We focus on the health impacts of major exposures associated with climate change, namely, increased temperatures, increasing frequency and severity of weather extremes, and sea level rise.…”

mentioning

confidence: 99%

Global Climate Change and Children’s Health: Threats and Strategies for Prevention

Sheffield

Landrigan²

2011

Environ Health Perspect

319

212

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BackgroundGlobal climate change will have multiple effects on human health. Vulnerable populations—children, the elderly, and the poor—will be disproportionately affected.ObjectiveWe reviewed projected impacts of climate change on children’s health, the pathways involved in these effects, and prevention strategies.Data sourcesWe assessed primary studies, review articles, and organizational reports.Data synthesisClimate change is increasing the global burden of disease and in the year 2000 was responsible for > 150,000 deaths worldwide. Of this disease burden, 88% fell upon children. Documented health effects include changing ranges of vector-borne diseases such as malaria and dengue; increased diarrheal and respiratory disease; increased morbidity and mortality from extreme weather; changed exposures to toxic chemicals; worsened poverty; food and physical insecurity; and threats to human habitation. Heat-related health effects for which research is emerging include diminished school performance, increased rates of pregnancy complications, and renal effects. Stark variation in these outcomes is evident by geographic region and socioeconomic status, and these impacts will exacerbate health disparities. Prevention strategies to reduce health impacts of climate change include reduction of greenhouse gas emissions and adaptation through multiple public health interventions.ConclusionsFurther quantification of the effects of climate change on children’s health is needed globally and also at regional and local levels through enhanced monitoring of children’s environmental health and by tracking selected indicators. Climate change preparedness strategies need to be incorporated into public health programs.

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“…17 While clinical vital signs include temperature, heart rate, respiratory rate, blood pressure and growth parameters, the RWJF Commission to Build a Healthier America strongly recommended that “new health vital signs” reflecting the root causes of health disparities be included such as food security, educational progress, family employment, health literacy, neighborhood safety and adequate housing. 18 For instance, poor housing is linked to health status.…”

Section: “Diagnose Disparities” In Clinical Encounters and Innovate Nmentioning

confidence: 99%

Child Health Disparities: What Can a Clinician Do?

et al. 2015

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Pediatric primary and specialty practice has changed with more to do, more regulation and more family needs. Similarly, the needs of patients have changed with more demographic diversity, family stress and continued health disparities by race, ethnicity and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This paper outlines specific, practical, actionable and evidence-based activities for clinicians to assess and address health disparities in practice. These tools may also support Patient Centered Medical Home recognition, national and state cultural and linguistic competency standards and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in 1) diagnosing disparities in one’s community and practice; 2) innovating new models to address social determinants of health; 3) addressing health literacy of families; 4) ensuring cultural competence and a culture of workplace equity; 5) advocating on issues that address the root causes of health disparities. Culturally competent care that is sensitive to family needs, their health literacy and health beliefs can increase satisfaction, improve quality of care and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include 1) screening for new health vital signs and connecting families to resources; 2) enhancing the comprehensiveness of services; 3) addressing family health in pediatric encounters; 4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity.

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Health Equity and Children's Rights

Cited by 73 publications

References 70 publications

For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade

For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade

Global Climate Change and Children’s Health: Threats and Strategies for Prevention

Child Health Disparities: What Can a Clinician Do?

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