The first American pediatrician, Abraham Jacobi, operated a nursery for orphans of economically destitute parents.For him, childhood disease and poverty were inseparably linked.The answer depends to a large extent on the local health and financial needs of each community.
It turns out this is true of not just health interventions but financial interventions too.
Policies and programs that support family financial stability early in a child's life like the Earned Income Tax Credit (EITC), Medicaid, Supplemental Nutrition Assistance Programs (SNAP) and affordable high quality childcare and preschool have been shown to improve various measures of children's health, development, achievement and, as adults, their ability to sustain themselves financially and create an economic return on investment to their communities.
I realized I could do more as a pediatrician to treat poverty and improve The notion that finances strongly influence health is far from new.
Physicians have recognized financial hardship as a root cause of illness for centuries.
asset building, debt reduction, credit counseling and so on).
A study conducted with LIFT-Los Angeles found that these comprehensive programs improve low-income parents' mental health which is a key determinant of their children's health and development.This has led to a host of clinical programs designed to identify actionable consequences of poverty and financial insecurity, like not being able to afford healthy food or a safe place to stay, and then connect patients to resources that can address these so called "social needs".Of course, these issues would be better treated if they were prevented in the first place by helping patients thrive financially.The baby had been treated for a life-threatening infection and his mother had been with him every minute, hanging on every development in treatment and going through the roller coaster of emotions.Meanwhile she could not work and was losing earnings, and, unbeknownst to me, during his hospital stay she was replaced at her job without legal recourse.Other clinicians and health care systems have implemented programs that integrate financial capability services into routine clinical practice, known as "medical-financial partnerships,” they provide accessible services to patients while also demonstrating how financial well-being and health care can intersect and overlap.Health systems have a huge opportunity to influence and impact financial well-being at the individual and community levels through these approaches.That being said, there are some especially promising strategies with a strong track record of success in many different communities.As a pediatrician, I gravitate toward interventions that focus on the earliest years of life because they have the biggest impact on our lifelong health trajectories.Other times the health harms accumulate over years, such as worse asthma in poor neighborhoods with greater air pollution or earlier development of diabetes due to a combination of the toxic stress of poverty and unhealthy food.Nearly every aspect of a child's health—from cardiovascular fitness to mental health to growth and development—can be deeply impacted by the financial circumstances of their family and community.
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