Childhood poverty is growing in North Carolina. As of 2012, more than half a million children in the state are living in poverty, and of these, more than half are in extreme poverty. The health implications for these children are profound; research shows children born into poor families have higher hospital readmission rates, sick days, rates of chronic illness, and death rates compared to children in non-poor families.
As most pediatricians have patients who fall below the poverty line, they are seeing the negative health consequences of poverty. Pediatricians are looking for ways to address these issues, which are affecting an increasing number of their patients. Unfortunately, conditions of poverty—inadequate housing, lack of access to healthy foods, lack of transportation for appointments—are not easily remedied.
Pediatricians cannot tackle these issues themselves, nor do they have to. Across the state, organizations and agencies across the states are working to address these issues on at the grassroots level. After speaking to North Carolina pediatricians, however, we found that most were unaware of these local resources and the services they provide.
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Our team of students at UNC set out to fix this by assembling a community health toolkit—a concise, informative database of local resources, the services they provide, and their contact information. With this toolkit, pediatricians can begin to address these larger issues. For example, if patients come in with asthma symptoms exacerbated by their family’s housing situation, instead of merely addressing the symptoms, the doctor can make referrals to an organization that works to get families better housing. This way, pediatricians can provide more than Band-Aid solutions to the problems they’re seeing. In addition, the toolkit benefits community organizations by helping them reach their target populations.
The idea of connecting pediatricians to these resources is coming at a critical time. The Affordable Care Act aims to shift the health care system to a system of value-based reimbursement instead of volume-based reimbursement. Under a value-based system, pediatricians are paid based on the health of their patients, not the number of medical services they provide. Therefore, pediatricians now have even more reason to look at the health of their patients more holistically and address the larger health factors at play.
What we have done by creating this community health toolkit is only the first step in what we see as a necessary change in how we approach health care. Research shows that the causes of poor health are multifaceted, so our solutions should be, too. We hope to see this toolkit model expanded so pediatricians across the nation can bring in local groups to help address the systemic poverty affecting millions of children.