Pediatric group recommends doctors make questions about poverty part of checkups

Subscribe Now Choose a package that suits your preferences.
Start Free Account Get access to 7 premium stories every month for FREE!
Already a Subscriber? Current print subscriber? Activate your complimentary Digital account.

PITTSBURGH — Calling poverty “one of the most widespread and persistent health risks facing children,” the American Academy of Pediatrics is issuing new recommendations Wednesday urging pediatricians to ask at checkups if families are able to make ends meet.

PITTSBURGH — Calling poverty “one of the most widespread and persistent health risks facing children,” the American Academy of Pediatrics is issuing new recommendations Wednesday urging pediatricians to ask at checkups if families are able to make ends meet.

Kids living in poverty can face a number of health problems, some of which could impact them for their entire lives, such as high rates of asthma and obesity, developmental problems and harmful levels of stress that can alter brain function.

Pediatricians “have a short period of time to really address some issues that could have an impact all through (a child’s) adult life,” said Dr. Joseph Aracri, system chair of pediatrics at Allegheny Health Network.

Poverty can be linked with myriad health problems, from poor housing conditions that can exacerbate asthma, poor nutrition that can lead to obesity and diabetes, and the overall stress of poverty itself.

“All those stresses that are happening in that life, are affecting that kid,” Aracri said.

The policy has been years in the making, said Dr. James Duffee, a primary care pediatrician from Springfield, Ohio, one of the authors of the policy statement.

In October, the American Academy of Pediatrics called on its doctors to screen children and families for problems getting enough healthy food to eat.

“We’re finally getting enough scientific information … to realize how much poverty affects a person’s health throughout the lifespan,” said Duffee, who is also clinical associate professor of Pediatrics at Dayton Children’s Hospital.

At Point Breeze-based Healthy Start Inc., which works with pregnant moms and children under age 2 to fight infant mortality, the health and developmental ill-effects of poverty are plain to see, said Executive Director Vicki Sirockman.

“You’ve got a lot of strikes against you if you are poor,” she said.

Stressed mothers who are worried about housing or where the next meal is coming from aren’t as able to hold and coo and talk to their young babies, which is important for proper development.

“The problems start when they are a wee one and they continue. You aren’t ready for school, you aren’t ready to learn.

“I’m thrilled that the pediatricians are doing this,” she said.

The American Academy of Pediatrics suggests doctors use the question “Do you have difficulty making ends meet at the end of the month?” to help identify families who might be in need of assistance.

To approach what could be a sensitive discussion, “you have to really listen to what your patients are telling you,” said Aracri, who also practices with Pediatric Alliance in Greentree.

“It’s not a screening question like, ‘Do you always use your seat belts?’ It’s a really intimate disclosure … it has to be done sensitively. You can imagine how it feels for people to admit that they don’t have enough food,” Duffee said.

“It’s really important to tell the parent, ‘You’re not in trouble,’ but to connect them with some services that maybe they don’t know about,” Aracri said.

The organization also emphasizes that poverty exists in all areas.

“Since 2008, suburbs have experienced larger and faster increases in poverty than either urban or rural areas,” the group’s policy statement notes.

The organization says pediatricians should also be advocates for safety net programs that assist children, such as the school lunch program, the Supplemental Nutrition Assistance Program (commonly known as food stamps), Head Start, early childhood education and affordable housing.