Advocating for advocacy in pediatrics: supporting lifelong career trajectories.

Abstract

* Abbreviation: AAP — : American Academy of Pediatrics As called for by Dr David Satcher, former US Surgeon General, pediatricians should be advocates to address both individual and community health issues.1 Child advocacy represents actions that promote child health and welfare on a population level, distinct from individual-patient advocacy. Pediatricians could advocate by collaborating with community groups to advance child health and updating legislators to enable more educated decisions regarding laws these policy makers consider. Less than 40% of pediatricians are involved in community-health activities, representing a downward trend from nearly 60% in 1989.2 Pediatricians feel responsible for the broader context of their patient’s health; however, personal and work-related matters may limit their involvement. To address this lack of engagement among the remaining 60% of pediatricians, as well as encourage future pediatricians to help sustain an advocacy mission, we propose the following: Community advocacy has been an essential part of pediatrics since its inception. Dr Abraham Jacobi, considered the founder of pediatrics in the United States, established public milk stations dispensing boiled milk, thus preventing diseases associated with feeding infants raw milk.3 Advocacy was also essential in the formation of the American Academy of Pediatrics (AAP), which stemmed from frustration among pediatricians with the American Medical Association’s condemnation of the Sheppard-Towner Maternity and Infancy Act. This legislation addressed high maternal and infant mortality rates by funding state-based public health programs, but was viewed by the American Medical Association as a threat to physician autonomy. Today, pediatricians remain a trusted source of health information.4 Leveraging this role with legislators makes pediatricians ideal agents for change at the community, state, and national … Address correspondence to Heather L. Brumberg, MD, MPH, Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children’s Hospital at Westchester Medical Center, 100 Woods Rd, Valhalla, NY 10595. E-mail: heather_brumberg{at}nymc.edu