Competency 7. Know how to advocate for the promotion of health and the prevention of disease and injury in populations

Abstract

The pediatrician's role as advocate for children's health from a population perspective has been recognized for centuries. 1 Rushton F.E. The pediatrician's role in community pediatrics. Pediatrics. 2005; 115: 1092-1094 Crossref PubMed Scopus (78) Google Scholar For physicians to effectively manage the health of individuals, it is essential that they are aware of and knowledgeable about “health promotion, disease prevention, and management of costs for a population of patients.” 2 Bowen J.L. Adapting residency training—training adaptable residents. West J Med. 1998; 168: 371-377 PubMed Google Scholar Pediatricians need to be informed about their community and the population they care for, including health and social risks, in order to effectively advocate for improvement in child health and safety. 1 Rushton F.E. The pediatrician's role in community pediatrics. Pediatrics. 2005; 115: 1092-1094 Crossref PubMed Scopus (78) Google Scholar An interdisciplinary approach in which the pediatrician collaborates with advocates from various walks of life is the best way to effect change and improve the health status of the population at large. This approach may include parents, teachers, nurses, lawyers, and government officials, among others. 1 Rushton F.E. The pediatrician's role in community pediatrics. Pediatrics. 2005; 115: 1092-1094 Crossref PubMed Scopus (78) Google Scholar Bicycle helmet and booster seat laws are examples of collaborative efforts pediatricians have engaged in that have had an enormous impact on the health of the pediatric population. Control of an influenza epidemic is a clear example of how a population approach to disease prevention can impact an individual patient. Physicians also advocate through mandated reporting responsibilities, such as reporting adverse drug events to the US Food and Drug Administration or reporting notifiable diseases to the state or local health department. 3 Pomrehn P.R. Davis M.V. Chen D.W. Barker W. Prevention for the 21st century: setting the context through undergraduate medical education. Acad Med. 2000; 75: S5-S13 Crossref PubMed Scopus (58) Google Scholar Physicians can become engaged at local, state, and national levels in this mission. The role of the physician requires him to inform, educate, and empower people and communities about health issues. 4 Zweifler J. Gonzalez A.M. Teaching residents to care for culturally diverse populations. Acad Med. 1998; 73: 1056-1061 Crossref PubMed Scopus (57) Google Scholar To be effective, the physician must have an understanding of the health literacy of the population served, so that the patients understand and act on the health care information provided. 5 Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. Health literacy: report of the Council on Scientific Affairs. JAMA. 1999; 281: 552-557 Crossref PubMed Scopus (1079) Google Scholar The medical literature supports the importance of an increased focus on the prevention of injury and disease in the medical community rather than just on the treatment of the resulting morbidity and mortality. 2 Bowen J.L. Adapting residency training—training adaptable residents. West J Med. 1998; 168: 371-377 PubMed Google Scholar , 6 Satcher D. Kaczorowski J. Topa D. The expanding role of the pediatrician in improving child health in the 21st century. Pediatrics. 2005; 115: 1124-1128 Crossref PubMed Scopus (44) Google Scholar It is essential that physicians' education about prevention and population health begin during medical school, with an expectation that advocacy and health promotion will become a part of routine practice.