Implications of Poverty for Practices Serving Suburban Families.

Abstract

* Abbreviations: AAP — : American Academy of Pediatrics SDH — : social determinants of health The adverse effects of poverty on health have been well documented. In response, pediatric clinicians have become increasingly focused on mitigating these effects on children’s health.1 In March 2016, the American Academy of Pediatrics (AAP) released the first-ever policy statement on poverty, calling for pediatricians to screen and address poverty and related social determinants of health (SDH).1 Recent research has developed an evidence base for strategies to address SDH in urban practices.2,3 Notably, poverty has grown by 66% in suburban communities over the past decade, double the rate in cities.4 However, comparatively little information is available for pediatricians on how to address poverty in the suburbs, where almost half of US pediatricians practice and where differences in infrastructure and resources may limit the generalizability of strategies successfully implemented in urban practices.5 This Perspective addresses barriers to and opportunities for pediatricians to better support suburban poor families. Forty-six million Americans, including 16 million children, live below the federal poverty level, or $24 230 for a family of 4. In the past decade, the suburbs have seen a larger increase in poverty than urban and rural areas.1 From 2000 to 2013, two-thirds of the increase in poverty in major metropolitan areas occurred in the suburbs (Fig. 1). The number of near-poor individuals (100% to 200% of the federal poverty level) also increased. Currently, more than half of … Address correspondence to Deepak Palakshappa, Department of Pediatrics, The Children’s Hospital of Philadelphia, 34th St and Civic Center Blvd, CHOP North-1455, Philadelphia, PA 19104. E-mail: palakshappad{at}email.chop.edu