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District II Member, |
Policy, & Politics...
pediatricians, we confront the challenges of keeping children healthy
and well. And we know only too well that children need more than the
very direct health related services we provide to attain their full
developmental, social, emotional and intellectual potential. Our own
Bright Futures model of pediatric care is rooted in the concept of
pediatrics not only assessing the health and well-being of the whole
child, but taking and suggesting concrete steps that children and
families may take to address the challenges they face. Anticipatory
guidance is itself the policy of prevention made real for children and
policy, and politics are inextricably related. State and federal policy
and the attendant politics directly impact our ability to do our work
keeping children healthy. Some very obvious examples of policy and
politics directly affecting children's health and well-being include:
gun control, addressing poverty, access to high quality infant and child
care, access to quality health care, equity in education, and
environmental justice. How our nation, our state, and our local
communities address these issues directly affects our ability to keep
our pediatric patients healthy and well.
read on for details.
Laraque, MD, FAAP
AAP District II, New York State
NYS AAP Public Policy & Advocacy Committee
the relationship between pediatrics, policy, and politics, the
NYS AAP has created a Public Policy and Advocacy Committee. The
Committee has representation from all 3 AAP NY Chapters. It
meets regularly to discuss, process, and come to consensus on
recommendations to the NYS AAP leadership on policy and
year's priorities are available on the NYS AAP website:
focus on both strengthening the practice of pediatrics and
improving the life chances of all children. I invite you to
review the documents, download them and use them in your
advocacy with your legislators. Part of our practice must
include educating our legislators and our other state leaders
about what it really takes to support the healthy development of
this time of strong divisions in politics and policies, it is
important that we remain focused on what is good for children.
That is, the presence of a caring, nurturing adult, and adequate
income to support stable and safe housing and good nutrition.
What is good for children - high quality, affordable infant and
child care and good schools.
we also know the conditions that can dim the prospects for
children's good health and well-being. Research has demonstrated
that poverty and toxic stress, often paired in our society,
negatively impact all aspects of child development. There are
evidenced based interventions that can be targeted to both
negative indicators. Child poverty can be addressed through
family income supports, fair wages for work, and other tools
such as real tax credits and adequate child care credits. These
strategies and tactics have been employed successfully in
countries with poverty statistics that are far better than ours.
Income inequality does impact child health. We can learn from
these lessons and apply them.
stress is a multifaceted problem. It is often related to lack of
parenting skills or absence of positive parenting role models,
domestic violence, child abuse and neglect, gun violence,
homelessness, untreated mental illness of parent and/or child,
substance abuse, and environmental toxins, to name a few.
Effective interventions may include mental health treatment, the
Nurse Family Partnership Home Visiting Program, housing support
programs such as rent subsidies, and supportive housing. Our
work is to identify the problems as child-focused and the
solutions as child-supportive.
the practical side, we have to assure that as we speak up for
the well-being of children, we are also speaking on behalf of
the health and survival of pediatrics in the ever changing
systems of health care delivery and new payment models.
2013 NYS AAP Annual Advocacy Day held on March 19th in Albany
highlighted children's mental health and the perspective on
children's health from the Chairs of the Assembly and Senate
Health Committees. The development of New York State's Health
Insurance Exchange and its potential impact on pediatric care
was reviewed. Sherry L. Tomasky, Director, Stakeholder
Engagement, NY Health Benefit Exchange, NYSDOH, described
the current implementation schedule and how the Exchange will
operate. She also detailed how families will be accessing care
through neighborhood based navigators and/or the electronic
portal. The general approach is to provide all types of support
for families to access the Exchange and get the information they
need to make informed decisions about coverage that is available
and affordable. The Exchange is planning to be ready to accept
applications by October of this year.
Oechsner, Deputy Superintendent for Health, NYS Dept. of
Financial Services, offered an overview of current health
insurance issues relative to children's coverage. He also
highlighted various improvements in coverage that the District
has worked on together with the department over the last several
years. His presentation was followed by a lively discussion of
the possibility of creating a New York State specific Bright
Futures benefit to be required coverage for all insurance
products, commercial and subsidized. The NYS AAP is planning to
follow up on this issue. We will keep you informed of our
* * * *
we enter the season of spring, there is much hope and potential.
But there is also much work to be done. Pediatricians have
always been child advocates. Now, more than ever, we know about
the detrimental effects of stressful environments. We must align
our scientific knowledge and our social consciousness with our
policies. The evidence on the positive effect of high quality
infant and child care, and importance of good and safe schools
are clear. We need to raise our voices for children and for the
pediatricians who serve them. It is past time that we create
another "Decade of the Child" here in New York.