Pediatricians must screen patients' families for poverty

Given the established link between poverty and its adverse effect on health, the country's largest pediatricians' group is urging its members to screen their patients for poverty.

In recommendations released today, the American Academy of Pediatrics (AAP) calls for its 64,000 members to ask patients' family members a question during office visits: "Do you have difficulty making ends meet at the end of the month?"

The question is intended to screen for poverty, which can have serious lifelong health consequences. Last fall, the AAP urged members to ask children if they regularly had enough to eat or ever went hungry. Physicians should screen for poverty-related health risks during child visits by asking about basic needs such as food, housing and heat, according to the new recommendations.

The association wants to help identify children and families that might suffer ill effects from the chronic stress that people living below the poverty line often experience.

Pediatricians can link families who need help to community resources, James Duffee, M.D., a Springfield, Ohio pediatrician and one of the authors of the AAP policy statement, said in an interview with Cleveland's The Plain Dealer. They can also keep a closer eye on these children who are at greater risk for health problems.

Poverty effects children living in both cities and suburbs, in places that physicians might not expect. "It's everywhere, and any doctors who say it doesn't affect their practices are wrong," Andrew Garner, M.D., a pediatrician at University Hospitals Rainbow Babies & Children's Hospital who has a practice in an affluent Cleveland suburb, told the newspaper. "It's a place that you wouldn't think you'd see much poverty, but there isn't a day that goes by when I don't have a conversation with a family about costs of medicine, or reluctance to see a specialist because of high copays, or problems with transportation."

The AAP policy statement appears in the April 2016 issue of Pediatrics and describes the ways poverty harms children's' health. The AAP says nearly half of young children in the U.S. live in or near poverty, which is tied to a range of lasting medical issues. Chronic or toxic stress, caused by long-term exposure to stress hormones and inflammation, can have lifelong health consequences.

It's not just children whose health is at risk from living in poverty. Nearly 40 percent of the U.S. population meets criteria to be considered low-income and the American Academy of Family Physicians last year advised that physicians must take special care to support such patients in a way that improves health outcomes. As FiercePracticeManagement previously reported, it's more difficult for adults who can't afford healthy food, prescription drugs or their utility bills to stay healthy.

To learn more:
- read the AAP announcement
- see The Plain Dealer article