Poverty and Child Health in the United States

Identifying poverty as one of the most widespread and persistent health risks facing children, the American Academy of Pediatrics (AAP) has issued recommendations urging doctors to ask at all well-child visits whether families are able to make ends meet.

The new policy statement in the April 2016 issue of Pediatrics, “Poverty and Child Health in the United States” and an accompanying technical report (both published online March 9), describe the pervasive ways poverty harms children’s health and development. The AAP calls on pediatricians to commit to helping the 1 in 5 U.S. children who live in poverty access the resources they need to thrive. A single question, “Do you have difficulty making ends meet at the end of the month?” can help identify families who would benefit from community resources.

“Pediatricians are dedicated to preventing illness in children and intervening early when there is a problem,” said James Duffee, MD, MPH, FAAP, one of the authors of the policy statement. “Because poverty so strongly influences children’s health and development, pediatricians are asking about poverty-related stress so we can connect families to resources in their communities.”

Research shows that living in deep and persistent poverty can cause severe, lifelong health problems, including infant mortality, poor language development, higher rates of asthma and obesity, and an increased risk of injuries. A growing body of research links child poverty with toxic stress that can alter gene expression and brain function and contributes to chronic cardiovascular, immune, and psychiatric disorders, as well as behavioral difficulties.

“We know that poverty-related conditions can take a significant and lasting toll,” said John M. Pascoe, MD, MPH, FAAP, a lead author of the technical report. “But we also know there are effective interventions to help buffer these effects, like promoting strong family relationships, which cause positive changes in the body’s stress response system and the architecture of the developing brain.”

Progress has been made to reduce child poverty in the U.S., but the rates remain stubbornly high. According to 2014 U.S. census data, 1 in 5 U.S. children (15.5 million) under age 18 live in poverty. When households designated as poor, near poor or low-income are included, the number of children living in poverty rises to 43 percent (more than 31.5 million).

While urban and rural areas continue to have high rates of poverty, the suburbs have experienced the largest and fastest increases in poverty since the 2008 recession. Pediatricians in every community need to understand the health risks of poverty and how to connect families to a network of local support programs.

Population of focus: Physicians

Links to resource:

Date: 2016

Organization: American Academy of Pediatrics