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What Will Open the Doors for Children and Youth With Special Health Care Needs From Traditionally Underserved Communities?

The articles in this supplement to Pediatrics raise serious questions about the current policies and practices that affect children and youth with special health care needs (CYSHCN) from traditionally underserved communities and are a call to action at a time when the United States is experiencing both unprecedented demographic shifts and a serious economic downturn. Although CYSHCN from underserved communities do confront persistent and even worsening barriers to community-based health and developmental services, the articles in this supplement also describe methods for meeting these issues head-on. In the face of these complex conditions, the supplement authors offer practical information and provide guidance that can steer child health care professionals, communities, parents, and policy-makers alike as they work together to form partnerships and take advantage of new models of interaction as well as the new rights and policies that are embedded within the Affordable Care Act of 2010.

Children with special health care needs are living longer and better lives because of improved health care through early identification of problems and new medical and surgical treatments. However, the report by Berry et al, “Children and Youth With Chronic Health Conditions: Another Case of Health Inequity,”1 is a remarkable documentation of the current status of childhood chronic disease disparity patterns and documents a wide gap in chronic disease severity and outcomes for black, Hispanic, and white children. The gap in incidence and prevalence of disease among white, Hispanic, and black children is essentially consistent across the clinical conditions researched. These findings are especially troublesome, because they reflect a worsening of conditions and complex issues for this vulnerable and often fragile population.

Social determinants such as poverty, substandard housing, poor nutrition, and undesirable social and environmental conditions are strongly influential factors in many minority communities and may heavily contribute to poor outcomes. … 

Address correspondence to Thomas Chapman, MPH, EdD, HSC Foundation, 1808 I St NW, 600, Washington, DC 20006-5429. E-mail: tchapman{at}cscn.org