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Education for Community Pediatrics

To have an impact on many of the most vexing child health issues of our era of necessity requires the pediatrician to expand the boundaries of practice well beyond the walls of the clinic or office. Without exception, none of the leading health needs of America’s children will be met without intense community-based work, as well as individual patient/family intervention.1,2 Examples include improving access to health care, ser ving children with special needs (chronically ill and handicapped), modifying the effects of school-related problems, preventing youth and family violence, reducing rates of obesity, and delaying the onset of degenerative diseases. Pediatricians see health problems that are socially determined, but not necessarily linked to low income, such as eating disorders, depression, substance abuse, and motor vehicle injuries. We are also increasingly aware of the effects of disparities in healthcare access and health status among poor children, children of color, and children of new immigrants. Addressing these “non-traditional” issues is a central part of our discipline and our practice.3-6 In community pediatrics, a pediatrician strives to provide services to and advocacy for a population of children in a community regardless of their social status or income to maximize their health and functioning. Community-focused pediatricians provide preventive and curative services and work to understand the determinants and consequences of child health and illness and the effectiveness of services provided. The American Academy of Pediatrics is clear that all pediatricians, generalists and specialists alike, need to practice community pediatrics, defined by all of the following:7