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AAP Agenda for Children: Health Equity

Significant child health disparities exist by race, ethnicity, and immigrant status. Across a range of health conditions including infant mortality, obesity, and asthma; children of racial and ethnic minority backgrounds fare worse than their majority peers.  These health disparities are shaped by a variety of factors within and outside of the health care system. Inadequate access to quality health care is a significant barrier and social and economic factors are equally influential. Poverty, inequality, and community conditions are particularly notable determinants of childhood health disparities.

Pediatricians are an essential part of the national effort to eliminate health disparities, as they can influence a child’s health, development, and life course trajectory. Promoting effective pediatric strategies and approaches to reduce child health disparities is critical for putting children on a healthy life course and improving the public health.

In addition to the numerous programmatic, advocacy, educational, collaborative, and research activities that incorporate concepts of health equity into them, the AAP has the following specific activities related to health equity:

AAP Health Equity Principles

In November 2009, the AAP Board of Directors approved a set of Principles to Reduce Disparities and Promote Equity in Children's Health Care. These principles are intended to frame the health equity universal principle found on the AAP Agenda for Children. The principles will serve to communicate AAP commitment to reducing disparities and promoting equity in children’s health care, as well as guide work in this area.

Health Equity Policy Statement

In April 2010, Pediatrics published the policy statement "Health Equity and Children's Rights". This policy statement outlines the need for reducing pediatric health disparities and increasing pediatric health equity; and presents recommendations for clinical practice and for the AAP.

Health Disparities/Health Literacy Supplement to Pediatrics

In November 2009, Pediatrics published a supplement dedicated to pediatric health disparities and health literacy. The health disparities supplement, "Starting Early: A Life-Course Perspective on Child Health Disparities - Developing a Research Action Agenda", presents papers that conceptualize and present potential ways to address child health disparities. The health literacy section of the supplement, "Health Literacy and Children", presents a series of articles highlighting current information and research about the importance of health literacy in caring for children and families.

Health Disparities Technical Report

In November 2009, Pediatrics published the technical report, "Racial and Ethnic Disparities in Health and Health Care of Children". This technical report reviews and synthesizes the published literature on racial/ethnic disparities in children's health and health care.

Health Equity Recommendations

In February 2008, the AAP Board of Directors approved the Academy's plan to reduce health disparities and increase health equity. Several recommendations were approved related to:
  • Improving access to quality care with adequate payment for services
  • Raising awareness and education
  • Assimilating health equity into the work of the AAP
  • A long-term implementation plan for the recommendations is currently being implemented.
Additional Health Disparities and Health Equity Initiatives across the Academy

  • Policy – There are a number of policy statements on the issues of pediatric workforce, culturally effective care, non-discrimination in pediatric care, care of immigrant, homeless, and migrant children, and access.
  • Education – Activities include sponsoring a national meeting Inuit and Native Child Health, health equity web page, the AAP health literacy initiative, and tracks and/or programs at several AAP-sponsored national meetings.
  • Advocacy – There are several advocacy efforts being undertaken including implementation of health reform legislation and advocating for access and funding for language interpreter services.
  • Research – Research is also being expanded to obtain adequate diverse samples, examining child health outcomes by race/ethnicity, and publishing data from select research studies being conducted on child health disparities and health equity.
In addition, the Academy collaborates with or participates on the following initiatives: Commission to End Healthcare Disparities, Health Professionals for Diversity coalition, and NICHQ Cultural Competence Project Advisory Committee.
Commonly Requested Resources

Additional AAP Policy Statements:

Community Pediatrics: Navigating the Intersection of Medicine, Public Health, and Social Determinants of Child Health

Committee on Psychosocial Aspect of Child and Family Health Pediatrics Policy Statement,  Promoting the Well-Being of Children Whose Parents Are Gay or Lesbian

Council on Community Pediatrics, Providing Care for Immigrant, Migrant, and Border Children

Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy
Pediatrics Vol. 114 No. 6 December 2004, pp. 1677-1685 - Reaffirmed 2008

Enhancing the Diversity of the Pediatrician Workforce
Pediatrics Vol. 119 No. 4 April 2007, pp. 833-837

AAP Resources:

Educational Goals and Objectives for Culturally Effective Pediatric Care for Residents in Pediatrics
AAP Committee on Pediatric Education, 2008 Provides list of goals and objectives in providing culturally effective care for pediatric residents.

Resources for Medical Education on the Provision of Culturally Effective Care
AAP Committee on Pediatric Education, 2008 Provides comprehensive list of resources, tools, articles, and Web sites regarding the provision of culturally effective pediatric care.

Culturally Effective Care in the Medical Home
The National Center of Medical Home Initiatives, housed at the AAP, has developed a list of helpful resources for engaging in compassionate and culturally effective care for children and families

Health Literacy PediaLink Course
Self-paced PediaLink course to assist residents in meeting the RRC competencies surrounding culturally-effective interpersonal and communication skills and systems-based practice.

Plain Language Pediatrics: Health Literacy Strategies and Communication Resrouces for Common Pediatric Topics 
A pediatric-focused health literacy guidebook that provides communication resources for common topics such as ear infections, temper tantrums, and medication dosing.

Web Conference - Putting Health Literacy into Practice: A Pediatric Approach May 2007
This web conference provides information for addressing health literacy issues relevant to improving communication with families and how to assess plain language print materials. In addition, five short video clips accompany the presentation to illustrate the challenges of health literacy from the parent perspective.

Children's Rights Curriculum
This curriculum can be used to raise awareness of the relationship between public policy and the health rights of children, and encourage a commitment to the development of an advocacy role related to children's rights.

If you would like more information about Health Equity activities, please contact the Council on Community Pediatrics Staff at or (800) 433-9016, ext 7085.
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