AAP Voices Blog

As we walk around the Pediatric Intensive Care Unit, we often peer into rooms and wonder how these children ended up at our respective hospitals. We may know what’s medically wrong with them, of course, but when we look closer, we find that many of them are here because of systemic failures that have led to significant health disparities for kids.

Perhaps a child has asthma, but that’s not the whole reason that he or she needed to be in the PICU. Perhaps the parents changed jobs or did not fill out long and confusing forms correctly, so their child did not qualify for insurance this year and could not see his or her regular doctor or get needed prescriptions. Perhaps there is no heat in the house, and the change in weather exacerbated his or her condition. Perhaps the child does not have a stable home at all.

We are surrounded by preventable illness and injury.

As peds intensivists, we are used to treating the acute conditions, stabilizing the patients, and transferring them to the pediatric floor or sending them home. But we are missing opportunities to improve the health of the child. Sometimes it is on an individual level: Did I ask the questions that would have helped me figure out the root cause of a child’s admission? Could I have done something concrete to improve the life and health of not just the child, but of his or her whole family?

“Many children grow up under constant threats of racism, food and housing insecurity, unstable access to health care, climate change, and pandemics, and they suffer when no one looks out for their needs.”

But there are other ways that we can fight for health equity. Pediatric subspecialists, including those of us in pediatric critical care, must take a more active role in advocacy. We underestimate our potential influence on policies and laws that can make real differences in the lives of all children.

The stories that we tell are important and powerful, and we often do not take the opportunity to share them.

The single most important thing that all pediatricians can do in the next 2½ weeks is to participate in the AAP Get Out the Vote campaign. In some recent elections, less than one-third of doctors voted, according to Stat.

We must change this by prioritizing voting in our practices, with our colleagues, and throughout our communities. Every eligible provider needs to check his or her voting registration, talk to patients and families about voting, and have a voting plan. Children cannot vote, of course, but we can speak for them through our ballots.

Many children grow up under constant threats of racism, food and housing insecurity, unstable access to health care, climate change, and pandemics, and they suffer when no one looks out for their needs. Child health issues are not partisan issues; in our professional lives, we are nonpartisan. We must recognize the connection between voting and health equity when choosing our elected officials. Systemic social differences should not be the deciding factor in a child’s health.

Congressman and civil rights activist John Lewis, who died this year, said: “The vote is precious. It is almost sacred.” What specifically can we in the pediatric community do to get out the vote? Here are a few ways:

• Make sure that your voter registration is current. Go to Vote.org to check, and if you need to register, you can check your state’s deadline on the site. Some states allow in-person registration on Election Day.
• You can apply for a mail-in ballot in your home state and encourage patients’ families to do the same. Mail-in ballots can ease fears about COVID-19 exposure at polling places. Check here to find out your state’s deadline for mailing back ballots.
• Talk to friends and family about voting. Talk to residents, students, trainees, and co-workers about the importance of voting and encourage them and the program to make plans so that they can vote in person, if they need to do so.
• Heavily promote voting on social media channels and be an active #tweetiatrician.
• Work with VotER, a nonprofit organization that posits that more voters build better health care systems. The program teaches health care professionals how to talk to patients about voting.

Because voting is a health equity issue, it can be approached through diversity and inclusion committees, starting in the children’s hospital and expanding to other residency programs such as emergency medicine, internal medicine, obstetrics and gynecology, and family medicine.

We strongly believe that pediatric subspecialists can harness the power of our voices and our votes to make the world better for children. Remember John Lewis’ words that “democracy is not a state. It is an act,” and #VoteKids on Nov. 3.