Child Poverty and the Health Care System

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty.

Original languageEnglish (US)
Pages (from-to)S83-S89
JournalAcademic Pediatrics
Volume16
Issue number3
DOIs
StatePublished - Apr 1 2016

Fingerprint

Poverty
Delivery of Health Care
Medicaid
Family Leave
Pediatrics
Patient-Centered Care
Federal Government
Insurance Coverage
Salaries and Fringe Benefits
Social Conditions
Practice Management
Taxes
Health
Case Management
Vulnerable Populations
Health Insurance
Public Policy
Health Services
Referral and Consultation
Economics

Keywords

  • children
  • health care systems
  • health economics
  • poverty

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Child Poverty and the Health Care System. / Racine, Andrew D.

In: Academic Pediatrics, Vol. 16, No. 3, 01.04.2016, p. S83-S89.

Research output: Contribution to journalArticle

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