advocacy

Transforming the Lives of Children with Asthma

Asthma continues to be a major public health concern affecting 26.5 million Americans nationwide.  Currently, it is the most common chronic condition among children with approximately 6.1 million children under the age of 18 diagnosed with asthma, and the third leading cause of hospitalizations in children. Asthma also has a significant financial impact, as it is currently responsible for an annual expenditure of $50.3 billion in healthcare costs and leads to numerous missed school and work days approximating $3 billion.  Fortunately, asthma symptoms and costs can be controlled when affected individuals have access to appropriate care and education.  Therefore, there is an increasing need to provide proper asthma education to patients and their families in order to prevent recurrent ER visits, hospitalizations, and even death.  (more…)

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Reproductive Health in Adolescence

While pediatric care spans from birth to 18 years, issues of adolescence, particularly regarding reproductive healthcare, often seem to be overlooked. According to the CDC, among high school students in 2017, 40% had ever had sexual intercourse, 10% had four or more sexual partners, and 46% did not use a condom when they were most recently sexually active1. Appropriate reproductive healthcare is crucial considering these statistics and their implications on various issues such as teenage pregnancy and sexually transmitted infections (STIs), as well as the mental and emotional well being of adolescents. Therefore, care of an adolescent patient should always include taking a thorough sexual history, as well as providing guidance on sexual health and safe practices. (more…)

Heat Stroke in High School Football Players: A Lack of Regulation Placing Children at Risk

At the start of every school year, thousands of high school athletes come in excited to hit the field.  Unfortunately, heat related death in high school sports, especially high school football, remains a real risk due to lack of regulations and safeguards in place.  However, these injuries and deaths are entirely preventable by proper practices.  Pediatricians have a duty and an opportunity to protect these athletes from environments and circumstances that put them at increased risk for heat stroke and death.

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Promoting Physical Activity in Children: The role of a Pediatrician

Almost everyone, especially medical professionals, would agree that getting regular exercise is good for your health. Many studies have shown that regular exercise decreases the risk of cancer, heart disease, and premature death in general. In children, increased physical activity has been linked to better performance in school. Despite the clear benefits of physical activity on health and other outcomes, few patients report receiving physical activity counseling from their primary care physician. As physicians and leaders in the community, pediatricians should provide appropriate physical activity counseling to their patients, as well support efforts to better assess and address obstacles to regular physical activity in the pediatric population. (more…)

Keep Schools Safe: No place for firearms

In 1990, the country took action to decrease the amount of gun violence present in schools across the nation by passing the federal Gun-Free School Zones Act originally part of the Crime Control Act. Now, a pending bill called the Safe Students Act, H.R. 34, proposes repealing prohibition of guns on school campuses and would threaten that protection. As pediatricians committed to improving children’s health and safety, we must help prevent this dangerous bill from becoming a law. (more…)

Consciously Supporting Concussion Awareness

In recent years, public interest has increased surrounding concussions/mild traumatic brain injuries (MTBI). This is due in large part to the recent hypothesis that concussive forces from contact sports may be a risk factor for the development of chronic traumatic encephalopathy (CTE), a disease seen most often in former boxers and professional football players.

Research, legislation, and documentaries have sought to better define the incidence and risks of concussions, its relationship to these 2 diseases, and to increase public awareness of this issue. Currently, legislation is pending in both the U.S. House of Representatives and the Senate that has the potential to further achieve these goals by increasing general awareness about concussions and giving parents and youth the ability to make informed decisions about the sports in which they participate. We as pediatricians can advocate for the safety of our patients by contacting our local representatives and asking them to become cosponsors for the “SAFE PLAY Act” (H.R. 829).

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It’s Time to Expand Family Medical Leave

The Family Medical Leave Act (FMLA) is a federal law that revolutionized the relationship between the American work force and medical care.  The law grants employees the right to up to 12 weeks of unpaid leave from work due to the birth of a child or to take care of serious health needs for themselves or their immediate families.  However, FMLA omits much of the American work force and only guarantees unpaid medical leave.  This means that the protection offered by FMLA is unavailable and inadequate for many American families, leaving the health of millions of American children is at risk.  As pediatricians we can advocate for our patients by supporting legislation that expands FMLA. (more…)

The Care of Refugee and Immigrant Children

The following is a general outline on approaching  care of a refugee or immigrant child.

Comprehensive Health Screen –In addition to a general history and physical, providers should be aware of the unique health care needs of the immigrant or refugee child. The following are examples of what a pediatrician should consider when evaluating the health of an immigrant or refugee child:

  • Nutrition (under-nutrition, malnutrition, vitamin/ nutrient deficiency or obesity)
  • Exposures (lead, opium, heroin, betel nut, herbal treatments)
  • Infectious Diseases (endemic to country of origin)
  • Mental Health (depression, anxiety, post-traumatic stress disorder)
  • Cultural Practices (female genital cutting or traditional cutting)

Access- connect children with public benefits and ensure that there is proper access to healthcare while in the States. (more…)

Binge Drinking in Adolescents, a Pediatrician’s Role.

Adolescence is a period of limit testing in which children and young adults are at increased risk of substance abuse. The most frequently used substance by adolescents is alcohol.  Adolescents who drink alcohol have an increased rate of binge drinking compared to adults. Adolescent alcohol abuse is associated with an increased risk of chronic alcohol abuse leading to serious illnesses as adults. Also, alcohol use can be associated with the leading causes of death and serious injury in ages 15 to 24 (unintentional injury, homicide, suicide).

The AAP Committee on Substance Abuse recently released a Clinical Report titled Binge Drinking (http://pediatrics.aappublications.org/content/136/3/e718.full). In the report, binge drinking is defined and characterized, risk factors are discussed, and neurobiology is addressed.  The authors provide screening guidance for pediatricians.   The report explains that at age 9, children start having positive feelings about alcohol and start thinking that alcohol may not be just for adults. This means that ages 9-15 is a critical period for screening and intervention.   The report recommends that pediatricians should screen every patient for alcohol use starting at age 9.

The NIAAA collaborated with the AAP to develop a quick two-question screening tool that varies by the  patient’s age.  The questions focus about asking the patient about their own alcohol usage and their friend’s alcohol usage.

Here is an image summarizing the screening tool:

Screen Shot 2015-09-30 at 4.29.54 PM
In addition to screening patients, pediatricians can support the Sober Truth on Preventing (STOP) Underage Drinking Reauthorization Act (H.R. 1717, S. 728).
This bill will reauthorize an act targeted at reducing underage drinking through research, a highly-visible national media campaign, and grants to public health care providers/community organizations/ and partnerships with higher education institutions.
( https://www.congress.gov/bill/114th-congress/house-bill/1717?q={%22search%22%3A[%22sober+truth%22]}&resultIndex=1 )

What YOU can do:

  • Educate yourself about alcohol use in adolescents and it’s health effects.
  • Screen every patient starting at age 9 for alcohol use; intervene as necessary.
  • Talk to your patients and their parents about alcohol-related risks.
  • Contact your federal representatives and ask them to co-sponsor and support  the Reauthorization of the STOP Act.

 

Sources and Resources:
AAP Clinical Report, Binge Drinking. http://pediatrics.aappublications.org/content/136/3/e718.full
http://pubs.niaaa.nih.gov/publications/Practitioner/YouthGuide/YouthGuideOrderForm.htm
http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/underage-drinking
http://www.stopalcoholabuse.gov/Default.aspx
http://www.samhsa.gov/underage-drinking

https://www.congress.gov/bill/114th-congress/house-bill/1717?q=%22search%22%3A%5B%22sober+truth%22%5D&resultIndex=1)

Paul Teran, MD

Child Trafficking: A Public Health Concern

Human trafficking is not only a global issue, but also a major public health concern within the United States. Studies suggest that up to half of trafficking victims seek medical attention at least once during their trafficking situation. This represents a large, often-missed opportunity for healthcare professionals to intervene. The injustices of human trafficking include forced labor, involuntary servitude, child soldiers, and sex trafficking. Some estimate that over 20 million men, women, and children are victims of human trafficking worldwide. [1] However, the scope of the problem is difficult to quantify, given the covert nature of the crime. The U.S. government no longer includes official estimates in its annual “Trafficking in Persons” reports. In 2004, the Department of Justice estimated that 14,500-17,500 trafficking victims were brought to the U.S. each year. [2] In addition to the victims brought illegally to this country, another 300,000+ youth within the U.S. are thought to be at risk of exploitation. [3]  As many as 80% of trafficking victims are female, and one-third to one-half are minors. [4] Cases of child trafficking have been confirmed in all 50 U.S. states over the last decade. [3]

Here’s what pediatricians can do to help: (more…)