Taking on Childhood Poverty
Jennifer Kusma, MD, Pediatric Resident, Nationwide Children’s Hospital The AAP has taken a stance on Childhood Poverty. There are many approaches to alleviate the side effects and toxic stress that result, and try to help children get out of the known cycle of poverty. The area I have focused on and taken interest in the past few months is food insecurity. The statistics are startling. In Ohio, nearly one out of every five children live in poverty. In the Hunger Vital Sign Study, children at risk for food insecurity were 56% more likely to be in fair or poor health. Additionally, in a study from 2011 in Ohio, only 10.8% of low income children utilized summer feeding programs. In only slightly better news 54% of those same children accessed their school breakfast. The numbers show that there are in fact many hungry kids, but then when I started to ask families in my residency clinic I learned just how much hunger affects the children that I see. So what are we doing about it? There is funding from the federal government for school and summer lunch programs, fortunately for me as a resident this wasn’t something that I needed to find funding for – this is about raising awareness. I have had the opportunity to go to Capitol Hill in DC to advocate with both of our Senators and some of our Representatives to talk about the importance of maintaining strong legislation on the topics of childhood hunger – school lunches, summer lunches, SNAP and WIC. I went with Dr. Murray in Columbus, OH to talk with members of Senator Brown’s staff about the importance of awareness of the summer nutrition program – and keeping it with nutritional options. Next steps would include encouraging all children’s
hospitals in Ohio to participate in a summer lunch program, such as the one this summer at Toledo Children’s Hospital. I have also gotten to help Dr. Sarah Denny put together a piece that was on Good Day Columbus where she raised awareness about summer food options at the start of summer. She provided information on how to find summer food resources in each individual’s neighborhood.
In Ohio, nearly ONE out of every FIVE children live in poverty The last arena that I have tried to tackle is within my own residency program. I have worked with amazing social workers, and they have helped me to put out information in our lobby with the listing of local food resources. We put out a stack at the registration table so that families could take a list if they were interested, and our social worker has said he has to restock this pile regularly. I’m working with preceptors to start screening in our well-child visits for food insecurity, and I’m hoping to also have the list of information available in our Emergency Department and Urgent Care Centers. Hunger is a problem for children in Ohio, and fortunately the funding and resources are there to help us alleviate this problem. We must, as advocates for children, look for ways to utilize what is available and help our kids be hunger free.
CQN ADHD Program: It Takes a Village to Care for Kids ADHD (Attention Deficit Hyperactivity Disorder) is one of the most common neurodevelopmental disorders. According to CDC data from 2011, approximately 11% of children are diagnosed with ADHD and diagnosis rates continue to rise. ADHD is known to have adverse effects on children’s behavior, academic performance, and peer relationships. It places children at risk for learning disabilities and is highly comorbid with other mental health conditions. Parents are often the first to recognize that something is different about their child and frequently seek support from their child’s pediatrician. Yet, many pediatricians feel ill prepared to diagnose and manage the disorder. 14
Ohio Pediatrics • Summer 2016
The American Academy of Pediatrics released guidelines for diagnosis, evaluation, and treatment of ADHD in 2011. Key action statements include the following: 1. Primary care physicians should initiate an evaluation for ADHD in any child 4-18 who presents with symptoms of inattention, hyperactivity, or impulsivity 2. The primary care physician should determine that DSM criteria have been met and rule out any other alternative cause for symptoms 3. The primary care clinician should evaluate for comorbid diagnoses 4. The primary care clinician should recognize ADHD as a chronic condition and manage these cases using the chronic care model and medical home ... continued on page 30