A statement of reaffirmation for this policy was published at 132(6):e1715
From the American Academy of Pediatrics Policy Statement
Health Equity and Children's Rights
Council on Community Pediatrics and Committee on Native American Child Health
Pediatrics April 2010, 125 (4) 838-849; DOI: https://doi.org/10.1542/peds.2010-0235
Abstract
Many children in the United States fail to reach their full health and developmental potential. Disparities in their health and well-being result from the complex interplay of multiple social and environmental determinants that are not adequately addressed by current standards of pediatric practice or public policy. Integrating the principles and practice of child health equity—children's rights, social justice, human capital investment, and health equity ethics—into pediatrics will address the root causes of child health disparities.
Promoting the principles and practice of equity-based clinical care, child advocacy, and child- and family-centered public policy will help to ensure that social and environmental determinants contribute positively to the health and well-being of children. The American Academy of Pediatrics and pediatricians can move the national focus from documenting child health disparities to advancing the principles and practice of child health equity and, in so doing, influence the worldwide practice of pediatrics and child health. All pediatricians, including primary care practitioners and medical and surgical subspecialists, can incorporate these principles into their practice of pediatrics and child health. Integration of these principles into competency-based training and board certification will secure their assimilation into all levels of pediatric practice.
INTRODUCTION
The American Academy of Pediatrics (AAP) is dedicated to reducing health disparities and increasing health care equity for children and adolescents. Toward this end, health care equity was established as a universal principle of its agenda for children in 2005. In 2008, the AAP included health equity in its strategic plan and agenda that expanded this universal principle to focus on other factors that influence children's health and well-being in addition to health care. The AAP continues to expand its programs and policies to address child health disparities through practice, advocacy, education, research, and policy formulation, primarily through initiatives related to ensuring access for all children to quality, patient-centered, and culturally effective medical care. These efforts are critical and must continue but are not sufficient to achieve health equity for all children. The fundamental determinants of children's health and well-being, and subsequently the health and well-being of the adults they will become, are rooted in social, environmental, and behavioral factors that lie beyond the purview of the health care system.1,2
Health disparities in children, as summarized in an upcoming AAP technical report on racial and ethnic disparities,3 will remain all too prevalent until these determinants are addressed through a national agenda on child health equity—an agenda informed by the global children's rights movement.4,5 The AAP and pediatricians have critical roles to play in designing, building, participating in, and sustaining this national agenda. To fulfill these roles, pediatrics and pediatricians must expand beyond a focus on health care and health disparities to engage the broader context of child health equity. This policy statement defines the principles and practice of child health equity as a foundation and framework to support and guide the work of pediatrics and pediatricians in the delivery of clinical services, child advocacy, and policy formulation.
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