Families in challenging socioeconomic situations face many barriers to adequate healthcare. According to the APA, children and teens living in poorer communities are at increased risk for a wide range of physical health problems including but not limited to chronic conditions such as asthma, anemia, and pneumonia as well as exposure to environmental contaminants, such as lead paint (http://www.apa.org/pi/families/poverty.aspx). You have likely seen the effects of poverty on healthcare in the child who uses the ED as their medical home, the patient with poorly controlled asthma due to lack of consistent care or the child in need of glasses but the cost to get them is too expensive.
There are a few organizations that are working to help meet the basic needs of children and families in an effort to combat the effects of poverty and improve overall healthcare and they are succeeding in very innovative ways.
"Health Leads works with clinic partners to treat the non-medical factors that impact patients’ health. By addressing basic resource needs like food and heat, Health Leads enables clinics to offer comprehensive care for their patients. A fully integrated component of care delivery, Health Leads provides a complete picture of patients’ health, improving outcomes while lowering costs."
Two other organizations are bringing medicine to the children directly in the low income areas where they live:
The University of Florida's Dr. Nancy Hardt wanted to be able "to do something to intervene in the lives of vulnerable kids on a large scale, not just patient by patient. So, by looking at Medicaid records, she made a map that showed exactly where Gainesville children were born into poverty, block by block" and launched a mobile clinic to go out to the highest poverty areas to directly meet the community needs. You can read more about Dr. Hardt's initiative here: http://www.npr.org/blogs/health/2015/03/10/377566905/a-sheriff-and-a-doctor-team-up-to-map-childhood-trauma
Understanding that "for too many children in poor rural and urban areas, there is no consistent, quality health care in their lives," the Children's Health fund has been meeting the needs of the uninsured and underinsured since 1987, http://www.childrenshealthfund.org/. According to their website, they have served over 2 million patients across the country. From their "blue bus " mobile clinics, which draw children and families curbside in some of the most underserved areas, to their Healthy and Ready to Learn initiative which addresses eight key health-related barriers to learning, they are truly making an amazing impact in the lives of children.
These organziations are providing an amazing service to those in need and using out of the box thinking to pave the way for new models in the delivery of healthcare. As we are seeing the field of child life slowly expand to areas outside the hospital walls, I see these new models as a great opportuity to reach more children and families who could benefit from the support of a child life specialist.