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@NEJM Ask the Authors & Experts: Saving Tiny Tim--Pediatrics and Childhood Poverty in the United States


Saving Tiny Tim — Pediatrics and Childhood Poverty in the United States

Perri Klass, M.D.

N Engl J Med 2016; 374:2201-2205| June 8, 2016 |DOI: 10.1056/NEJMp1603516


In pediatrics, growing and learning almost always go together. Health in a pediatric population implies growth and development. The differential diagnosis for failure to thrive encompasses just about every organ system — because when something goes wrong with the heart or the kidneys or the endocrine system, a child may not grow — and then takes you back to the family, the economic circumstances, the social context. Children grow and learn when they are healthy — or to put it another way, health is expressed in children partly by growing, developing, and learning.

Poverty stunts that growth and development. The damage it does to children’s health is reflected by many indicators, from birth weight to language acquisition to risks for both chronic illness and accidental injury.2 So pediatricians find ourselves talking about how to mitigate those effects of childhood poverty — and how to reduce the number of children living in poverty. Targeted antipoverty efforts have worked before: poverty among the elderly, once the poorest U.S. demographic group, was dramatically reduced by Social Security and Medicare in the mid-20th century. Children, and families with young children, are now disproportionately poor. But bipartisan efforts directed at child poverty have been remarkably successful in Britain and other developed countries, by employing strategies particularly aimed at reducing the expenses and increasing the resources of families with young children.

Originally Appeared in The New England Journal of Medicine on June 8, 2016.

Click here to read the original article.

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