Why Pediatricians Need Lawyers to Keep Children Healthy

Zuckerman, Barry; Sandel, Megan; Smith, Lauren A.; Lawton, Ellen

doi:10.1542/peds.114.1.224

Cited by 80 publications

(55 citation statements)

References 16 publications

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“…5 By screening, identifying, and resolving unmet social needs before they develop into true barriers and legal emergencies, Medical-Legal Partnership programs have shown the ability to improve care delivery for pediatric populations. 22,23 This has important implications for cancer care delivery in safety net settings caring for similar vulnerable populations. While LegalHealth (New York, NY), the first legal services program serving people with cancer, has documented patient benefits through several case studies, 5 more rigorous studies are needed targeting the most vulnerable populations.…”

Section: Discussionmentioning

confidence: 99%

Social Service Barriers Delay Care Among Women with Abnormal Cancer Screening

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Social Service Barriers Delay Care Among Women with Abnormal Cancer Screening

et al. 2013

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“…31 Attorneys with expertise in poverty law are natural allies for pediatricians caring for lowincome patient families with multiple legal needs found at the bottom of Maslow's Hierarchy. 32 Our collaborative began with a shared vision of child and family well-being and the recognition that the 2 organizations served many of the same families (phases 1 and 2). An assembled team of staff from both organizations designed how to most effectively serve needy families.…”

Section: Figurementioning

confidence: 99%

“…11,38,39 Just as a primary care physician might refer a patient to a clinical subspecialist to intervene clinically, the physician could similarly refer patients to communitybased experts to intervene on behalf of economic, environmental, and psychosocial needs. 32,40 …”

Section: Figurementioning

confidence: 99%

A Road Map to Address the Social Determinants of Health Through Community Collaboration

Henize¹,

Beck

Klein

et al. 2015

Pediatrics

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Economic, environmental, and psychosocial needs are common and wideranging among families cared for in primary care settings. Still, pediatric care delivery models are not set up to systematically address these fundamental risks to health. We offer a roadmap to help structure primary care approaches to these needs through the development of comprehensive and effective collaborations between the primary care setting and community partners. We use Maslow's Hierarchy of Needs as a well-recognized conceptual model to organize, prioritize, and determine appropriate interventions that can be adapted to both small and large practices. Specifically, collaborations with community organizations expert in addressing issues commonly encountered in primary care centers can be designed and executed in a phased manner: (1) build the case for action through a family-centered risk assessment, (2) organize and prioritize risks and interventions, (3) develop and sustain interventions, and (4) operationalize interventions in the clinical setting. This phased approach to collaboration also includes shared vision, codeveloped plans for implementation and evaluation, resource alignment, joint reflection and adaptation, and shared decisions regarding next steps. Training, electronic health record integration, refinement by using quality improvement methods, and innovative use of clinical space are important components that may be useful in a variety of clinical settings. Successful examples highlight how clinical-community partnerships can help to systematically address a hierarchy of needs for children and families. Pediatricians and community partners can collaborate to improve the well-being of at-risk children by leveraging their respective strengths and shared vision for healthy families.Pediatricians and primary care centers embrace the importance of identifying and acting on the economic, environmental, and psychosocial needs faced by their patients and families. Early recognition and action on these social determinants of health (SDH) are increasingly seen as critical, given their known impact on morbidity and mortality. [1][2][3] The related toxic stress model suggests that adverse childhood events often rooted in the SDH disrupt physiologic processes and cause such experiences to "get under the skin."This places children at risk for adverse health and developmental outcomes that can persist into adulthood. 4,5 Defining, identifying, and mitigating these toxic stressors could therefore promote childhood resilience, positive development, and health later in life.There are increasing calls to reshape pediatric care to better address the SDH. The American Academy of Pediatrics has outlined principles of patient-and family-centered care that include supporting and empowering children and families across the life

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“…1). 4 Given that over half of poor and moderate-income individuals experience multiple legal problems, 5 the addition of lawyers to the medical team can promote health and address barriers to effective health care. 6 These non-medical needs have legal solutions that, if addressed, can diminish health disparities.…”

Section: Introductionmentioning

confidence: 99%