Pediatrics
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Advocacy on behalf of children who are medically underserved and the pediatricians who care for them has been a long-standing core commitment of the Royal College of Paediatrics and Child Health and the American Academy of Pediatrics. Although different in etiology, barriers to adequate health care exist in both nations. In the United States, almost 18 million children have either no health insurance or inadequate coverage, whereas in the United Kingdom, parents can, in most cases, readily enroll their youngsters in a universal health insurance program that is not dependent on employers or employment.(1) However, despite universal access to health care in the United Kingdom, as in the United States, there are infants and children who do not regularly use or otherwise connect to available health care delivery systems. ⋯ Both nations have citizens living in extreme poverty with its associated environmental and health hazards and tendencies to health risk behaviors. Both the Royal College of Paediatrics and Child Health and the American Academy of Pediatrics have strategies and programs to address these issues and to support pediatricians who work in their communities to improve the lives of children. The following describes the American Academy of Pediatrics Community Access to Child Health infrastructure that supports practicing community pediatricians in these efforts and opportunities to develop collaborative international endeavors to advance the practice of community pediatrics.
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Poverty has been described as an economic state that does not allow for the provision of basic family and child needs, such as adequate food, clothing, and housing. However, the debate about the effects of poverty on the growth, development, and health of children is as much involved with the culture or general context of poverty as it is with the economics of poverty. This culture of poverty is in part mediated through environmental deprivations, such as failing schools, gangs, drugs, violence, and struggling families. Heclo(1) described this sociocultural and environmental dimension of poverty as "a condition of misery, hopelessness, and dependency." The subject of this article is to review the literature on the effects of poverty on US children as mediated through economic, ecologic, and family influences.