News Release

It takes a village to improve the health of children

Peer-Reviewed Publication

Indiana University

INDIANAPOLIS -- Optimum health care to youngsters is far more than providing routine physical exams, making diagnoses, prescribing therapies, and charting appropriate treatment plans. The ever-evolving role of pediatric physicians requires a fuller understanding of children and adolescents' total environment.

A review article published in the April supplement of the journal Pediatrics outlines strategies for engaging physicians-in-training in this new approach to providing care and building strong community partnerships.

Rigorous residency training in community health and child advocacy will help fight the increasing impact of social and environmental risk factors on the health of children and adolescents. "Many of the health issues affecting our nation's children are problems which the whole community, not solely the individual family must address," says pediatrician and health services researcher Nancy L. Swigonski, M.D., M.P.H., assistant professor of pediatrics at the Indiana University School of Medicine, coauthor of the study.

"Pediatricians see patients for 15 minutes a few times a year to treat such problems as asthma or lead poisoning, but for these illnesses, as for many others, treating the disease is not sufficient. We must alter the environment to get to the root of the problem and we must equip our physicians with the knowledge and skills to work in a community environment, says Dr. Swigonski.

Dr. Swigonski, Sarah Stelzner, M.D., IU assistant professor of clinical pediatrics, and other co-authors provided examples of training programs and strategies for involving pediatricians in community health issues. No single best-practice training model exists, nor should it, for each community and each residency training program is different in its resources and needs, the authors stress.

"For residents and medical students, this training provides an important reconnection to interests and passions that may have led them to a career in medicine, advanced competencies in working with communities and the acquisition of life-long leadership skills relevant to careers in both subspecialty and general pediatrics," the authors observe.

Rigorous training of young physicians in community health and child advocacy will help fight the increasing impact of social and environmental risk factors on the health of children and adolescents.

"Former Surgeon General Dr. David Satcher has warned that 21st century health problems will cause decreased life expectancy, diminished quality of life, lower productivity and increased costs to our society. Pediatricians must learn to partner with other disciplines and community based resources in order to fight problems such as obesity, violence and mental health disorders in our children and youth to stop this negative trend," said Dr. Stelzner. "

This review article, which is co-authored by Laura Jean Shipley, M.D., Elisa Alter Zenni, M.D., Dana Hargunani, M.D., Julie O'Keefe, M.D. Carleen Miller, M.A. and Brian Alverson, M.D., appears in a supplement of the journal Pediatrics devoted to the training of future pediatricians.

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