Child health equity and children’s rights: A new paradigm for pediatrics

This workshop introduced the principles of child health equity as a new approach to practice, child advocacy, health policy generation, research and professional education. The interactive workshop was led by Dr Jeffrey Goldhagen, University of Florida College of Medicine, Jacksonville, Fl and Thomas F. Tonniges, Boy’s Town National Research Hospital, Omaha, NE.

Dr Goldhagen discussed how the impact of social determinants and the relevance of human rights to health are well established. Child health equity provides pediatricians a way to know how to approach children’s health equity, and child advocacy. As pediatricians learn more about social determinants ie social, economic, political, environmental and cultural, they will gain the tools to intervene on behalf of child health equity. The practice of child health equity is something all pediatricians have the capacity to practice at the clinical, community, and public policy level.

Goldhagen defines equity as the absence of systemic and potentially remediable differences in one or more aspects of health across populations. Disparity tells us there is a difference, it doesn’t tell us why there is a difference and how to intervene. Health disparity is judged to be unfair, unjust, unavoidable and unnecessary.

Goldhagen discussed an equity-based health systems model using the framework from the UN Convention on the Rights of the Child. To gain the full impact of the meaning of child health equity, see the UN Convention online. It is available from the Society for Equity in Child Health, www.EquityChildHealth.org

Dr Tonniges led the audience through a case scenario to demonstrate the use of the principles and model. He talked about his organization of a coalition in his hometown area, Omaha, Nebraska, to address childhood obesity in the community. He noted that children are treated differently depending on what area they live in, in the same community. The community has come together to address this issue and they are using the health equity model. Committees made up of the citizens of the community are overseeing areas designated as important in having an impact on reducing obesity in their children. Some of the committees are addressing areas such as the physical environment, nutrition, physical activities, funding resources, social marketing, and evaluation of outcomes. Some of the areas already being addressed are identification of the children at risk for obesity, the redesign of park areas for recreational use, and testing children for lead levels. Other social advocacy issues suggested by the audience were maternal education regarding breastfeeding, and access to nutrition education about foods eaten outside of the home.

Visitors can access the AAP curriculum “Children’s Rights and Child health: The Interface”, as a resource for study and teaching from the Society for Equity in Child Health website, www.EquityChildHealth.org.