Suburban poverty is a new kind of challenge for pediatricians

National political discourse has been prone to paint poverty as an urban issue.

That understanding is supported by very real, compelling narratives of unemployment, crime and homelessness — intractable problems that sometimes draw attention away from the fact that poverty is very much a public health issue.

But it’s not one limited to adults, and certainly not one limited to cities.

This past fall, Public Citizens For Children and Youth released a series of reports on childhood poverty in Philadelphia’s suburban counties: Over 22,000 children in Delaware, Montgomery, Chester and Bucks counties are experiencing deep poverty, the nonprofit learned.

That’s over 22,000 children struggling with food security. Whether they’re in a city or a suburb, the health implications of childhood poverty don’t change: All have a higher risk of developing anemia, asthma and psychosocial behavioral problems, said Dr. Deepak Palakshappa, an attending physician at Children’s Hospital of Philadelphia (CHOP).

The current body of research, Palakshappa said in a CHOP blog, deals largely with addressing those issues in urban areas. Childhood poverty in the suburbs was an unforeseen problem.

“I think there’s probably some differences in infrastructure and resources in suburban locations, and some of the studies focused on the urban sites may not translate in particular to the suburban sites,” he said. “For example, there may be fewer food pantries in the suburbs, and they don’t necessarily have infrastructure like public transportation to get people to those resources.”

(Side note: Vetri Community Partnership is experimenting with a way to meet people where they are, healthy foods in hand).

Pediatricians and other health care providers, Palakshappa said, need to become advocates for impoverished families struggling to pay for childcare — especially considering pending shifts in healthcare. Financing for Children’s Health Insurance Program (CHIP) is scheduled to end in 2017, and the incoming administration intends to repeal the Affordable Care Act. (Here’s how local social workers and community health providers are feeling about that.)

Cuts to Medicare will impact children, too:  The health field is just beginning to scratch the surface of holistic family health care.

Immediate work for providers, Palakshappa said, will be attempting to translate methods and resources for fighting food insecurity in cities to the suburbs. He’s currently wrapping up a food security resource guide for suburban families living in poverty.

But the larger task at hand will be influencing policy.

“Pediatricians, nurses, nurse practitioners, and everyone, all have the ability to advocate, locally, statewide, and nationally, to bring up these issues,” he said. “Having that one-on-one connection to families gives them a lot of insight that policymakers and other groups may not have.”