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Child Health Inequality

Numerous studies have acknowledged that the well-being of the nation hinges on the health of its people. This research also shows growing disparities in health outcomes for children.  In a special issue of Health and Social Work Journal from the NASW Press, authors Virginia Rondero Hernandez, Salvador Montana and Kris Clarke explore ways to reduce such disparities in “Child Health Inequality: Framing a Social Work Response.”  

Ignoring children’s health needs can compromise their educational preparedness, occupational pursuits, productivity, and longevity. Current science demonstrates that developmental, emotional, or behavioral limitations experienced during the early years of life and over the life course are associated with poor adult health outcomes. Poverty, restricted access to health insurance and health care services, cultural and linguistic barriers, neighborhood conditions, and racial and class inequalities all contribute to poor health.  (How do we know this is happening?)

The authors believe social workers can effect change that improves health outcomes for children through practice, policy, and research that adheres to the profession’s ethical principles and standards, and promotes aggressive public health strategies.   By examining infant mortality, obesity, asthma, mental health and toxic exposures, the profession can better understand how these issues disproportionately affect children of lower socioeconomic status, and then develop more effective prevention programs.

The authors believe that social workers need to bring their unique skills and perspectives to bear on the problem of child healthcare inequalities.  By looking at and addressing not only the individual healthcare cases, but the family situations and the systemic and environmental factors that play into health and healthcare cases, social workers can work to alleviate the root causes of healthcare problems and healthcare inequalities.  Social workers not only can aid individuals and families in seeking out the healthcare they need, but address the government and societal provision of and facilitation of access to that healthcare.

In order to act against the increase in healthcare inequalities among children in the US the authors outline the following suggestions:

  • Social workers need to be familiar with the philosophical assumptions of the social epidemiology framework and best practices in disease prevention and health promotion.
  • Social workers must remain current in their knowledge about policies related to child health and proficient with research and evaluation strategies in this arena.
  • They must also stay abreast of large-scale efforts to reduce poverty, efforts to improve community environments, and findings that emerge from national studies on child health.
  • Social workers should also become familiar with other disciplines’ perspectives on how to support the developmental health of our nation, research on social determinants of health, and critiques of U.S. health policies that have historically placed the responsibility for health outcomes on individuals, with little consideration of the influences of socioeconomic status and physical environments. 
  • Social workers should also familiarize themselves with sources that demonstrate the importance of culturally relevant interventions and contemporary viewpoints on the role of racism in the development of child health inequality.

The growing healthcare inequality increases the vulnerability of child health in the United States.  This situation threatens the immediate and future health of the nation.  Social workers, who are trained to view problems not only as they affect the individual, but in how they are rooted in the environment, must lead the fight for improving healthcare for all US citizens, and for lessening the inequalities in healthcare for children.

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