Pediatricians group: Ask parents about poverty

Eyes, ears, throat, check. Parents’ income, check. Pediatricians will soon be asking parents about their financial status because of the negative effects of poverty on a child’s health.

In recommendations to be released Wednesday, the American Academy of Pediatrics urges doctors to ask parents this question at each appointment: “Do you have difficulty making ends meet at the end of the month?”

The question should be asked in all areas of the country, since economic insecurity can affect families in cities, suburbs and rural areas. Parents who answer “yes” will be directed to community resources for housing, nutrition and job assistance.

As detailed in the recent Post-Dispatch special report “The Crisis Within: How toxic stress and trauma endanger our children,” one in four children in Missouri lives in poverty — putting the child at higher risk for asthma, allergies, diabetes, obesity and other long-term health problems.

Poverty can impair children’s development and shorten their life spans. A study from Washington University used brain scans to show that local children living in poverty had smaller areas of white and gray brain matter. Poverty is also linked to teen pregnancy, drug and alcohol abuse, and lead poisoning.

“We need to do something about poverty in childhood because it affects kids’ health,” said Dr. Katie Plax, professor of pediatrics and medical director of SPOT (Supporting Positive Opportunities with Teens) health care. “We really want families and kids to get help.”

In addition to help from local charities, the pediatricians’ group is in favor of policies that support school lunch programs, Medicaid, food stamps and other government assistance for families.

Spending upfront to help children living in poverty will save the state in future health care costs and allow children to become productive citizens, said Dr. Kenneth Haller, president of the Missouri chapter of the American Academy of Pediatrics and associate professor of pediatrics at St. Louis University.

Haller said children living in poverty have stress-related health problems which can turn the body’s immune system against itself.

Stress hormones can cause inflammation in the body’s circulatory system, leading to heart and breathing problems. The hormones can accelerate fat storage and suppress the immune system. The constant stress can permanently change a child’s genes, potentially shortening their lives. The damage is not only physical but mental, causing problems with attention and learning.

Pediatricians already talk to parents about safety concerns such as bike helmets, car seats and guns in the home. Questions about financial security are also of critical importance to a child’s well-being, doctors said.

“Our job as pediatricians is to address the health and welfare of a child, not just whether they have a bad cold or ear infection,” Haller said. “If we can do some screening to help people early in life to meet some minimum goals in terms of nutrition and housing security, it’s not going to be good just for the kid and family but the entire society.”