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Pediatricians Urged To Screen For Poverty At Child Check-Ups
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Pediatricians Urged To Screen For Poverty At Child Check-Ups

Children's Health

Pediatricians Urged To Screen For Poverty At Child Check-Ups

Pediatricians Urged To Screen For Poverty At Child Check-Ups
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Pediatricians are being urged to screen for poverty during office visits. To better understand what this means in practice, NPR's Kelly McEvers talks to Dr. Barbara Ricks.

KELLY MCEVERS, HOST:

Here is a grim fact. One in 5 children in the United States today lives below the federal poverty line. The influential American Academy of Pediatrics has found, not so surprisingly, that children living in poverty are more susceptible to a whole range of illnesses - obesity, diabetes, asthma, toxic stress. Babies who are born into poverty have a higher chance of dying during infancy. So the Academy is issuing new guidance to pediatricians, asking them to screen for poverty at checkups. And to better understand how this works, we've called Dr. Barbara Ricks. She's a pediatrician in Greenville, Miss. Dr. Ricks, welcome to the show.

BARBARA RICKS: Hello.

MCEVERS: Tell us about the community that you serve. How prevalent is poverty in your area?

RICKS: Sure. Poverty is quite rampant here. Probably 45 percent of our residents are in the poverty level, and that includes our children. It's something in my practice I see every day either directly or indirectly.

MCEVERS: I mean, given these new recommendations, how do you screen patients for poverty during a visit with a child and the child's parents? I mean, what questions do you ask?

RICKS: Well, when we are evaluating children in my office, if we see that there's a problem that's rather apparent, we will very discreetly ask them if there are any specific issues that they may have in caring for the child.

For example, if I have a child who's an asthmatic - which I have many - I will ask them about mold exposure because often times, they're living in dilapidated homes or mold-infested homes, and that may be exacerbated their asthma. So initially, I look at the medical issue at hand and sort of direct my questioning from there. I'm oftentimes reluctant to just ask head on without any medical issues because it can be perceived in a negative light, and we - and I try not to do that

MCEVERS: Yeah. I mean, poverty is a tough thing to talk about with people.

RICKS: Sure, yes.

MCEVERS: How do parents react when you do ask them these nonmedical questions - things like, you know, do you have electricity? Do you have mold in your house?

RICKS: Well, we get a variety of reactions, honestly.

MCEVERS: Yeah.

RICKS: Sometimes it is perceived as, you're a doctor; why are you asking me...

MCEVERS: Yeah.

RICKS: ...About my finances? Why are you asking me about the types of foods that we eat and the type of home that I'm living in. So we do have to be mindful of how we approach that. But surprisingly, many are forthcoming because they want help.

MCEVERS: Can you remember a time during an exam when you've said to yourself, I've got to talk about this family's economic situation; I've got to addresses this head on?

RICKS: Probably the one that has resonated with me since it happened - I have a family. This mother - she's a single mom of four, and one of her children - he's a paraplegic. And the mother brought him into my office with the complaint of animal bites. When I saw the child, I realized that the animals were rodents. The rodents had bitten the child, and the child was not aware of it because, again, the child's a paraplegic. And I began to question her.

After we discussed what we would do about the bites and taking care of that problem, I wasn't comfortable letting her go take the child back into the home without really knowing what was going on. And she proceeded to tell me that she's been dealing with this for some time now, and it's the best home that she can rent for this particular time.

Fortunately, this particular mother had an older son who was working odd jobs, and so she was depending on pooling her resources with those resources of her young-adult son to rent a better quality home. And that was something they were planning on doing within the next week or so after the clinic visit. So you know, that just really goes to show how some of these families are constantly in a high-stress situation.

MCEVERS: We should say that American Academy of Pediatrics, which issued these recommendations, isn't just advocating these screenings, right? They're advocating for the expansion of government programs that address poverty, like food stamps and housing support. They're also pushing for a raise in the minimum wage. Is this something you talk about with your patients?

RICKS: Sure we do. We will talk about if they're getting access to those programs, if they're aware of those programs such as Head Start and the Women, Infant and Children program - anything that could buffer the negative consequences of poverty that they're living in.

MCEVERS: You've been practicing in the Mississippi Delta for 17 years.

RICKS: Yes.

MCEVERS: When you started out, did you expect that a big part of your job would be doing work that most of us would associate with that of a social worker?

RICKS: Not at all (laughter).

MCEVERS: Yeah.

RICKS: No, no, not at all. I thought that I would be taking care of sick children (laughter). I had no idea of the amount of social issues and, more importantly, not just the social issues and the financial issues but how they would impact children's health.

MCEVERS: That was Dr. Barbara Ricks of Greenville, Miss. Dr. Ricks, thank you very much.

RICKS: Thank you.

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