Pledge 43 for the 43%: Pediatric Residents Respond to Community Needs During the COVID-19 Pandemic : Academic Medicine

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Trainee-Authored Letters to the Editor

Pledge 43 for the 43%: Pediatric Residents Respond to Community Needs During the COVID-19 Pandemic

Brayer, Samuel W. MD1; Warren, Paul W. MD2

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Academic Medicine 97(7):p 947-948, July 2022. | DOI: 10.1097/ACM.0000000000004442
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To the Editor:

The COVID-19 pandemic led to a tragic loss of life and an economic collapse that rivaled the Great Depression. During the early stages of the pandemic, the detrimental health effects of COVID-19 were less apparent in pediatric patients. Nevertheless, many patients and families in our pediatric primary care center (~90% Medicaid) experienced an amplification of their already significant social and financial struggles—The largest local food bank had urgently solicited donations to meet demand that was 5 times higher than normal. 1 As pediatrics residents, we initially felt powerless to help. However, when the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided a stimulus check of $1,200 to most of our coresidents and fellows, it allowed us to devise a strategy to help families in our community.

We created a fundraising drive called Pledge 43, the name highlighting the staggering 43% of children living below the federal poverty level in our home city of Cincinnati, Ohio. 2 Pledge 43 allowed our residents and fellows to redirect some of their stimulus funds to those in need by donating up to 43% of their stimulus checks to help those most affected. Residents and fellows responded: We raised over $26,000, which purchased 63,000 meals and 4,300 surgical masks distributed to families, assisted living facilities, Cincinnati public schools, and first responders. This was critical given the early food and personal protective equipment shortages.

Now more than a year into the pandemic, children have remained relatively shielded when compared with adult patients. However, the social consequences (e.g., lost wages, food insecurity, housing instability, education gaps) continue to be most acutely experienced by children in low-resource communities. 3,4 The Pledge 43 fundraising drive highlights a simple yet meaningful way that residents can affect an immediate and continued positive impact in their respective communities, outside of direct patient care efforts.


The authors thank their mentors on this project: Drs. Ndidi Unaka, Melissa Klein, and Andrew Beck. They thank the Freestore Foodbank and Matthew 25 Ministries for all their work to help families in our communities every day and for their dedication to increase services during this especially difficult time. The authors also greatly appreciate the continued support of their pediatric residency program. They are profoundly grateful to current residents and fellowship-level trainees for their engagement with Pledge 43 and for giving selflessly to help families in their community.


1. March S. ‘People are at risk of going hungry:’ Freestore Foodbank needs help, Cranley warns. Cincinnati Enquirer. Published April 13, 2020. Accessed September 22, 2021.
2. May L. New Census data show Greater Cincinnati’s child poverty rate improved, but lots of work remains. WCPO. Published December 6, 2018. Accessed September 29, 2021
3. Webb Hooper M, Nápoles AM, Pérez-Stable EJ. COVID-19 and racial/ethnic disparities. JAMA. 2020;323:2466–2467.
4. Cajner T, Crane LD, Decker RA, et al. The U.S. labor market during the beginning of the pandemic recession. National Bureau of Economic Research. Revised August 2020. Accessed September 22, 2021.
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