Childhood poverty is associated with inadequate access to health care, high rates of preventable illnesses, and increased mortality and morbidity. Rising poverty has produced high rates of uninsured children and inequitable health-care access despite recent Medicaid mandates for pregnant women and children up to 6 years of age. Chronic multigenerational poverty results in poor health through inadequate preventive health care and vaccinations, homelessness, malnutrition, lead poisoning, and substance abuse. Furthermore, other “purely” medical illnesses of all types are routinely more prevalent in poor children: black children, for example, have a 300% increased mortality from asthma compared with white children. Given the serious nature of these problems and their high prevalence, medical centers face an obligation to train pediatric residents to provide culturally sensitive, informed care for these high-risk multiproblem families. In this review, we attempt to summarize the multiple components of childhood poverty and briefly discuss methods for training residents to assess risk, analyze barriers to care, work in multidisciplinary teams with community outreach, and accomplish social advocacy.
© Lippincott-Raven Publishers.