Pediatric Collections: Social Determinants of Health - Part 3: Promoting Health Equity Doody's Expert Review Review Questionnaire ISBN: 9781610026383 ISBN-10: 1610026381 Copyright: 2022 Edition: 1st Author: AAP, Doody's Expert Review    Score: 100 Doody's Star Rating™ and Doody's Expert Review provide by Doody Enterprises, Inc. Reviewer: Ellyn Cavanagh,  PhD, MN,BSN  (Tender Care Pediatric Services, Inc.) Description This is the third book in the Social Determinants of Health series, focused on promoting health equity. The book consists of one AAP Policy Statement, Eliminating Race-Based Medicine, with 15 peer-reviewed articles providing knowledge and clinical strategies focused on screening families for unmet social needs and interventions to reduce the social risks. The underlying theme is community-clinic partnership with the goal of ensuring families maintain their humanity, autonomy, and shared decision-making. The ultimate outcome is that improvement in health equity contributes to better health outcomes for children. Purpose The purpose is to provide pediatricians with a roadmap highlighting the importance of working alongside community stakeholders and organizations to build social safety nets (universal preschool, improved wages) and to eliminate the paradigm of race as a biological construct, thus altering the historical roots of medicine and, in some cases, clinical protocols and institutional practices. These are worthy objectives. The health care system from education to delivery is based on flawed race-based science. In 2019, the American Academy of Pediatrics (AAP) identified the racial fallacy; in 2020, the leadership forum passed a resolution prohibiting the use of race-based medicine; and in 2021, the board of directors operationalized the elimination. Members of the AAP, as well as associated clinicians (dentists, social workers, nurses) need current evidence-based guidance for strategies to begin changing practice. This book meets its objectives for the year 2022. Basic tenets such as conferring equitable care to all young children regardless of race and eliminating all race-based clinical algorithms in practice (race modification for eGFR calculation, UTI in febrile infants and children 2-24 months) should be completed within one to two years. Debunking the construct of race as a biological proxy and replacing the flawed science will need to be undertaken and results measured using legitimate social determinants of health. At this juncture in U.S. history, post-pandemic with children being re-integrated back into schools and families facing 40-year record inflation, the paradigm shift in pediatric medicine is critical to level the playing field and protect all children. Child poverty costs the U.S. $1.1 trillion annually in terms of lost adult productivity (p. 18). New strategies are necessary to address inter-generational poverty and systemic racism. This book presents a starting point. Audience The book is published by the American Academy of Pediatrics and all articles are peer reviewed, published in the Academy's journal, Pediatrics, from 2019 to 2022. This series of three books is available to members and the general population. The content is written at a graduate and post-graduate level, intended for the main audience of clinical pediatricians and secondary research scientists. The other audiences associated with pediatric health and social wellness include educators, administrators, and professionals in the fields of psychiatry, nursing, and law. The authors are all outstanding clinicians and scientists with expertise in pediatrics. Features This book immediately plugs the readers into a stable platform to understand the underbelly of racism in pediatric medicine. The policy statement, Eliminating Race-Based Medicine, reviews the 400-year history, flawed research in race-based medicine, and subsequent examples of the outgrowth of race-based approaches to clinical care (calculation of pulmonary function, atherosclerotic heart disease, and ethnic modifiers in decision-making about vaginal birth after cesarean, p. 8). The practical conundrum in dismantling the construct of racism is developing a tool to screen all children equitably for social determinants of health (SDoH). One of the best studies identified 11 unique screening tools. Issues arose such as defining SDoH, determining which have the greatest impact on children's health, and the literacy level of respondents. Availability of social safety nets is another factor in providing equitable care. Community partners prioritize children and families with varying levels, altering the linkages available to clinical providers. Medical providers need to identify favorable community assets, establish trust with families, and use tactics to support partnerships for health equity. There are research articles addressing the challenges, mobilizing school partnerships, and screening infants at six months to ensure high-risk families participate in routine health care early in life. Organizational and institutional racism in pediatrics is addressed as long-standing and escalating. There are three publications, Promoting Culture Change Within Organizations, Building Inclusive Work Environments, and The Path Forward: Using Metrics to Promote Equitable Work Environments. These are exclusive to the central tenet of women as underrepresented in medicine. Gender-bias, lack of diversity, and hiring/promotion bias are barriers to equality. The best special article is "Leveraging the Biology of Adversity and Resilience to Transform Pediatric Practice." There is a discussion of toxic stress and prolonged stress system activation and the science of early development. The only shortcoming is a review of institutions or organizations taking the initiative to change practice, such as increasing diversity, or highlighting best practice. Assessment This is an outstanding book that is necessary for the development of a community-based healthcare system to improve pediatric population health. New strategies are needed to recognize, measure, and intervene with families of children experiencing inter-generational poverty, systemic racism, and structural inequities. This level of transformation demands a focus on addressing adverse social conditions with respect for families' autonomy and priorities. The book identifies approaches to screening for social determinants of health, trauma, and adversity with information to promote whole-child wellness and prevent illness. Diversity and inclusion for women and minorities in medicine is also presented with specific interventions, such as a "Road Map for Racial Equity" (p. 96). Review Questionnaire Range Question Score 1-10 Are the author's objectives met? 10 1-10 Rate the worthiness of those objectives. 10 1-5 Is this written at an appropriate level? 5 1-5 Is there significant duplication? (1=significant, 5=insignificant) 5 1-5 Are there significant omissions? (1=significant, 5=insignificant) 5 1-5 Rate the authority of the authors. 5 1-5 Are there sufficient illustrations? 5 1-5 Rate the pedagogic value of the illustrations. 5 1-5 Rate the print quality of the illustrations. 5 1-5 Are there sufficient references? 5 1-5 Rate the currency of the references. 5 1-5 Rate the pertinence of the references. 5 1-5 Rate the helpfulness of the index. 5 1-5 If important in this specialty, rate the physical appearance of the book N/A 1-10 Is this a worthwhile contribution to the field? 10 1-10 If this is a 2nd or later edition, is this new edition needed? N/A ©2024 Doody Enterprises, Inc.