Letters to Obama: Concerns about the pediatric services

August 18, 2009

We have a very challenging situation related to keeping our children healthy and safe.

We have a very challenging situation related to keeping our children healthy and safe. A few of our challenges that I have seen that I would like to tell Obama are:

1. Preventive services are extremely inadequate for children. The chronic health problems like obesity, diabetes, and asthma are not addressed adequately for most children based on their developmental needs, and continue to create very poor outcomes. The current obesity epidemic especially is the evidence of our poor preventive services, where the children and families do not receive adequate support or guidance about healthy lifestyles. This reflects inadequate public policies that allow poor school meals/activity/safe havens for activities in all neighborhoods.

2. Emotional health of teenagers is one of the areas needing urgent attention. Many who live in difficult environments or very dysfunctional families, or have a genetic predisposition for emotional issues, are depressed, anxious, or have borderline personalities resulting in poor emotional intelligence, adaptation difficulties, substance/chemical dependencies, etc. They live their lives in utter misery, and sometimes create their own families that are prone to violence, abuse, and suffering. The awareness about mental health/well-being, and the necessary preventive or early identification and management resources, are very sketchy.

3. Pediatric care is under-compensated compared to the adult care, even though its more challenging and needs subspecialty skills. In consequence, pediatric surgery and many other Pediatric subspecialties are rarities. Adult practitioners who are not familiar with child-specific needs are handling it reluctantly, often resulting in poorer outcomes. This should be reversed: compensate pediatric subspecialists more.

4. No child should be ever left without a health insurance and the basic health care services: both are currently prevalent. There should be mandatory child health insurance based on parental income. Negligent parents should be identified early, especially through the school system, and held accountable through the child welfare services.

5. The child abuse/negligence prevention services are very inadequate. Child care providers all over the country (not just a few states) should be trained to intervene early as a mandate.

6. Safety of teenagers is in jeopardy. Parental guidance and safe neighborhoods are basics that need to be enforced to keep the children safer.

7. Effective preventive and health maintenance programs and services at and through the schools could make such programs cost-effective, easily accessible, and create and avenue to identify child health problems early.

Thanks,
Shaija George, MBA, MS, CPNP, APN