The Medical Model of Health

As the pace of genial change quickens, pincerren are faced with sweet social and environmental risks to their growth and development. Of these changes, childhood pauperization poses the sterling(prenominal) threat to childrens well-being. One in four American children beneath the age of 3 years lives in poverty; (Haggerty 1999) a higher percentage of children live in poverty than both other age group. As pediatricians, we know that children in poverty experience a double jeopardy. First, they are more much exposed to risks to their health and development (such as lead poisoning, malnutrition, and family dysfunction). Second, children set up more negative consequences (such as developmental delay and take aim dysfunction) from such exposure than do children with more advantaged socioeconomic circumstances. (Barry 2000)

Although credit entry of and sensitivity to these risks cause increased, primary preventive efforts, the cornerstones of pediatric practice, have failed to keep pace with changing circumstances. On the contrary, the pediatric primary-care clinician is asked to raise an ever greater burden in reducing the make of social disadvantage on children--a trend that continues to increase as the social safety net for children has become increasingly porous.



The primary-care clinician is enjoined to fork over anticipatory guidance, to perform developmental surveillance, to prevent unintentional injuries, to signalise and address parental substance use and depression, to solve issues of child abuse and family violence, to advocate with the school system and other social agencies, to manage behavioral and family issues, etc--all in the context of a 20-minute health supervision visit. Clearly there is a confine to a clinicians ability to address such a daunting agenda, and that limit has long since been exceeded, even for families without social disadvantages.

Perhaps the problem lies neither in the primary-care pediatricians abilities or motivation nor in the multitude of clinical expectations, tho rather in a...

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