Contemporary Pediatric Public Health Challenges

The pediatrician who cared for children from the neighborhood or, at the very least, the community no longer exists in many places. Today, pediatricians are more likely to care for children and families from all walks of life. Some may still be children we know from our neighborhoods. Many more, however, are likely to be children from other lands and various cultures. We may speak the same language as some of your patients and their parents and need a translator to enable us to have a meaningful connection with others. Some conditions and social issues look the same as they did a generation ago, but our patients and their families present with other needs that look dramatically different than those that children used to encounter. Children come to us with different social and emotional concerns, and as we care about and care for their physical and mental health, our concern also extends to their families. And we care about how children are doing in all environments: at home, at school, and in their communities.

In this era, children and their families are impacted by social and political changes in our homes (social media and screen time), in our communities (refugee populations), in our health care networks (EMR in every tertiary pediatric center), and in our larger world (multiple military deployments of fathers and mothers). Our young patients are involved in a variety of activities at school, at places of worship, and in the community. When a child is diagnosed with a life-threatening condition or when there is an act of gun violence that affects one child, that child’s entire community is touched.

In addition to helping children and families by treating a child’s physical or mental illness, pediatricians today are called upon to guide children and their parents through what sometimes seems like a mine field with potential danger looming with the next step. Although our responsibilities may seem daunting at times—and especially difficult to address in the 15-minute appointment—there are new ways to help children and families and expertise that is developing around us. As we make the adjustments to incorporate some of the “newness” that the twenty-first century has presented to us, we may find that, in many ways, our role is not more difficult; it is just richer and more robust.

This issue explores the impact of contemporary public health challenges for pediatric care, promising models for caring for chronically ill children, and state-of-the-art therapies for complex childhood conditions. It is our hope that that issue of Pediatric Clinics of North America will provide you with some new solutions to old problems; some new solutions to new problems; and a great deal of “food for thought” as you ponder not only how your practice looks today but also how it will appear in the future. Thank you for your interest.

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