Seminars in Pediatric Surgery最新文献

Hazardous consumer products are a leading cause of preventable injuries among children, despite oversight by the U.S. Consumer Product Safety Commission (CPSC). With their unique clinical insights, pediatric surgeons can play a critical role in advocating for improved product safety standards. This paper explores strategies for reducing injuries linked to products like all-terrain vehicles, button batteries, and magnets, emphasizing using injury data, collaboration with policymakers and manufacturers, and engagement with professional organizations. It also underscores the need for advocacy training in surgical education to prepare surgeons to lead these efforts. Importantly, it highlights the crucial role of public awareness campaigns in engaging the community and fostering a safety culture. By aligning clinical expertise with public health initiatives, pediatric surgeons can support the CPSC's mission and foster safer environments for children.

Health status and outcomes are known to be impacted by social stressors, yet social-political change to improve health outcomes through social determinants of health is stagnant. The well understood associations between social stressors and health are often chronic in nature and are without causal evidence. A new model that demonstrates a clear cause and effect between food insecurity and accelerated tumor growth has the potential to change the way public health scientists and advocates frame their arguments for change. This model provides a novel framework for ethically sound, controllable, and translatable social determinants of health research based in objective science. Implementation of this model across other human stressors and pathologies will lay the groundwork for irrefutable evidence to support social-political change for improved health outcomes.

Equitable health is the state in which all have the opportunity to attain full health potential and no disadvantage from achieving this because of social position or another socially defined circumstance [1]. One measure of society is marked by how vulnerable populations, like children, are treated, including the right to achieve and access good health. Focusing on health equity helps to address the social determinants of health which can adversely affect pediatric care and threatens surgical outcomes for the most vulnerable children in society [1-5]. Inextricable from attaining health equity is a surgical workforce that adequately represents the populations they serve. Pediatric surgery, like many surgical subspecialties, has fallen short in its goal of achieving equitable gender and ethnic representation at the fellowship, faculty, and leadership level [6-8]. Racial physician-patient discordance has been suggested as a mechanism that perpetuates health inequities within the minority pediatric populations [9-15]. Underrepresentation in pediatric surgery, and more broadly medicine can be attributed to both historical and present-day racism conjoined with high barriers to entry in our field [16-28]. The impact of chattel slavery, Jim Crow laws, federally sponsored residential segregation, mass incarceration, and ongoing systematic disinvestment, reverberates and perpetuates the paucity of representation. To address this issue requires a multi-faceted approach [29-33]. Pathway programs have been deployed in many contexts to provide mentorship and exposure to medical careers [2, 35-40]. But these avenues alone are insufficient. Advocacy is necessary to address systemic inequities in early childhood education where pathways to careers in medicine, including pediatric surgery, are significantly threatened.

This paper explores the integral role of advocacy in pediatric surgery, a critical yet often underrepresented aspect of surgical education that influences healthcare policies, systems, and patient outcomes. Through a comprehensive review, we discuss the challenges and strategies for integrating advocacy training into pediatric surgical curricula,emphasizing experiential learning, structured mentorship, and community engagement. We highlight the unique position of pediatric surgeons in advocating for vulnerable populations, exemplified by their efforts in firearm injury prevention and healthcare accessibility. The paper underscores the need for academic institutions to foster and reward clinician-advocates by aligning advocacy with traditional academic roles and promotion criteria, ensuring that advocacy is recognized as a fundamental component of academic medicine. By embedding advocacy into the curriculum, pediatric surgeons are equipped not only to promote patient-centered care but also to drive systemic changes that improve health outcomes at a community and national level.

Addressing the number one killer of kids, firearms, as a public health crisis involves a multitude of strategies. Advocacy and policy are two interconnected approaches to firearm injury prevention. The breadth of firearm policies and variable quality of data assessing their outcome may leave a potential advocate asking where to start and what works. Pediatric surgeons care for pediatric firearm victims clinically and if motivated to engage in policy advocacy, here we aim to guide the surgeon towards data driven policies with impact to optimize efficiency of advocacy time and efforts. Specific gun policies that may impact children which are discuss include child access prevention laws, extreme risk and domestic violence protective orders as well as universal background checks and minimum age requirements. Assault weapons and guns in schools are worth mention as they may also affect children. We review which firearm policies potentially have the greatest impact on kid's health and safety with a focus on evidence-based policy.