Child Health Advocacy

By Lucy Crain MD, edited by Amy Whittle

Pediatricians are naturals when it comes to advocating for children. We spend our careers caring about and for children.  We understand the importance of families, of child development and education, and of healthy nutrition and environments. We also understand that children do not vote and deserve to have the pediatric community speak up/ advocate for them.  This is the first of a series of articles about Advocacy for pediatricians of all ages and career experiences. Contributors are members of the Chapter I Child Advocacy Committee and readers are invited to offer feedback, including their own experiences with advocacy.

One current Federal legislative topic has particular urgency: unless Congress takes action, funding for CHIP(Children’s Health Insurance Program) will end after September 30, 2017.  For 20 years, CHIP has been a lifeline for 8.9 million children living in families who earn too much to qualify for Medicaid but not enough to buy private coverage. Without this funding, millions of children could lose health coverage and states will have to take actions that will create chaos in program administration and confusion for families trying to access coverage for their children.  PLEASE WRITE/CALL YOUR FEDERAL REPRESENTATIVES TO TELL THEM TO EXTEND FUNDING FOR CHIP FOR 5 YEARS.  For more information:

On a personal note, after some 40 years of advocacy on a variety of issues including children and adults with disabilities, access to health care for children and adults with disabilities, swimming pool safety and prevention of drowning/near drowning, firearm safety, prevention of tobacco and alcohol use by children and youth, and other issues, I’m more recently involved with the topic of child hunger/food insecurity.  I led the committee’s project to educate our 2,000+ chapter members about this topic. The project, “WHO’S HUNGRY? YOU CAN’T TELL BY LOOKING!”, was launched with the voluntary assistance of local acclaimed photographer Karen Ande, RPT and a group of pediatricians and other child advocates. 

We knew that our pediatric membership screened routinely in well-child encounters for diabetes, for obesity, for hypertension and other entities, but food insecurity was not among the identified items. Knowing that 1 in 4 children in California are food insecure, we drafted a successful resolution for ALF (and were joined by CA Chapter 2 in the effort) to require inclusion of Food Insecurity in the new edition of AAP’s Bright Futures screening guidelines.  

Meanwhile, Ms. Ande, with permission, photographed children who were food insecure and who represented the ethnic diversity within San Francisco. The findings were presented to the Chapter I Board of Directors with the clear message that our members needed to screen consistently for hunger/food insecurity and to work with their local food banks to develop efficient and effective means of referral for families who are food insecure. As President Trump’s budget draft poses even more dire cuts to food stamps, school lunches, and a myriad of child unfriendly proposals, there has never been a more crucial need for dedicated child advocates on child health issues. Remember, you can’t tell just by looking if a child is hungry!

Lucy Crain, MD, MPH, FAAP