By: Amritha Patel, MD

As a graduating third year pediatric resident, I have been reflecting on the last three years of training along with the journey I took to get to this point. Many of the experiences that led me to the field of medicine were based around community service on local, national, and international levels. Whether it be teaching refugees in Arizona how to speak English and get job placement, or traveling to Haiti after the earthquake for relief work and rebuilding communities and schools, or volunteering in poor communities in rural India to address basic needs, I was drawn to the socioeconomic impact of health. Naturally, when I joined residency, I was drawn to our Community Longitudinal Experience to get immersed with the populations we serve in Hartford, Connecticut. I was fortunate enough to continue my work with refugee and international populations and found Hartford to be one of the most diverse communities I had been a part of. For example, teaching English to refugee populations now involved interpreting into multiple different languages in one session, including Swahili, Karan, and Spanish. The city is also unique in that it houses some of the lowest income families in the nation directly adjacent to very affluent neighborhoods, and seeing this impact on school and community systems has been profound.

Pediatric residents at Connecticut Children’s have robust exposure and opportunities to develop their skills in promoting the health and welfare of the children and families of Hartford’s neighboring communities. The Resident Education in Advocacy and Community Health (REACH) pathway allows for those with deeper interest to pursue opportunities in community health research, policy formation, and social program development. I was fortunate enough to be the first resident to take part in this pathway and gained tremendous knowledge from local experts in the field of Community Child Health to build systems and solutions to address gaps in medical care and community services for families.

During my time on the REACH pathway, I was introduced to the legislative process and the various steps involved in executing community health programs. I was introduced to the government and media relations teams at Connecticut Children’s, which helped me gain insight to the resources available to pediatricians who are interested in advocacy, but need guidance to promote their agenda. I learned how to write an Op-Ed, by publishing an article on Lead Poisoning in Children and how it affects Connecticut’s healthcare system. I was also able to work closely with the Injury Prevention Center to develop policy briefs regarding suicide risk assessments and campaigns to prevent distracted driving.

Ultimately my interests reside in primary care pediatrics with a focus on community health, whether that involves local, national, or international communities. So much of primary care pediatrics depends on promoting the best quality of life for children at home and in their communities, whether that be promoting safe housing or nutrition and exercise. In fact, much of the advocacy work done by preventative pediatricians focuses on social determinants of health that impact health outcomes, rather than focusing on healthcare systems alone. However, this philosophy is not unique to primary care; the most important thing I have learned through this pathway is that opportunities for advocacy are present in every subspecialty within pediatrics. Many of our attending physicians from all specialties are working with legislative and community partners to promote childhood health.

Pediatricians can play a profound role in optimizing the welfare of children in their communities. While there is an intimate connection between pediatrician and patient/family on an individual basis during prevention, diagnosis and treatment of organic medical problems, there is also an opportunity to serve patients and families on a much larger scale through advocacy work in various areas. This is especially important in this age of firearm-related injuries in the pediatric population and a rising resistance against immunizations. In this era of the COVID-19 pandemic and immigrant child separation, pediatricians can be powerful and credible sources to educate the public and create policy change.

I encourage all residents and residency programs to foster an interest in advocacy and get involved in opportunities within respective communities. As mentioned earlier, I have learned about the social context in which our patients live, which gives great perspective into health disparities and challenges faced outside of immediate medical needs, including poverty, racial and ethnic barriers, and childhood trauma. Without organized experiences to expose residents to these areas, many of our medical interventions may become ineffective and only temporarily mask symptoms. Through advocacy and community health, I have learned to also prioritize environmental, social, and economic determinants when addressing the medical needs of patients and families.

Note: This article was originally published in the American Academy of Pediatrics Section on Pediatric Trainees blog and republished with permission.