Health Equity in Pediatrics
What is health equity?
“Health equity means that everyone has a fair and just opportunity to be as healthy as possible (Braveman et al., 2017). It’s health equity, not equality… because let’s face it, we are not all equal. Some people got a head start with roller skates on the journey to health while others have heavy baggage to carry in flimsy, plastic flip flops. Because power is unequally distributed throughout our society. Health equity is about fairness and justice, not being the same. It’s inherently easier for some to have health, while incredibly difficult for others to access it.”
- Episode 1, Health Equity in Kids
Episodes
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Ep. 1 Health Equity in Kids
In the first installment of a miniseries dedicated to Health Equity in Pediatrics, we define health equity and review some communities often affected by disparities that limit a person’s opportunity to be as healthy as possible. And while health equity can seem like a seismic public health crisis too big for one person to tackle, each episode will give listeners tangible best practice changes that can be implemented right away, just with a change in behavior. As you learn to view every patient encounter through a lens of health equity, you’ll be able to apply these concepts to the evaluation and management of the children for whom you care and improve their journey toward health.
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Ep 2. Identifying Your Implicit Bias
In the second episode of the Health Equity in Children miniseries, we explore implicit bias as unconscious attitudes and stereotypes held against a group that may even be contrary to one’s stated beliefs. Identifying your implicit bias is a best practice that can enable you to limit its impact on your behavior and prevent harm from skewed management. In this episode, we discuss examples of how implicit bias can impact health care in children and the skills that provider’s can hone to combat its influence.
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Ep 3. Interrupting Microaggressions
Microaggressions are subtle slights, snubs, and digs that are seemingly innocent, innocuous, and naive, but are psychologically disparaging and invalidating to the people from marginalized groups they offend (often people of color). They reflect implicit bias that is unconsciously embedded into language and behavior. As an ally, interrupting microaggressions can be a challenge that requires curiosity to confront. The decision to interrupt is individual and complex, but this episode will provide allies with the skills to microintervene through role play in several scenarios.
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Ep. 4 Say My Name Correctly
The fourth episode in our Health Equity in Children miniseries highlights one of the simplest individual actions a provider can take to be an ally in health equity. Saying a person’s name correctly validates their identity, family, culture, and heritage. Whether the name is difficult to pronounce or varies from the name given at birth, providers can use simple tools to correctly pronounce and address their patients in a way that honors the patient and their caregivers. Together we can prove that a rose by another name would smell just as sweet.
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Ep. 5 Weight Bias and the AAP Guideline on Children with Obesity
The seminal publication of the AAP’s Guideline on the Evaluation and Treatment of Children and Adolescents with Obesity serves as the source of our fifth episode in the miniseries on Health Equity in Children. The best practices for providers managing obesity go beyond discussions of beauty and body image to include systemic racism, obesity as a chronic disease, and the reckoning that children and adolescents with obesity are people first.
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Ep. 6 Misgendering and Heteronormative Assumptions
It’s good advice for any pediatric provider to not assume anything. In the sixth episode of the miniseries on Health Equity in Children, we understand how not making assumptions is a best practice for pediatric providers from the evaluation and management of LGBTQ patients, to communicating with diverse families, and serving as an ally in health promotion.
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Ep. 7 Mental Health Stigma in Children
Mental health is one of the greatest health risks encountered by children and adolescents in today’s world. Stigma can be one of the biggest barriers to diagnosis, access to care, and treatment for children, particularly in communities that are marginalized. In the final episode of the miniseries on Health Equity in Children, we bring mental health into your everyday conversations to diminish stigma and give mental health the time it deserves to help your patients grow up happy and healthy.
How you can help
We know a lot about the dissemination of knowledge using podcasts from several decades of research in nursing and medical education, but we don’t know a lot about how they impact your practice… either in a tangible, front lines, bedside way… or even just to get you mentally ready to change your practice when the opportunity arises. And that matters with regard to health equity because if we’re going to make progress in the uphill battle against eliminating disparities, we need to be on the same page and know whether what we’re doing is actually working.
Thank you to the listeners who chose to complete an anonymous survey on their knowledge and practices surrounding these health equity issues. Your responses will help us to better understand the impact of listening to a podcast on health equity on the care of our nation’s children.
Survey responses are now closed.
What made you want to podcast about health equity?
I grew up in a small college town that prides itself on community and inclusivity. I graduated from the University of North Carolina at Chapel Hill, drank from the well, and considered myself born from the Carolina Family.
Then I read To Drink from the Well by Geeta Kapur (2021), which gave me the complete racial reckoning that I had begun to personally investigate since Silent Sam, a confederate monument prominently displayed at the threshold of the University, became controversial in my adult life.
Spoiler alert: The book begins with a slave creating the cornerstone brick of the oldest public university in the nation. A person, whose ancestor was kidnapped from their home, made and laid the foundation of what would become a great institution of higher learning in a town that, two hundred years later, I would love and raise my family in.
The reckoning of my hometown’s history was harrowing and humbling. I thought I lived in a liberal “zoo” that was immune to the racial inequities that must exist elsewhere in the country. Not us. But, as I realized, yes, us.
I’m in the majority of pediatric nurse practitioners who identify as 1) White, 2) cis-gender, and 3) female. Yet a majority of the children we care for will differ from us in some way. And if children and their caregivers don’t see their needs and values reflected in our care, they may experience further obstacles on the journey to health.
Health equity so often feels like an insurmountable problem that should be left to public health officials, policy makers, and non-profits to fix. But in my research, I realized that empathy and understanding on behalf of an ally can make a world of difference to someone from a community that is often marginalized. Using small practice changes that prioritize the needs of people over the bias of society, we can better address health disparities more readily.
These practice changes don’t cost a thing.
They can be implemented by a single person.
And you can start right now.
So through small changes in my practice, I realized I can empower my patients and put my privilege in check. It doesn’t fix the bigger problems of systemic racism, bias, and injustice, but even small changes make a difference by helping to advocate for people and produce better outcomes for kids.
I use this podcast to promote the application of evidence-based practice in real-life clinical conundrums that encourages us to implement research at the bedside. To make better outcomes for kids.
Yet I had often pondered with my mentor, how do we know whether the knowledge we disseminate does any good? Are we changing practice?
If the pen is mightier than the sword, then what is a podcast?
Becky Carson in her hometown of Chapel Hill, North Carolina circa 2010.
Meet the Volunteer DEI Editors and Contributors
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Felisia Bowen, PhD, DNP, APRN, FAAN
EDITOR AND AUTHOR
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Anne Derouin, DNP, APRN, CPNP, PMHS, FAANP
ACADEMIC MENTOR
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Jeremy Jordan, PhD, CRNP, CPNP-AC, CCRN, CNE
EDITOR
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Dawn Mason, PMHNP-BC, PMHS, CPNP-PC
EDITOR AND CONTRIBUTOR
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Bianca Salvetti, DNP, CNS, CPNP
EDITOR
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Brad Sobolewski, MD, MEd
PODCAST MENTOR
Disclaimer
The Health Equity in Pediatrics series received funding from the North Carolina (NC) Chapter of the National Association of Pediatric Nurse Practitioners (NAPNAP) via the Dr. Rasheeda Monroe Health Equity Grant, which is aimed at improving health equity among infants, children, and/or adolescents. The content of these episodes is my own and does not necessarily represent the views of, nor endorsement by the NC NAPNAP, NAPNAP, or the Dr. Rasheeda Monroe Health Equity Grant.
As an ally in health equity, I surrounded myself with Diversity, Equity, and Inclusion (DEI) experts from NAPNAP’s DEI Committee to ensure content accuracy and offer diverse perspectives on the podcast. I’m grateful for the learning experience from the DEI experts who reviewed content and offered scholarly contributions.
