Anti-Poverty Medicine Through Medical-Financial Partnerships: A New Approach to Child Poverty.
Anti-Poverty Medicine Through Medical-Financial Partnerships: A New Approach to Child Poverty.
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DOI：
10.1016/j.acap.2021.03.017
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发表时间：
2021-11
影响因子：
3.1
通讯作者：
Vinci, Robert J
中科院分区：
文献类型：
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作者：
Marcil, Lucy E;Hole, Michael K;Jackson, Jasmyne;Markowitz, Molly A;Rosen, Laura;Sude, Leslie;Rosenthal, Alice;Bennett, Mary Beth;Sarkar, Sonia;Jones, Nicholas;Topel, Kristin;Chamberlain, Lisa J;Zuckerman, Barry;Kemper, Alex R;Solomon, Barry S;Bair-Merritt, Megan H;Schickedanz, Adam;Vinci, Robert J
贫困威胁着儿童健康。在美国，财务紧张，包括收入和资产贫困，是常见的许多复杂的病因。即使是相对成功的扶贫计划和政策也不能满足所有有需要的家庭的需要，从而危及健康。我们描述了一种新的方法来解决这个普遍的健康问题：反贫困医学。从历史上看，医学一直将贫困视为其范围之外的社会问题。保健越来越多地处理贫穷的下游影响，如粮食和住房无保障。然而，现在有强有力的证据表明，贫困影响生物学，因此，值得作为一个医学问题来对待。一种新的方法使用医疗-金融合作伙伴关系（MFP），其中医疗保健系统和金融服务组织合作，通过减少家庭财务压力来改善健康状况。多功能一体机通过增加储蓄、减少债务、改善信贷和经济机会来帮助家庭增加资产，同时为终身的财务、身体和心理健康奠定坚实的基础。我们回顾了以证据为基础的扶贫方法，包括有条件和无条件的现金转移，储蓄工具，债务减免，信用修复，财务辅导和就业援助。我们描述了当前的国家多功能一体机，并强调了这些基于证据的临床财务干预措施的不同应用。目前的MFP模式揭示了实施的机会和挑战，包括时间和空间的限制，时间敏感的过程，缺乏熟悉的病人和社区服务，以及在传统的医疗环境的可持续性。我们的结论是，儿科医疗保健的做法可以干预贫困，并应考虑拥抱扶贫医学作为一个重要组成部分，未来的儿科护理。
Poverty threatens child health. In the United States, financial strain, which encompasses income and asset poverty, is common with many complex etiologies. Even relatively successful anti-poverty programs and policies fall short of serving all families in need, endangering health. We describe a new approach to address this pervasive health problem: antipoverty medicine. Historically, medicine has viewed poverty as a social problem outside of its scope. Increasingly, health care has addressed poverty’s downstream effects, such as food and housing insecurity. However, strong evidence now shows that poverty affects biology, and thus, merits treatment as a medical problem. A new approach uses Medical-Financial Partnerships (MFPs), in which healthcare systems and financial service organizations collaborate to improve health by reducing family financial strain. MFPs help families grow assets by increasing savings, decreasing debt, and improving credit and economic opportunity while building a solid foundation for lifelong financial, physical, and mental health. We review evidence-based approaches to poverty alleviation, including conditional and unconditional cash transfers, savings vehicles, debt relief, credit repair, financial coaching, and employment assistance. We describe current national MFPs and highlight different applications of these evidence-based clinical financial interventions. Current MFP models reveal implementation opportunities and challenges, including time and space constraints, time-sensitive processes, lack of familiarity among patients and communities served, and sustainability in traditional medical settings. We conclude that pediatric health care practices can intervene upon poverty and should consider embracing antipoverty medicine as an essential part of the future of pediatric care.