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MNAAP Newsletter

Pediatricians’ Voices on Equity Needed Outside the Clinic

By Nate Chomilo, MD, Minnesota Doctors for Health Equity

Nate ChomiloHere’s a statistic that may be hard to hear: Only 10 to 20 percent of health outcomes are attributable to health care.

For all our education, training and expertise, there is only so much we as physicians can do if we choose to only work within our clinics or hospitals.

We can highlight the ongoing health disparities (health differences that arise from economic, social or environmental disadvantages) that are worse in Minnesota than almost every other state, but putting a spotlight on the problem alone is not a solution. These disparities also arise from implicit bias, explicit bias and the structural racism intrinsic to many parts of our society, our healthcare system being no different.

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The Providers Will See You Now, Congressman

In early September, South Lake Pediatrics in Eden Prarie hosted a visit with Representative Erik Paulsen. It was his second visit to the clinic to discuss health care and other issues affecting children.

Anne Skemp, MD, reached out to MNAAP for talking points on CHIP reauthorization and DACA. Below is a summary of the visit:

Why did South Lake Pediatrics decide to invite Rep. Paulsen to a meeting? What did the clinic hope to accomplish or communicate?
This was Rep. Paulsen’s second visit to our clinic. The first time, on November 16, 2016, we wanted to highlight our clinic’s relationship to the Somali population in his district and to discuss some of the ways that he could keep that population of children in mind in his legislation. This time, we wanted to discuss the ongoing efforts to repeal the ACA and also topics such as immigration and health care policy affecting minors, such as defunding Planned Parenthood.

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MNAAP Policy Committee Begins Agenda-Setting Work

Eric Dick headshotBy Eric Dick, MNAAP Lobbyist

While fall has only recently arrived, planning for the 2018 legislative session has begun in earnest with the first meeting of the MNAAP’s Policy Committee in late September. The 2018 session is slated to begin on February 20.

Despite the difficulty in predicting the issues that will dominate the action at the Capitol in 2018, some predictions can safely be made. As the second year of the biennium, the 2018 session will be dominated by debate on policy issues, rather than the budget-focused nature of the previous session.
Many Capitol veterans are predicting a session with very little substance. Though it’s a policy year, it’s also possible that legislators will have to address budget issues should tax revenue not meet projections. All too often, deficits have been “fixed” by cutting health care programming.

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Threats to Children’s Health Care Abound


Eric Dick headshot

By Eric Dick, MNAAP Lobbyist 

The program that provides care to millions of America’s infants, children, and adolescents is under siege, and the threats come from multiple directions.  From Washington, D.C. to St. Paul to the boardrooms of major insurers, coverage for pediatric patients is under constant risk.

As of this writing in mid-July, legislation under consideration in the U.S. Congress remains a moving target. Solid intelligence about what is being included or left out of proposals is rare, and reports suggest that many different versions of these bills remain in play.

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Advocating for Prenatal to Three Investments and Interventions

By Mark Nupen, MD

As a retired pediatrician but lifelong child advocate, I had the privilege of recently attending the bipartisan “Prenatal to Three Policy Forum” hosted by Elders for Infants and Representatives Deb Kiel and Dave Pinto.

These quarterly forums, which have been gaining traction among policy makers and pediatric advocates, are designed to help attendees “learn about what key organizations and coalitions are working on to improve state policy for early childhood, from prenatal through age 3.”
I highly recommend pediatricians attend, if possible, because prevention works best when it’s done early.

Literacy, for example, is an extremely important social determinant of health. Although language development is critical in the first three years, half of all new mothers receiving Medicaid do not have books in their house. Research suggests as many as 70 percent of prison inmates are mostly illiterate. Low literacy is also a key factor in high school dropouts and teen pregnancies.

If I were still in practice, parental literacy would be one of my new “vital signs.”

In my opinion, prenatal to age 3 is the perfect span of time for focused interventions. It is the prime age for child abuse and family dysfunction, which is why it is the prime age for building parenting skills and literacy.

During the forum, legislators spoke about the importance of keeping in contact with your own representatives and senators because it is likely they have little knowledge about these issues and need your help.

Following the forum, I connected with Clara Sharp, a doula from North Minneapolis who works with at-risk moms. I also connected with Laura Lacroix-Dalluhn who works with the Minnesota Coalition for Targeted Home Visiting, which includes pregnant moms in prison.

We cannot do this work alone, nor can we rely on a few legislators. We all need to contribute to our legislators’ skills and knowledge.

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