The APA Task Force on Childhood Poverty was formed in July 2012 to bring the voice of pediatricians to the critical issues of childhood poverty in the United States. Since then, the Task Force has engaged leaders in pediatrics from throughout the US and Canada, and endeavors to address childhood poverty at its root through four paths: Health Care Delivery, Research and Data, Public Policy and Advocacy, and Education. Present leadership of the APA and the AAP are part of the Task Force, as well as 13 previous APA/AAP Presidents, policy and research institute leaders, and 37 other pediatric leaders. The entire Task Force has been meeting in person once a year at PAS, supplemented by conference calls during the year.
Please check out our Strategic Roadmap as well as membership listing and resources at
Pediatric Academic Societies (PAS) Meeting in Vancouver
Our 2nd State of the Art Plenary Session on Childhood Poverty will be held at PAS on Saturday, May 3, 2014 from 2:45 pm to 4:45 pm. In consideration of the untimely death of Joel Alpert, former President of both the APA and the AAP (and a member of the Task Force), whose career focused on the needs of low-income children and families, the Plenary will be held in his honor. Please make sure to attend this exciting session, co-sponsored by the APA and the AAP. The agenda is:
State of the Art Plenary Session on Childhood Poverty at PAS 2014
Benard Dreyer, Paul Chung, and Jim Perrin are co-chairs.
Childhood Poverty and Its Consequences: Potential Solutions
- Benard P Dreyer
New York University School of Medicine, New York, NY
The Role of Policy and Parental Employment in Reducing Childhood Poverty and Improving Children's Well-Being
- Carolyn J. Heinrich
Lyndon B. Johnson School of Public Affairs, U of Texas at Austin
The Canadian Experience: Targeted Child Tax Benefits and Impact on Child Well-Being
- Kevin Milligan
Vancouver School of Economics, University of British Columbia
Welfare Reform, Pregnancy Delay and Other Strategies to Decrease Intergenerational Poverty
- Ron Haskins
School Reform and Beyond: Improving the Educational Outcomes of Low-Income Children
- J. Lawrence Aber
NYU Steinhardt School of Culture, Education, and Human Development
Changing the Standard of Pediatric Practice: A Clinical Model that Recognizes and Effectively Treats Adverse Childhood Events and Toxic Stress in Children
- Nadine J. Burke
Founder and CEO, Center for Youth Wellness, San Francisco, CA
Four subcommittees have been set up to effectively move the strategic agenda forward:
- Health Care Delivery
- Public Policy and Advocacy
Reports from the Health Care Delivery Subcommittee and the Education Subcommittee follow.
Health Care Delivery Subcommittee:
The Health Care Delivery Subcommittee of the Task Force on Child Poverty began its work with two phone calls in the beginning of January. Based on the conversations that took place among the members, and following the guidance of the Task Force's Strategic Road Map
(http://www.academicpeds.org/taskforces/pdfs/StrategicRoadMap_ver3.pdf), the subcommittee agreed to focus on defining and presenting the key elements that should be included in models of healthcare delivery for children living in poverty, such as screening tools, parenting programs, Reach Out and Read and enhanced social and community supports and linkages. The group also agreed that a set of guidelines should be developed for providers. The recommendations for key elements in healthcare delivery and the guidelines developed should be as evidence-based as possible. In order to tackle these goals, the subcommittee has identified 3 main areas to be addressed by separate working groups:
- At the practice level: Identify key components and best practices of excellent systems of care for children living in poverty. Identify the important practice connections with support programs (e.g., ROR, Health Leads, parenting groups, home visiting, medical-legal partnerships). Summarize the evidence base for patient-centered medical homes, and recommend additional medical home components that are needed for impoverished populations.
- At the patient-provider level: Create a toolbox of evidence-based screening tools for social determinants of health. This will include much overlap with efforts on behalf of other vulnerable groups (e.g., foster care children), and will require review and consideration of what is already available that is applicable to our effort (e.g., trauma-informed care, the Health Home model, Bright Futures, AAP toolboxes, materials from MCHB, etc.). This group will also define recommended provider training standards (e.g., knowledge and skills in health literacy, use of tools and resources, etc.). Health literacy considerations will also be of importance.
- Finance/Payment Systems: How should practices that are designed around the needs of poor families be made financially stable / viable? What are the optimal financial and payment systems to support the essential elements of care for children living in poverty?
At a minimum, we expect that the subcommittee's work will result in a "white paper" with guidelines for pediatricians that can also be used in advocacy/lobbying work, a workshop for PAS 2015, and possibly a training module for pediatricians.
We expect to set up a meeting time for our subcommittee at PAS in Vancouver, and we will be participating in the APA Health Care Delivery Committee meeting this year (Sunday, May 4 11-12:30), so please join us! Like the Task Force, membership in the Childhood Poverty Health Care Delivery Subcommittee is open to all interested APA members - please contact us if you are interested in participating.
Arthur and Joanne
Arthur H. Fierman
Joanne E. Cox
We are thrilled to update you on the exciting developments of the APA Taskforce on Childhood Poverty's Education Subcommittee. Our group is committed to "building a national curriculum to empower physicians to contribute to the elimination of childhood poverty and the alleviation of its effects."
The subcommittee's diverse and energetic members self-selected into four workgroups based on their interests and experiences. The workgroups met independently to develop goals and objectives around these four key components: 1) the epidemiology of US poverty, 2) the social determinants of health, 3) the biomedical influence of poverty and 4) advocacy and leadership to address poverty. These initial goals and objectives are currently being refined and restructured into two goals with three corresponding objectives by a team of nine educators. We expect to share the final version on the APA's Wiki by mid-February. The next step is development of educational experiences and activities that will allow educators to teach the next generation of physicians about the impact of poverty and their role in addressing it.
We are very excited to develop and evaluate this innovative curriculum to establish best practices for teaching learners across the educational continuum about the impact of poverty on health outcomes.
Hope you and your families are enjoying this cold winter!
Lisa and Melissa
The APA Remembers Dr. Joel Alpert
Joel J. Alpert, MD, of Palm Beach Gardens, FL, Wayland, MA and East Parsonsfield, ME. Professor and chair Emeritus of the Boston University
School of Medicine (BUSM)
Department of Pediatrics, assistant dean for student affairs, member of the BUSM Dean's Advisory Board (DAB), and chief of Pediatrics at Boston Medical Center (BMC) died Tuesday, December 31, 2013 of leukemia at the age of 83, born on May 9, 1930. Beloved husband of Barbara
(Wasserstrom) Alpert. Devoted father of Norman Alpert and his wife Jane of Purchase, NY, Mark Alpert and his wife Michelle of Canton, Deborah Levin and her husband Steven of Wellesley. Adored grandfather of Caroline, Erin, Heidi, Adam and Natalie Alpert, Joshua and Zachary Levin and Samantha Alpert. Dear brother of Edith Slossberg and her husband Burton of Hamden, CT. Also survived by many nieces and nephews. Dr. Alpert was a recognized leader in pediatrics. During his 42 years at BUSM and BMC (and its precursor Boston City Hospital) he pioneered pediatric primary care training, including continuity clinic sites at community health centers and the development of a curriculum that emphasized child development, advocacy and community care. BUMC's pediatric resident training in primary care in health centers was among the first in the United States. A graduate of Hillhouse High School, New Haven, CT Class of 1948,Yale College Class of 1952 and Harvard Medical School Class of 1956. Dr. Alpert completed his residency at Boston Children's Hospital and also trained as an Exchange Registrar at St. Mary's Hospital in London, UK from 1958 until 1959, he then served as Captain in the US Army at Ft. Leavenworth, KS from 1959 to 1961 and joined the Harvard faculty in 1961. He became professor and chair of the Department of Pediatrics at BUSM and Boston City Hospital in 1972. Dr. Alpert served as president of the American Academy of Pediatrics (AAP), where he received the AAP Job Lewis Smith Award in Community Pediatrics in 1994. He also served as president of the Ambulatory Pediatric Association (APA) and received the APA George Armstrong Award in 1992, the APA Lifetime Career Achievement Award in 2000, and the APA Public Policy and Advocacy Award in 2002.
Joel Alpert on the APA:
- Tell us about the early days of the APA.
- Has the APA been successful, in your opinion?
- What has been the key to the APA's success?
- Where in your mind has the APA's advocacy been most successful?
The following stories and memories are from Dr. Alpert's APA friends, former trainees and colleagues.
It is with great sadness that I have learned of Joel's passing. I just got his seasons greeting card where he told me of his health concerns. I sent him a response and truly grieved to hear of his passing. Joel was a life long mentor to me, from my first days in the APA in 1976. His influence, advocacy for children, for training in general pediatrics, for the APA, and so many other passions, he became he was a blazing scion for how important we pediatricians are in the life of children and families and pediatric trainees. I had the honor of awarding him The George Armstrong Award during the spring APA meeting in 1989, concluding my Presidency of the APA. He was truly overwhelmed with that honor, and I remember how much it meant to him, and certainly to me. Our meetings will never be the same with his absence. We had many shared passions, and it will just not be the same. My love to Barbara, his children and Grandchildren. We should all carry on our good work, as individuals and as an organization, with his passion deeply burning in our hearts and minds.
An amazing person with a commitment to children and to training pediatricians to care for children, especially those who came from less advantaged situations. Even as a high school student in New Haven, he was an amazing person. As a teacher and an advocate, Joel has done so much for pediatrics and pediatricians.
Wonderful pediatrician, and great role model. He will be missed, but his legacy will remain with us.
He was a real mensch and an amazing advocate for children. I would rate him as one of the giants in pediatrics.
He was truly a giant and hero in so many ways.
How sad, the "giants" are leaving us one by one. I remember at the 30th APA anniversary none of the previous APA Presidents had died, many have died in the past 20 years. My son David who is now a dermatologist had the good fortune of working with Joel during the "Tobacco Wars" of the 1990s. I believe Joel wrote a support letter for David's application to medical school (he ended up at Duke).
I will miss Joel. Whenever we saw each other at PAS, we exchanged warm hugs and checked in on each other's health as cancer survivors. He loved to assert contrary views and was not afraid to speak his mind - often! We first met when I chaired a Healthy Start review committee back in the early 90's. He complimented me with a slight air of surprise that I had done a good job. Goodbye Joel.
I am so glad I got to see Joel in May. He was a major inspiration for me, as for so many others. The conscience and guiding star of our organization for so many years. Very big shoes to fill&33;
I had the opportunity to know Joel best when he was president of the AAP and he attended the annual Association of Medical School Pediatric Department Chairs (AMSPDC) meetings as an AAP leader and not the Chair of Pediatrics at BU. When I was President of AMSPDC, Joel and I often talked about the joys and frustrations of being a pediatric chair. He gave me lots of practical advice that I value even today when I am no longer a chair. He was the first person to tell me that it is important for a leader to know when to step down as a leader, an idea I had never considered until I talked to him, a wise man. Joel was also a very capable tennis player. He always clobbered me!
It is easy for me to remember my first interaction with Joel Alpert. During my year as President of the American Medical Student Association I had heard many things about him from our sources on Capitol Hill and in the various federal agencies with which we worked. They described his energy, his innovations in pediatrics and pediatric education and, most importantly, his passion regarding access to healthcare for poor children. After all of the good things I had heard, I couldn't wait to meet him. From practically the first minute of his time with a group of us applying for a residency position at Boston City Hospital (BCH), he announced that it was outrageous that the US did not yet have a national health program to provide health care for all. And off we went!
Ultimately I did my training at BCH during the last years of Dr. Alpert's time as Chair of the Pediatrics Department. On top of the practice of pediatrics ("Don't forget to percuss the chest!"), we were taught that advocacy -- at the individual, local, state and national levels -- was essential to addressing the varied issues faced by our patients. Conferences were not only a time to share clinical and research information, but also a time to hear legislative updates as well.
I feel thankful for Joel's consistent mentorship, opinionated politics, passionate advocacy and playful sense of humor. He took me under his wing and helped me with my first research efforts. He was a giant in the field and an inspiration for so many of us.
APA members who trained after 1990 or outside of the Boston area may not recognize Joel Alpert's name. Joel was one of the true seminal thinkers in the literature of primary care. His 1973 monograph, The Education of Physicians for Primary Care (coauthored with Evan Charney) set a primary care education agenda that remains relevant today. He was ever a fierce advocate for children and mentored a generation of general pediatric leaders. He will be missed by all who learned from him and his exemplary pediatric career.
Dr. Alpert was an extraordinary child advocate. He was not one to mince words when it came to sticking up for the health and wellbeing of children and families. He was an early APA President who made sure that advocacy was part of the mission. I had the honor of conducting a video interview of him for the APA Oral History Project three years ago. When we were done taping he paused and then said he felt he wasn't articulate and strong enough in the interview and wanted to do it again. Of course we did. I hope you can see clips of his video interview on the APA website.
Words are simply not enough, but here are some that come to me. Dr. Alpert was a true voice for children and an inspiration for many cohorts of pediatriciansâ€¦a man deservedly on a pedestal, though he did not seek one. His influence will remain though I shall greatly miss his presence among us.
Joel Alpert was the Jiminy Cricket, the conscience, of the pediatric community. He was never shy about expressing his frustration at the slow progress we were making toward universal health care for children. We needed to sprint and not walk leisurely toward this end. And he was not hesitant to berate those who hurt children by cutting programs such as Head Start and Food Stamps. He will always be my role model. It was an honor to work with him and host him at my home during his visit to California during his AAP presidential campaign. His voice will continue to echo at our PAS meetings: "Alpert, Boston." His message and passion will stay with me always.
In 1980, two female residents from Puerto Rico applied for a PG2 position in Boston on a reduced schedule arrangement (2 residents in the same position, each half time and a total of 2 years to complete it). Both were mothers who wanted to be pediatricians and required a different kind of training that would fit their needs and that of their young families. Three program directors considered the application and one was the brave one, the learner- centered and the innovator. That program director was Dr. Joel Alpert. We enjoyed every minute of Boston City Hospital training under his leadership and will always be grateful to him and his dedicated faculty for the best and most rewarding pediatric training that we experienced. Thank you Dr. Alpert!
Joel Alpert was a grand, active, and convincing leader of the Academic Pediatric Association - and of pediatrics in general. So many of us read time and again the tremendously influential report on training primary care physicians that he and Evan Charney developed so many years ago. Its relevant themes and ideas still can guide the best work we do. Joel kept a vigorous eye out for Title VII funding - and admonished any APA leader who might shirk the responsibility of vigorous advocacy for this program. His focus on the right health insurance for children and families set standards for what we still work to achieve. Joel trained so many leaders in general pediatrics - and was always available for guidance and advice - not always taken, but always interesting. We will miss his presence, but will always remember the cadence of his voice reminding us and all around about what children, families, and communities need and must get.
I am deeply saddened by the death of Joel. He was a very good friend who was an advocate for all my struggles to create a health care delivery system geared towards primary health care for the poor at Montefiore Medical Center, Albert Einstein College of Medicine in Bronx, New York. He provided me with much appreciated guidance and support in establishing a program for primary health care education and training of medical students, residents, and other health care professional in this medical facilities. My deepest condolences to Barbara and Family I will miss Joel dearly.
-Mutya San Agustin
Founding President, Philippine Ambulatory Pediatric Association, Inc
We, the current officers and members of the Philippine Ambulatory Pediatric Association, Inc. (PAPA), a professional medical society, founded in 1994, with its founding President and past members of the Board of Trustees are deeply saddened by the demise of our good friend, colleague, and supporter, Dr. Joel Alpert. We would like to express our sincerest and deepest condolences to Barbara and his loved ones.
Dr. Joel Alpert was our keynote speaker and main plenary lecturer during our 5th Annual Conference, in 2000. He was an honorary member of our organization. We have very fond and wonderful memories of Joel's and Barbara's visit to the Philippines. He was not only an engaging speaker but a warm and sincere person. Even years after that conference, some of us would meet him at annual meetings of the AAP and APA, and he would always have a ready welcoming smile, never forgetting us, his Filipino friends. He was well loved and respected. We will surely miss Joel.
-Florianne Feliza F. Valdes
President, Philippine Ambulatory Pediatric Association, Inc.
Joel loved the APA and called it his most important professional organization. On the APA website there is a history of the APA that Joel wrote. It contains remarkable facts and personal stories as well. It is a loving and personal account. I can remember the meetings when at the membership meeting, there would be true debates on the floor. I will never forget Joel's passionate defense of the organizations name at the time. We may have outgrown our former name, but we could never outgrow Joel's devotion to the mission of the APA.
If you haven't his article describing our origins, please do- we still keep a link on the website (http://www.academicpeds.org/aboutUs/APAhistory.cfm). In his telling of our story in 1995, one can hear Dr. Alpert's passion for children, particularly the children living in poverty, in Boston and throughout the country. I met Joel in 1991, when he invited me to think about a job at the old Boston CIty. Turned out he didn't have a job to offer, but I learned much about how to be an effective advocate for children in that one day mentoring session and we remained in touch over the last 23 years. Dr. Alpert has supported the careers of many of us in the APA, always with an eye to making us better doctors, better researchers, better educators and ALWAYS better advocates for children. Our thoughts and prayers are with his family and his colleagues throughout the country. He will be missed.
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