Careers in paediatrics: Community paediatrics revisited (part 2)

8 Jul

The genesis of Haggerty’s concept of ‘community paediatrics’ arose in the mid-1960s. Student idealism and the United States-based ‘war on poverty’ generated pressure on medical and academic institutions of the day to demonstrate ‘relevance’ by addressing the perceived imbalances in health services. Community paediatrics was a response to these pressures, and informed the new and innovative models of care that were introduced. The Neighborhood Health Centre programs in Rochester and at Montefiore and the Community Health Centres in Montreal (Quebec), Toronto (Ontario) and Vancouver (British Columbia [BC]) were examples of university-driven outreach paediatric programs. Since then, the concept of community paediatrics has not flourished in Canada.However, while somewhat balkanized, it has evolved, and paediatricians are participating in a diversity of community-based programs. These include: school health; day care and preschool programs; primary care in private practice settings, community clinics and hospitals; injury prevention programs; and international child health initiatives. You can cialis professional right now – buy asthma inhalers for more advantages.


In the United States, community paediatrics is a formal academic entity within paediatrics. In 2005, the American Academy of Pediatrics (AAP) issued a revised policy statement on “The Pediatrician’s Role in Community Pediatrics”, in which it “reaffirms the pediatrician’s role in community pediatrics” and outlines the concept’s core elements. It also quotes a later article by Haggerty to the effect that “the unique feature of community pediatrics is its concern for all of the population (of children and youth)”. The AAP identifies the core elements of community paediatrics as including: working collaboratively with public health and related professions to identify and address imbalances in health services for children and youth; working collaboratively to advocate for the needs of children and youth in families, schools and communities; educating students and residents from within ambulatory care and community-based settings; providing caring, compassionate, competent, and knowledge-based services to all children and youth; and providing leadership and support to existing and emerging models of community paediatrics. The AAP also states “pediatricians should use community data to increase their understanding of the health status and risks of children and youth”.