Pediatric – Week 1 Discussion 1st REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.  
ASC Discussion:
What are the sources of pediatric primary care in the United States? Are these sources sufficient for providing health-care services to the pediatric population? Why or why not?
Sources of pediatric primary care include pediatricians, community health centers, health departments, family nurse practitioners, as well as family medical doctors.  According to Children’s Health Fund [CHF] (2016), there are nearly 73 million children under the age of 18 in the united states. 20.3 million or 28% of children, despite the above listed sources, still do not have access to quality care that meets current standards and expectations for pediatric care. Included in these numbers are uninsured, children who do not receive routine primary care, as well as children who are insured by public entities who receive primary care but lack access to the pediatric subspecialty they require for their disease state such as pediatric pulmonology (CHF, 2016). According to Kuo, Etzel, Chilton, Watson, & Gorski, (2012),  there are nine million children who are uninsured: 1 out of every five Latino and American Indian children, 1 out of every 8 black children,  and 1 out of every  9 Asian children are uninsured as compared to 1 in every 13 white children are without health insurance.
Are there certain pediatric populations that lack access to health-care services? Why?
There are several pediatric populations that lack access to quality health care services. Black and Latino populations have higher uninsured and underinsured rates than their white counter parts and are four times more likely to be in fair or poor health (Kuo et al., 2012). Impoverished, as well as children whose parents are uneducated, also lack access to adequate health care services. Additionally, parents of children who speak limited English lack adequate health care services as well (Agency for Healthcare Research and Quality, 2012).
What are the barriers to children in accessing health-care services in the United States? Why do these barriers exist? 
Barriers to children accessing adequate health care services in the united states can be divided into two categories financial and non-financial. Financial barriers include lack of insurance, underinsured, lack of funds to pay copays, lack of funds to pay for prescriptions, lack of parents owning a car or adequate public transportation, and providers who implement insurance stigma and do not accept certain insurances (CHF, 2016).  Non-financial barriers are due to children’s’ dependence on adults to receive care, lack of full adult rights, as well as children being at the bottom of the family structure and in a family with limited resources, elders receive care first (Unite for Sight, 2015). Additionally, marginalization of black and Latino cultures, racism, lack of insurance, geographic location, as well as unawareness, create barriers as well. Barriers to adequate health care services lead to increased morbidities, mortalities and disease incidences among minority and poor children.
References
Agency for Healthcare Research and Quality. (2012). Disparities in healthcare quality among racial and ethnic groups: Selected findings from 2011 national healthcare quality and disparities reports. Retrieved from https://archive.ahrq.gov/research/findings/nhqrdr/nhqrdr11/minority.html#Introduction
Children’s Health Fund [CHF]. (2016). Unfinished business: More than 20 million children in U.S. still lack sufficient access to essential health care. Retrieved from https://www.childrenshealthfund.org/wp-content/uploads/2016/11/Unfinished-Business-Final_.pdf
Kuo, A. A., Etzel, R. A., Chilton, L. A., Watson, C., & Gorski, P. A. (2012). Primary care pediatrics and public health: Meeting the needs of today’s children. American Journal of Public Health, 102(12), e17–e23. doi:10.2105/AJPH.2012.301013
Unite for Sight. (2015). Module 2: Unique barriers to health care for children and adolescents. Retrieved from http://www.uniteforsight.org/women-children-course/barriers-children