Pediatric Medicine

By Steven Lipshultz, MD

Our country’s 75 million school-aged children are an abundant treasure. While only 24 percent of the population, they are 100 percent of our future. Their future will be our legacy.

Research is fundamental to infant and child health. In recent decades, it has resulted in substantial progress in reducing deaths and improving the health-related quality of life worldwide, but many problems remain. Continued and increased investment in research will be especially effective if it focuses on preventable conditions and emphasizes local health issues when findings are implemented.

Infants and children tend to be healthy, so much of their care is preventive. This population, however, is uniquely vulnerable to the effects of prolonged, elevated stress that can have a toxic effect on development and life course trajectory. Today’s pediatricians therefore not only manage the physical and psychological wellness of infants and children, but additionally their socio-emotional development and well-being. The powerful impact of the social context on children’s health cannot be overstated. Social determinants of health—including quality schools, transportation, housing, health care, food and jobs—affect outcomes in life, since child health is a strong predictor of adult health. These complex, integrated and overlapping issues, which in many communities are widening, are responsible for most health inequities.

UB faculty are involved with identifying systems that perpetuate inequality and with examining risk factors that contribute to health disparities and inequities. All children should have an equal opportunity to be healthy, to learn, and to achieve their maximal potential. The zip code where a child grows up should not determine his or her future.

Over the next 25 years, UB pediatricians will increasingly focus on the role of children’s social and physical environments in lifelong health, social competence, and the quality, accessibility, outcome efficacy and cost-effectiveness of clinical care. To do this, they will more often incorporate developmental and behavioral pediatrics, mental health and treatment of emotional disorders of children, especially for members of vulnerable special needs populations. All of this will involve reframing how children and their families receive care and services by increasing effective advocacy and by engaging myriad child-focused community stakeholders; e.g., pediatricians, health agencies, neighborhood organizations, human services organizations and policymakers.

Research initiatives will increasingly focus on improving the public and economic health of underserved populations and on identifying conditions that predispose children and adolescents to adult diseases. A paradigm shift from cost containment to avoiding unnecessary suffering and premature death will be key.

The UB Department of Pediatrics is well prepared to accomplish its research goals by focusing on precision genetic medicine and personal health history to: (1) create therapies for individual patients, (2) enhance preventive medicine to transform health care systems from illness to prevention and wellness, and (3) manage chronic illnesses.

Determinants of health, well-being and disease exist in our community, and that is where they should be addressed. Health is our outcome.

There is a tremendous, relatively untapped set of opportunities to create synergy between UB, the Jacobs School of Medicine and Biomedical Sciences and our many world-class partners on the Buffalo Niagara Medical Campus and in Western New York.

A dynamic interaction between these research entities with policymakers, advocacy groups and funding institutions is essential if we are to ensure that infant and child health research remains a top priority in concert with the teaching and training of future child health care professionals.

If successful, our combined efforts will accelerate pediatric research advances over the next 25 years, helping to ensure that future generations of children have a healthier life than those who have gone before.