Abstract
Chronic diseases of environmental origin are a significant and increasing public health problem among the children of New York State, yet few resources exist to address this growing burden. To assess New York State pediatricians self-perceived competency in dealing with common environmental exposures and diseases of environmental origin in children, we assessed their attitudes and beliefs about the role of the environment in children’s health. A four-page survey was sent to 1,500 randomly selected members of the New York State American Academy of Pediatrics in February 2004. We obtained a 20.3% response rate after one follow-up mailing; respondents and nonrespondents did not differ in years of licensure or county of residence. Respondents agreed that the role of environment in children’s health is significant (mean 4.44 ± 0.72 on 1–5 Likert scale). They voiced high self-efficacy in dealing with lead exposure (mean 4.16–4.24 ± 0.90–1.05), but their confidence in their skills for addressing pesticides, mercury and mold was much lower (means 2.51–3.21 ± 0.90–1.23; p < 0.001). About 93.8% would send patients to a clinic “where pediatricians could refer patients for clinical evaluation and treatment of their environmental health concerns.” These findings indicate that New York pediatricians agree that children are suffering preventable illnesses of environmental origin but feel ill-equipped to educate families about common exposures. Significant demand exists for specialized centers of excellence that can evaluate environmental health concerns, and for educational opportunities.
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Notes
Consent was implied by completion of the form and/or verbal contribution. Attendance at each focus group was strictly voluntary and participation was at the discretion of the attendee. The Institutional Review Board of the Mount Sinai School of Medicine exempted the community meetings from review.
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Acknowledgements
This research was supported by the New York Community Trust. We are deeply grateful to Dr. Marie Casalino of District II (New York State) American Academy of Pediatrics for her assistance with obtaining membership rosters and with survey distribution. We also appreciated the input of Ms. Lauri Boni, Drs. Carl Johnson and Shuba Kamath in piloting versions of the survey prior to distribution. Drs. Landrigan, Graber, Galvez, Trasande and Forman are all members of the Mount Sinai PEHSU that is referenced in this manuscript.
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Trasande, Graber, Falk, Galvez, Moline, Forman, and Landrigan are with the Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA; Trasande, Boscarino, Graber, Galvez, Forman, Laraque, and Landrigan are with the Department of Pediatrics, Mount Sanai School of Medicine, New York, NY, USA; Boscarino and Moline are with the Department of Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA; Boscarino is with the Center for Health Research, Geisinger Heath System, Danville, PA, USA; Schechter is with the Department of Family Medicine, Albert Einstein College of Medicine, Bronx, NY, USA; Dunkel and Geslani are with the American Academy of Pediatrics, District II, NY Chapter 2, New York, NY, USA and the American Academy of Pediatrics, District II, NY Chapter 3, New York, NY, USA; Kaplan-Liss is with the Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, USA; Miller is with the Department of Obstetrics & Gynecology, and of Pathology and Clinical Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Miller and Korfmacher are with the Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Carpenter is with the Institute for Health and the Environment, University at Albany, Rensselaer, NY, USA; Balk is with the Department of Pediatrics, Division of General Pediatrics, Children’s Hospital at Motefiore, Albert Einstein College of Medicine, Bronx, NY, USA; Frumkin is with the National Center for Environmental Health, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Trasande, L., Boscarino, J., Graber, N. et al. The Environment in Pediatric Practice: A Study of New York Pediatricians’ Attitudes, Beliefs, and Practices towards Children’s Environmental Health. JURH 83, 760–772 (2006). https://doi.org/10.1007/s11524-006-9071-4
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DOI: https://doi.org/10.1007/s11524-006-9071-4