Does Well-Child Care Have a Future in Pediatrics? abstract

The most common adult chronic diseases affect 1 in 3 adults and account for more than three-quarters of US health care spending. The major childhood drivers of adult disease are distinctly nonmedical: poverty, poor educational outcomes, unhealthy social and physical environments, and unhealthy lifestyle choices. Ideally, well-child care (WCC) would address these drivers and help create healthier adults with more productive lives and lower health care costs. For children without serious acute and chronic medical problems, however, traditional pediatric preventive services may be largely ineffective in addressing the outcomes that really matter; that is, improving lifelong health and reducing the burden of adult chronic disease. In this article, we examine what role WCC has in addressing the major childhood drivers of adult disease and consider various models for the future of WCC within pediatrics. Pediatrics 2013;131:S149–S159 AUTHORS: Tumaini R. Coker, MD, MBA,a Tainayah Thomas, MPH,bc and Paul J. Chung, MD, MSc aUCLA/RAND Prevention Research Center, Los Angeles, California; bDepartment of Health Policy and Management, UCLA School of Public Health, Los Angeles, California; and cDepartment of Pediatrics, Mattel Children’s Hospital, UCLA David Geffen School of Medicine, Los Angeles, California