Novel approach to health care delivery for inner-city children.

Poverty is a reality for many families living in Canadian inner cities. There is no accepted definition of poverty in Canada. However, it was estimated that 9.6% of Canadians were living on a low income in 2009.1 This is based on a low-income cutoff defined as the income level at which a family might be in straitened circumstances because it has to spend a greater portion of its income on basics (food, clothing, and shelter) than the average family of similar size does.2 Previous research has described substantial associations between low socioeconomic status and poor academic performance and psychiatric disorders.3 While marginalized inner-city families experience the negative downstream effects of poverty on health, they also have the greatest difficulty accessing mainstream health care. The difficulties include lack of transportation, cultural and language barriers, lack of health insurance, discrimination, and stigmatization.4 Children are particularly vulnerable, as they must rely on others to advocate on their behalf. Further, Canadian children from disadvantaged families are twice as likely to be living in poorly functioning families as children from high-income families are.5 Children are of particular interest as timely health care access would provide the greatest opportunity for illness prevention. In 2009, nearly 1 in 10 Canadian children were living in lowincome households.1