Major Finding: Forty percent of pediatricians reported involvement in child health in their communities in 2010, compared with 45% in 2004.
Data Source: American Academy of Pediatrics periodic surveys for 2004 and 2010.
Disclosures: Dr. Minkovitz said she had no relevant financial disclosures.
Fewer pediatricians participated in community child health initiatives in 2010 than in 2004, according to a study that compared two periodic American Academy of Pediatrics surveys.
In 2010, 40% of 820 pediatricians reported caring for children in their community (other than their own patients). This figure significantly decreased from 45% of 881 who reported such involvement in 2004, Dr. Cynthia S. Minkovitz said.
“The bad news is the rate is going down. The good news is we're higher than other specialties, at least 10 percentage points higher than others,” Dr. Minkovitz said in response to a question at the annual meeting of the Pediatric Academic Societies.
Despite the decrease, perspectives regarding the importance of community pediatrics remained unchanged, Dr. Minkovitz said. “More than three-quarters feel 'moderately' or 'very responsible' for child health in both years.”
Of those who did get involved in child health outside their day-to-day practices, a greater percentage of pediatricians did so as unpaid volunteers: 86% in 2010 vs. 80% in 2004, according to this study contrasting two national, mailed surveys.
Practice constraints and changing demographics in the pediatrician workforce may play a role. Older age, not having children of their own 5 years or younger, and practicing in a rural setting were factors associated with community involvement. For example, 47% of pediatricians older than 50 years reported involvement, compared with 44% of those aged 40-50 years, 40% of those 35-39 years, and 33% of those 34 years or younger.
Women comprised a greater percentage of survey respondents in 2010, 59%, vs. 52% in 2004. The percentage of pediatricians who said general pediatrics accounts for more than half of their practice was 67% in 2010, down from 72% in 2004. Likewise, the percentage who reported a rural practice was 9% in 2010, vs. 13% in 2004.
In addition, more respondents in 2010 reported receiving formal training in community pediatrics before medical school (5% vs. 3%) and during residency (28% vs. 22%), compared with respondents in 2004, said Dr. Minkovitz, director of the women's and children's health policy center at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
In a multivariate analysis, formal training (odds ratio 2.10) and older age (OR 1.38) were significant, independent predictors associated with community child health involvement.
The response rates of 58% and 60% for the two surveys are consistent with rates from other national physician surveys, and represent a strength of the study.